Supplement Safety: Is It Time to Give Big Pharma a Chance?
Why in the world would I, a chiropractor, consider Big Pharma when I make a vitamin / supplement recommendation to a patient? There are several supplement manufacturers at every chiropractic conference, even at some of our schools.
A Little More Chiropractic, A Lot Less Pain
Why should I visit a doctor of chiropractic when I'm not experiencing pain or other symptoms? That's the question many patients still ask themselves, despite the growing body of research supporting the value of chiropractic maintenance care.
The Carcinogen Most Patients Consume
A known carcinogen is being naively consumed by many, if not most of your patients, who have little to no understanding of how dangerous it really is. Depending on the age of the patient, this carcinogen is a leading, if not the leading, risk factor for death and disability.
Renying-Cunkuo Pulse: The Essential Pulse Method of the Ling Shu
The Ling Shu is a Han Dynasty classic book on the practice of Chinese medicine. It presents five main channel systems: Muscle Channels, Chapter 13; Luo Collaterals, Chapter 10 and others; The Main Channels, Chapter 10 and many more; Separate Channels (Divergent Channels) Chapter 11; and the Eight Extraordinary Channels, referenced in chapters throughout the book (there is very little theory).
A Moment of Silence for Dr. Leon Chaitow (1937-2018)
After months of declining health, Dr. Leon Chaitow – clinician, author and teacher – passed away on Sept. 20, 2018 at the age of 80.
How to Address the Question, "Do You Accept Insurance?"
Do you ever dread getting asked the question, do you accept insurance—when you only accept cash, or when you are out-of-network? As part of my daily practice, mentoring acupuncturists to grow their practices faster and more effectively, I talk to a lot of practitioners.
Pregnancy Health: Looking at the Lower Extremities
When patients tell us they are pregnant, many times we focus on the obvious pregnancy signs and symptoms related to their current trimester of pregnancy, and the biomechanical impact on the spine and pelvis.
Procuring a Place for the Future
As the acceptance of acupuncture continues to grow in the U.S. it is important that the profession be licensed in every state, and nationally board certified.
A New NCCIH Director ... One That Backs Acupuncture
The third time is a charm—the National Center for Complementary and Integrative Health (NCCIH), a division of the National Institutes of Health (NIH), announced it's newest director, Dr. Helene Langevin.
Exercise Therapy Following Motor Vehicle Trauma (Pt. 1)
In the absence of acute trauma, a usual strength-building session includes concentric, eccentric and isometric exercises. Popular exercise programs typically include concentric movements as the major muscle contraction and should constitute approximately 70-75 percent of the workout time.
Paradise Lost: AWB Relief in Hawaii
In November, 2014, Acupuncturists Without Borders (AWB) was hosting a training seminar on Oahu. A couple of us from the big island (aka "Hawaii" County) contacted AWB because the big island was in the middle of a crisis.
Manual Muscle Testing for Cervical Radiculopathy (Pt. 2)
Dr. John Bandy developed a protocol that associated specific muscles with myotomal nerve root levels. The deltoid is associated with the C6 nerve root; the triceps with the C7 nerve root; and the finger abductors with the C8 nerve root.
World Acupuncture Day: A Meeting in Paris
World Acupuncture Day is an event organized by the World Acupuncture Day Organization (WADO) in response to the eighth anniversary that UNESCO has included acupuncture and moxibustion on it's Representative List of the Intangible Cultural Heritage of Humanity.
Creatine: Muscle Fuel No Longer Just for Athletes!
Erase that image of the 20-year-old, muscle-bound bodybuilder using creatine. Replace it with the image of a lean, strong, fit 80-year-old hiking up a mountain. Creatine, a staple of athletes for more than 50 years, is now being used by athletes and non-athletes alike to help slow normal age-related muscle loss, improve exercise recovery, increase strength, and live a more active lifestyle.
Travel-to-Treat Coverage Finally Becoming a Reality?
Long-awaited legislation poised to hit the president's desk extends liability insurance coverage from one state to another for DCs and other state-licensed health care professionals who care for athletes / athletic teams that cross state lines.
NBCE Exams: Better, Shorter, More Opportunities
The NBCE's Written Exams department, led by Bruce Shotts, DC, developed a solution to computer-based testing on college campuses. Their work has resulted in 11 exam opportunities per year. CBT exams are on schedule to begin January 2019 as follows:
The Husband/Wife Imbalance
The Husband/Wife Imbalance, like Aggressive Energy, is an energetic block that will result in death, unless cleared, as its presence indicates that nature has given up the fight against the internal or external pathogenic factors that have assaulted the body/mind/spirit of the patient.
