Electrotherapy Gives Hope for Patients With Spinal Cord Injury
There has been little optimism for recovery from a spinal cord injury because the central nervous system does not repair itself well. The severity of the injury depends on the affected area.
Malpractice Insurance: Understanding the Cover Letter
Purchasing medical liability insurance is quick, easy and not terribly expensive. The benefits are clearly listed on a certificate—but do you really know what you are getting with that peace of mind?
Exercise Therapy Following Motor Vehicle Trauma (Pt. 2)
In cases of cervical spine trauma, particularly trauma related to a motor vehicle accident, my plan is to teach the patient one exercise per session and build a progression. This is an effective approach I call an "activation circuit."
VA Choice Claims Denied? Here's How You Can Get Paid
The VA Choice Program (PC3 as well) indeed pays for chiropractic care including manipulation (CMT 98940-98943) and some physical medicine services.
Map It: Understanding the Customer's Journey
One of the biggest marketing mistakes most practice owners or administrators make is not putting themselves in their prospective or current patients' shoes. How do they think and feel about you and your practice? What makes them take action?
A Simple Miracle: Treatment for Mysterious Foot Pain
Under the old ICD-9 diagnosis codes, there was actually a diagnosis for "adventures in medical mismanagement" to describe patients who had been run down the rabbit hole of poor case management and care. I encountered one of those patients in my office today.
A New President for AOMA: A Conversation With Mary Faria
Dr. Faria was formerly a health care executive for over 30 years, the last 17 of those years as vice president and chief operating officer of Seton Southwest Hospital in Austin. She chairs the board of Austin Mayor's Health and Fitness Council.
Year in Review: DC's Best of the Best for 2018
As 2018 winds down, let's highlight the most popular articles in Dynamic Chiropractic by month (December – this issue – excluded, of course).
Knocking Down the Doors: Big Media Success for F4CP
Three articles authored by a DC or a chiropractic organization and promoting the value of chiropractic care – par for the course if you're Dynamic Chiropractic, but if you're Forbes, BOSS Magazine and Becker's Spine Review, three media outlets tailored toward high-level executives and decision-makers, we're talking about an entirely different story.
Acupuncture in Hospital Systems: Transitioning From Tolerated to Celebrated
I've had the pleasure of working with Susan Luria, Director of University Hospitals Health Systems Connor Integrative Health Network (CIHN) for the past year on the Integrative Health Policy Consortium (IHPC) Board of Directors and Federal Policy Committee.
Reaching for Our Roots: Healing Digestion With a Simple Traditional Therapy
Are you ignoring a powerful tool in your doctor's bag? Many acupuncturists realize that Spleen Qi deficiency has reached epidemic proportions in the U.S. Yet, we don't prioritize educating our patients about the importance of warm, cooked foods.
A Soy Isoflavone That Packs a Punch: Genistein
Soybeans contains unique substances called isoflavones, most notably genistein and daidzein, which have been shown to block the buildup the dangerous type of testosterone in the prostate gland linked to prostate enlargement and prostate cancer.
Cynicism and Burnout: It Can Happen to You
Trying to achieve fulfillment as a doctor in today's health care environment is a "rigged game" and physicians are programmed to burn out. At least this is the opinion of Dike Drummond, MD, in his thehappymd.com blog.
Reality Check: Do We Need to Try Harder?
While waiting for a flight to a recent chiropractic event, I overheard the ticket agent at the gate next to mine on his cellphone. His side of the conversation went something like this: "Where are you now? How long before you think you can be at the gate? OK, that will work, see you soon."
The Truth About Malpractice Claims Against DCs (Pt. 1)
Over the past 20 years of active practice, I have seen a number of scary case scenarios regarding signs, symptoms and patient presentations in my office. These presentations scream, This patient is going through an event or This patient does not need chiropractic care, they need emergency care.
When Computers Cause UCS: Adjusting Strategy
With the widespread use of mobile devices such as smartphones and tablets, the incidence of "text neck" has reached almost epidemic proportions. But there is another challenge to the spinal health and well-being of our technology-driven society.
Acupuncture is a Science-Based Medicine
A longstanding patient of mine came in for a routine treatment after she recently began seeing a chiropractor for neck pain. She saw him a couple of times and wasn't getting the relief she had hoped for, so he recommended she let him do dry needling.
A Guide to CBD Dosing: The Correlation Between Dose & Potency
There is an abundance of information available about the daily use of whole plant hemp CBD oil to help maintain and support a healthy lifestyle, however there remains a lack of sound guidance on CBD oil dosing.
Goodbye, Year of the Dog: Two-Thousand-Eighteen Comes to a Close
As Year of the Dog (2018) comes to a close we can look back and see the progress this profession has made. For example, the International Classification of Diseases (ICD) added traditional medicine codes, which were released in June.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
The Raw Food Debate: Practitioners Discuss Nutrition & TCM
Licensed acupuncturist and fellow blogger Elissa Gonda joins this month's column for a conversation about raw food diets. She brings her perspective on the healing potential of a raw primal diet.
ACA Champions H.R. 7157; ICA Voices Major Concerns
While the American Chiropractic Association recently penned an open letter – signed by not only the ACA, but also the Congress of Chiropractic State Associations, Association of Chiropractic Colleges, Clinical Compass and a number of state associations.
Bad for the Back! Exercises That Can Prevent Healing
The questions "Who gets well? Who doesn't? Why?" prompted the following observations based on my close to 40 years of chiropractic practice.
The Top 5 Strategies to Manage Your Reputation Online
You don't need an acupuncture website anymore! Okay, maybe that statement is a little over the top. But it's not that far from the truth. A recent study on Google searches revealed that 34 percent of all searches resulted in no clicks at all.
Dietary Supplements That Help Restless Leg Syndrome
It is estimated that 7-10 percent (possibly up to 15 percent) of the U.S. population has restless leg syndrome. It is a bit more common in women than men.
VA Chiropractic Reduces Veterans' Use of Opioids?
Utilization of pain medication – particularly opioids – has been massively high in among veterans for decades, but Veterans Administration guidelines that recommend nonpharmacological first-line treatment options create a greater opportunity than ever for VA chiropractors to make a dent in the opioid and overall pain-management crisis.
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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