Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
November, 2005, Vol. 05, Issue 11
Avian Flu: How Threatening Is It?
By Ruth Werner, LMP, NCTMB
Fall is here, and with it, another flu season. Last year, we were bombarded with information (some of it pretty alarmist) about flu, flu vaccines and the emergence of a dangerous new player on the field of infectious disease: avian flu.Since massage therapists work closely with lots of people, and because we are health care professionals, it behooves us to be up to speed on the latest developments about flu, and I am here to help.
A brief disclaimer: this information changes almost daily, but it's accurate as of mid-September, 2005.
What is It?
Flu (short for influenza) is a viral infection of the respiratory tract. Flu viruses are classified as type A, B or C. Type A flu is by far the most aggressive, with the highest risk of significant complications or even death.
In the United States, often we don't consider flu to be a significant health issue, but for at-risk populations it can be a life threatening infection. Anywhere from 5% to 20% of the population has flu each year. It accounts for 200,000 hospitalizations and 36,000 deaths, mostly from pneumonia. The people most at risk for the serious complications of flu are the very young, the elderly or people with underlying diseases that affect lung or immune system function.
How Does It Work?
Flu viruses work in the usual way of infectious agents: they gain access to the body (often inhaled as airborne particles, although it can be spread by hand from contaminated surfaces) and then they invade their target cells. In this case, mucus-producing cells that line the respiratory tract. Once the infection becomes established, the immune system response causes most of the extreme symptoms, which appear one to three days after exposure. Flu is most communicable for three to seven days from onset of symptoms, depending on the age and health of the infected person.
Signs and Symptoms
In most cases, flu symptoms look like a bad cold: respiratory irritation with runny nose and dry cough; sore throat, headache, chills and a long-lasting high fever. Flu-related fevers often go over 102° in adults, and they might last for three days or more.
Unlike colds, flu infections affect more than the upper respiratory tract. Many patients experience aching muscles and joints, as well as debilitating fatigue. (One area flu viruses generally won't attack, however, is the gastrointestinal tract. What commonly is referred to as "stomach flu" is far more likely to be infection with norovirus or a case of food poisoning).
Flu symptoms usually appear one to three days after exposure to the virus, and they might persist for up to two weeks. If they last longer than that, or if the coughing begins to produce a lot of phlegm, the original viral infection might have opened the door to bacterial pneumonia: a potentially serious or even life threatening complication.
The Flu Vaccine
Every year, a flu vaccine is created from live, weakened viruses, based on predictions about which types of virus will be most active. Because predominant viruses change quickly, the vaccine is only effective for a year. For the 2005/2006 flu season, the vaccine is being distributed only to high-priority populations until late October; then it will become available to the general population. It's available in an injectable form or as a nasal spray (although the spray is recommended only for people between four and 49 years old).
I'm not going to open the floor to a debate about vaccinations here; that is a completely personal decision, and each individual must weigh possible benefits and risks. The Centers for Disease Control and Prevention caution, however, that persons who are allergic to chicken eggs, who have a history of Guillain-Barre syndrome or who have had an extreme reaction to a previous vaccine should not receive the flu vaccine.
Avian Flu: What's the Difference?
The avian flu that made the news last year is an infection with a particular subset of type A virus, called H5N1. (Other subtypes infect birds as well, but they appear to be much less dangerous to humans). The "H" stands for hemagglutinins; the "N" stands for neuraminidase. These are surface proteins on the virus; every flu virus is classified by what type of H or N it is. Water birds (ducks and geese) particularly are vulnerable to H5N1, although they often don't die from it. They shed virus in oral and nasal secretions, and in bird droppings. Wild birds can spread the infection to domestic poultry it's far more likely to kill chickens than ducks and from that point humans might be exposed.
Here's where it gets tricky. Bird-to-bird transmission of H5N1 is easy. Bird-to-human transmission of H5N1 is harder, but not impossible; it has happened a few dozen times in Thailand, China, and Vietnam. Symptoms are similar to human flu, with the added risk of conjunctivitis and viral pneumonia, but the mortality rate among infected humans is very high, close to 50%. So far, human-to-human transmission of H5N1 is very rare indeed, and might have happened only a few times that we know of. That's because H5N1 doesn't have many of the properties that make viruses easily transmissible between humans.
But that could change, and that's what health officials are worried about. At this moment, researchers foresee two possible ways for H5N1 to become easily transmissible between humans:
How high is this risk? That depends on whom you ask. While some public health officials are talking about "a time bomb waiting to go off," others point out that we are much better prepared to deal with an aggressive infection like H5N1 today than we were the last time a threat with a similar scope (Spanish flu, 1918-1921) hit the scene. Specifically, we are better at diagnosing the problem and aggressively isolating infected people, which, as we saw with SARS (Severe Acute Respiratory Syndrome), can quickly and effectively contain the problem.
On the other hand, no vaccine for avian flu has yet been developed (although this is being worked on), and it turns out H5N1 is resistant to the two most common anti-viral medications we have available: amantadine and rimantadine. So, our ability to shorten the lifespan of the infection is limited.
Massage and Flu
A person with flu who receives a rigorous, circulatory massage might find themselves with a much more serious infection than they would otherwise have. A person who receives massage after the infection has peaked and is on the mend, might find that recovery comes more quickly. However, two cautions must be kept in mind. The first is that squeezing several days of recovery into one or two days might make the client feel sick again. The client should know this is a possibility. The second is that a person recovering from flu still might be shedding virus.
What about our own self care? Like it or not, massage therapists are role models for taking excellent care of our own health. This means eating right, exercising, and getting good quality sleep: we all know these measures are the most important parts of keeping our immune systems strong. I will add one final point: if you're sick, be sick. Stay home. Drink hot fluids, get some rest. Do yourself and your clients a favor by investing your time and energy into conquering your infection, not into hiding your symptoms.
For Next Time
I would like to continue our exploration of emerging and re-emerging infections with a discussion of pertussis: whooping cough. This disease, which can be quite dangerous for young children, is on the upswing for two reasons: incomplete childhood immunizations and the fact that the pertussis vaccine doesn't have the lifespan we once thought it did. So, adults who were assumed to be protected are not. I would be especially interested to hear from people who have had this or seen this infection among their clients or children. Write to me and let me know: what's on your table?
Until then, many thanks and many blessings.
Special thanks to David Jackson, Communicable Disease Surveillance Program Manager, Utah Department of Epidemiology.
Click here for previous articles by Ruth Werner, LMP, NCTMB.
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