Case Study: Osteoporosis and the Role of Orthotic Support
The following is the second of three case studies by Dr. Wong on conservative management of lower-extremity complaints. Article #1 (September issue) explored chiropractic management of patellofemoral arthralgia.
Bait & Switch: Are You Guilty?
One of my three sons recently shared a story with me regarding an experience with a chiropractor, which stimulated me to write this ethics article. According to my son, he called a chiropractor's office and asked if his insurance was accepted at the office.
Cyberthreat Checklist: 10 Key Steps to Defend Your Practice
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.
Vertebral Subluxation: Give Credit Where Credit Is Due
Vertebral subluxation: have any other words caused as much turmoil and controversy in the chiropractic profession? As a chiropractic term, vertebral subluxation did not make its debut until six or seven years after the profession's founding.
Chiropractic Integration a Big Success, Suggests Research
Whether chiropractors should integrate with other health care professionals in medical / multidisciplinary settings remains a contentious issue, depending on whom you ask, but there's no denying two realities.
An Effective Herb for Stress
We all know stress has become a significant factor in the increasing number of reported mental health disabilities and a contributor to various physical health conditions, such as ulcers, high blood pressure, heart disease, and so on.
On Point: Acupuncture Theory & Discussion
Welcome to my new column for Acupuncture Today, which will focus exclusively on the theoretical discussion and clinical application of acupuncture theory and acupuncture points. One of the most common questions I encounter from novice to experienced practitioners is "how do I choose the correct acupuncture point?". I hope this column can help answer some of these questions.
The NCCIH Seeks Participants for Acupuncture RCT
The National Center for Complementary and Integrative Health (NCCIH) is seeking participants for a new Funding Opportunity Announcement (FOA)—a Randomized Control Trial (RCT), which will evaluate the impact of, and strategies to best implement acupuncture treatment of older adults (65 years and older) with chronic low back pain (CLBP).
Checking Your Posture: A Wholistic View From Head to Toe
As you begin reading this article, what position is your body in? Are you sitting down, standing up, lying down, or walking down the street perhaps? Whatever position you are in, stop and observe your posture.
Avoid These New-Patient Turnoffs (Before It's Too Late)
I can't believe this doctor is making me watch this video in a room by myself, your new patient thinks to herself as she texts her best friend.
The Road to TCM, A Talk With Bob Doane
Bob Doane, a veteran acupuncturist, talks about his journey to TCM, the evolution of this medicine, and what he foresees in the future.
Cynicism, Burnout and the Search for the Ideal Patient (Pt. 1)
There is a video on the Internet that has gathered 6 million views as I write this article (so likely millions more by the time you read it). The video is of a doctor in an ER mocking a patient who is extremely weak and distressed.
Placebos, Presence and the Zero Point
We spend a huge amount of time learning the techniques and methods of acupuncture and Chi-nese medicine, and are given professional licenses based on our ability to remember and accu-rately apply them.
A Moment of Silence for Dr. Leon Chaitow (1937 – 2018)
After months of declining health, Dr. Leon Chaitow – clinician, prolific author and teacher – passed away on Sept. 20, 2018 at the age of 80.
News in Brief
The Next Generation of Chiropractic Researchers: Historic NIH Grant; Cleveland University – Kansas City VP Joins CCE Site Accreditation Team; NUHS Opens Second Veterans Clinic; R.I. Chiro. Society Celebrates 100 years.
August, 2009, Vol. 9, Issue 08
The Mysteries of Poison Ivy, Oak and Sumac Revealed
By Ruth Werner, LMP, NCTMB
In the summer, many of us enjoy time outdoors in the woods, hiking in the mountains or working with clients who are doing the same. One of the consequences of that pastime is the possibility of a common allergic reaction to a chemical called urushiol. This is the irritant found in the sap of three major plant species that are members of the cashew family: Rhus radicans, Rhus diversiloba or Rhus vernix. In other words, the topic for this column is poison ivy, poison oak, and poison sumac.
A lot of contradictory and flatly incorrect information is circulated about these plants and the rashes they cause, so I decided to take this opportunity to clear up some common misconceptions. This is in attempt to keep massage therapists safe, and to provide information to give useful advice to our clients who are dealing with these allergic reactions.
Poison Ivy, Oak and Sumac: What are they?
