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.
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.
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...
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
June, 2008, Vol. 08, Issue 06
The Danger of Mastitis
By Elaine Stillerman, LMT
While flying home to New York from a trip to California to introduce my 6-week-old son to his uncle, aunt and cousins, I struggled with nursing him. It wasn't until two years later, when we got his diagnosis of fragile X, that his failure to latch on and global hypotonia made any sense.
However, my breasts were bursting and I decided to bring my breast pump into the bathroom to fill a bottle and feed my son. I looked around for an electrical outlet and was stunned to find they had all been removed for fire safety reasons. I attempted manual (breast) expression, but that wasn't very effective, and I sat for the remainder of the five-and-a-half-hour flight in agony as my breasts engorged and a fever developed. Luckily, I didn't develop mastitis, but the discomfort was intense nonetheless. (Since that time, I have suggested to my clients they carry a battery-operated pump for such eventualities.)
It's not at all uncommon for women in late pregnancy and/or new mothers to feel their breasts engorge, especially when they first start nursing. When the tenderness becomes painful, a serious breast infection or mastitis might be the problem. Mastitis, or inflammation of the breast, used to be called "milk fever" or "milk leg," and there actually might be a genetic component for susceptibility to this painful condition.
This infection, which generally affects only one breast, usually occurs two to three weeks postpartum, but it might occur after only one week. It's caused by Staphylococcus aureus and Escherichia coli bacteria.1 These bacteria often are carried on the mother's or (hospital) staff's unwashed hands, or in the newborn's mouth.2 The bacteria enter the mother's body through an open, injured area of the nipple, although in some cases there might be no discernible wound.
Engorgement and milk stasis often precede mastitis, so new mothers can start paying closer attention to these warning signs. Sometimes the breasts engorge if the baby misses a feeding, when the baby starts to sleep through the night, or when mom starts to wean the baby. Other causes might be failure of the milk ducts to drain completely, underwire bras or bras that are too tight, as well as maternal stress and fatigue. Any pre-existing condition that lowers her immune system also might be a contributing factor.2
Once mastitis has developed, new mothers suffer with very sore and tender breasts. A red, inflamed spot develops and a red line can be seen that traces the clogged milk duct. Flu-like symptoms, general aches, fever (101.1 F or higher), headaches and chills accompany mastitis. If left untreated, a painful abscess can develop. This occurs 5 percent of the time.8 The milk from the affected breast might taste saltier than usual because there are higher levels of sodium within the swollen, inflamed tissue. The baby might even notice the difference and protest during the feeding.3
Some women misdiagnose plugged ducts for mastitis, although many women who have frequent bouts of plugged ducts often develop at least one case of mastitis. While plugged ducts, which are more prevalent than mastitis, can feel equally painful and require treatment, they don't hurt as much as mastitis and are not caused by bacterial infections. Milk ducts might become blocked for other reasons: an overabundance of milk, poor latch (when the baby's mouth does not form a firm seal around the nipple), a shift in nursing patterns or compressed breasts (either a bra that is too tight or from sleeping on the affected side).4
Other differences that set plugged ducts apart from mastitis are:
However, one of the best ways to treat mastitis is to continue nursing. Breastfeeding with mastitis is safe for the baby and most antibiotics used to treat this inflammation are not going to harm the newborn. La Leche League urges women not to give up on nursing because it actually shortens the duration of the infection and reduces a woman's chance of developing an abscess.3 Some women might be concerned about taking antibiotics when the child is so young. At least half of new mothers who develop mastitis don't need antibiotics.1 There also is reason to be cautious about multiple rounds of antibiotics. One study suggested repeated dosing of antibiotics might increase the risk of breast cancer.5
So, what can a new mother do to treat this painful infection? Obviously, strategies to prevent the condition need to be in place. Gentle breast massage will keep the milk ducts from becoming plugged. While in the shower or when moisturizing, the new mother can lightly effleurage around her breasts six times, lightly knead the base of the breasts and press on any areas that might feel tender. There also are some effective acupuncture points that might help reduce the discomfort. She can draw an imaginary line from the nipples vertically upward, just beneath both clavicles. These tender spots are Stomach 13. Press both points for a count of 6-10, repeating 6-10 times. From there, she can make an imaginary line about 3 inches down to the beginning of each breast. These are the Stomach 16 acupuncture points. Treat them as you would Stomach 13.
In the middle of the sternum, your client can find Conception Vessel 17. This point is going to feel tender to the touch. She should start the treatment by pressing gently and gradually increasing her pressure.6
Other natural treatments to treat plugged ducts or mastitis can be used once symptoms appear, as a way to prevent the condition from worsening. For those women who chose to avoid antibiotics, these techniques might be their best form of defense and care.
When the breast starts to feel tender, apply moist heat to the area. This will help dilate the milk ducts and prevent them from clogging. She can stand in the shower, facing away from the shower head, and let the water cascade over her shoulder(s). Anyone who has ever taken my workshop knows what to do with potatoes (I am going to keep the rest of you guessing). For breast tenderness, grate a raw potato and apply a cold poultice a few times each day to the sore spot.6 Place cold, raw cabbage leaves in the bra to reduce swelling. Rupture the veins by rolling over the leaves with a rolling pin and wear them until they become room temperature, and then change them. Some women report a decrease in milk supply from using the leaves, so the new mom needs to be attentive to that change.4
Start nursing with the sensitive breast first until it's empty and direct the baby's chin toward the tender area to create more sucking power on the clogged duct.1 Dietary changes also can have a positive impact. Reducing the amount of saturated fats and sodium in the daily diet has been shown to help some women. Certain nutritional supplements also might aid mastitis prevention: lecithin, bromelain, the vitamin B complex, vitamin C, echinacea and iron. Be sure your client discusses any and all supplements, herbs or homeopathic remedies with her care provider before taking them if she is nursing.1,3,7
Another simple remedy is to remember to drink adequate amounts of water daily. Eight to 12 glasses will help maintain the milk supply and keep the new mother's body running (internally) smoothly. Once the baby stars to crawl, bacteria can be picked up from the floor and any surfaces they touch, so moms should wash their hands and the baby's face before nursing. If mastitis persists, she should consult with her care provider. She might want to get another opinion to rule out tumors.
By paying attention to her body and heeding the warning signs, a new mother can enjoy the intimacy, nurturing and pleasure of breast-feeding her baby.
Click here for previous articles by Elaine Stillerman, LMT.
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