Poison ivy, poison oak and poison sumac are plants that are found in various places throughout North America. They favor wooded and watery areas. They have one feature in common: the presence of a chemical called urushiol that is carried in the sap of the leaves. The old rhyme, "leaves of three, let it be" applies to poison ivy and poison oak, as leaflets often appear in groups of three. Poison sumac can have leaflets numbering five, seven or more. One mark that is sometimes observed on these plants is shiny black spots that look like spatters of tar. This is actually the urushiol on the surface of the leaves.
The leaves of these plants are incredibly delicate, and even very gently brushing against them can allow the transfer of a tiny amount of urushiol, which then binds to cells deep in the epidermis. Symptoms, which include an itchy rash with fluid-filled blisters, typically develop 12-72 hours after contact with the oil. Some areas of the skin appear to react more quickly than others, so the rash may continue to develop over a few days. Further, the person may inadvertently spread the irritant on him or herself before bathing. This can make it appear that the rash is spreading spontaneously from the original site of exposure.
About 85 percent of the population is allergic to urushiol, although some people are more sensitive than others. It may take several exposures to launch an immune system reaction. Some people also find that their sensitivity declines with age: older people appear to be somewhat more tolerant of urushiol exposure.
Interestingly, humans and some other primates appear to be the only species sensitive to urushiol. Birds consume the berries of these plants with great enthusiasm. This is why they are often found growing near trees and fences: the seeds are spread by birds. Deer eat these plants with no apparent ill effects. And dogs don't appear to develop a rash, although they can effectively and enthusiastically share the urushiol that is on their fur.
Is it contagious?
Poison ivy and its partners are contagious from person-to-person only between when a person is exposed to the sap, and the next time that person bathes. This means that if a client arrives for a massage just after a pleasant walk in the woods, she or he may have had some exposure but has not yet developed symptoms. Receiving a massage at this point could put both the client and the therapist at risk for a much more extensive exposure to urushiol than anyone expects.
One example I witnessed along this theme was at a hot spring resort. An enthusiastic hiker joyfully made use of a public hot tub, not realizing that she had been exposed to poison oak during her morning walk. The oily sap spread on the water, affecting other bathers, and one of them had a very extreme reaction that bordered on anaphylaxis.
A poison ivy rash may involve fluid-filled blisters, but the fluid does not spread the rash. Scratching or popping the blisters, however, may introduce the risk of a secondary bacterial infection: definitely not a benefit.
It is important to understand that the cause of the rash seen with exposure to these plants is the sap, and only the sap. If the urushiol has been removed, even if the rash persists, the risk of the affected person spreading or sharing the rash is likewise gone. However, the oil in urushiol is amazingly stable and can retain its potency for months or longer. Dead plants can carry active urushiol for up to five years. It can also cling to fabric or metal, including the lawn mower or weed whacker that was used last season, the work boots that have been in the shed all winter, and the gardening gloves that are still on the tool bench. Another indirect way to contact this allergen is when it is vaporized in the atmosphere. For this reason, it is important never to burn clippings of poison ivy or its cousins.
What to do?
How do we limit the effects of urushiol? This is the million-dollar question, and it yields a surprising variety of answers. The one thing that seems consistently clear in the literature is that no single intervention appears to work on every person.
Experts agree that when exposure to urushiol is suspected, the area should be cleaned as quickly as possible. If the oil can be dislodged within 30 minutes the rash appears to be less extreme. The open question is how that removal should take place. Some people recommend treating the area with a skin-friendly solvent like rubbing alcohol or witch hazel first (the very scent of witch hazel takes me back to my poison ivy-filled youth!), rinsing with cool water, and then bathing with warm water and soap. Others suggest rinsing with warm soapy water right away. Some products have been developed that claim to be specifically targeted to shield the skin from urushiol, or to be especially effective at dislodging the molecules from skin cells, but the research on their efficacy is inconsistent at best.
Once the rash has emerged, a variety of topical applications are soothing and effective at managing the itching and swelling: calamine lotion (another evocative scent and color!), oatmeal baths and cortisone creams are all well-accepted.
Obviously an active urushiol-caused rash is at least a local contraindication for massage, but not because the rash is contagious or will spread; simply because any compromised skin is a possible invitation for secondary infection, and who needs to bring more circulation to an itchy area anyway?
Clients who have been spending time in areas that put them at risk are well advised to bathe before receiving massage. Massage therapists can give good advice about how to avoid contact with these plants and how to minimize their irritating effects. It's almost enough to make you look forward to autumn, isn't it?
For next time: The floor is open, and I am waiting for suggestions. This is your column, so let me know: what's on your table? Until then, many thanks, and many blessings.
Click here for previous articles by Ruth Werner, LMP, NCTMB.
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