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Older Patients, Stroke Risk and Manipulation
The first population-based study in the United States to evaluate stroke risk following spinal manipulation – and the first involving older adults – suggests that "[c]hiropractic cervical spine manipulation is unlikely to cause stroke in patients aged 66 to 99 years with neck pain.
News in Brief
ACA Exec. Vice President Out, Acting EVP In; F4CP Executive Director Retires; New ED Named.
Joint Supplements for Athletes (Part 2)
A fairly recent discovery in nutrition supplemental medicine has proven to be a breakthrough in maintaining athletic joint health. Research suggests a combination of undenatured type-II collagen and tetrahydro-iso-alpha acids helps revitalize joint function and performance in athletes.
Pain Is Only a Piece of the Puzzle
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, etc.
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.
What Do You Know About Physician Compare?
Physician Compare is a website that allows consumers to search for and obtain information about physicians and other health care professionals who provide Medicare services.
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.
Keep Seniors Safe: Age-Proofing the Home
I want to give Dr. Claudia Anrig kudos for her Dec. 1, 2014 column, which highlighted safety issues youngsters might encounter in the home.
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.
Treating GERD and Incontinence: Focus on Trigger Points
Gastroesophageal reflux disease (GERD) is defined as the regurgitation of stomach acid in the esophagus. Previously, it was thought that GERD was caused by a hiatal hernia, but recent trials suggest the cause is an inability of the hiatal sphincter to contract normally.
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.
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.
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!
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.
Viewpoints: Massage Reduces Nonspecific Shoulder Pain, Improves Function
While seemingly universal, pain and stiffness in the shoulders can be a significant cause of disability. Often a pain that does not go away on its own, shoulder complaints tend to linger, sometimes for 12 months or longer.
God and the Chiropractor
My wife went to church last Wednesday night and brought home a CD of the pastor's message. As she handed it to me, she said, "You should listen to this; you'll like it." Our family regularly goes to church and our faith plays a major role in our lives.
Managing Tibialis Posterior Tendon Injuries
The tibialis posterior is the deepest, strongest and most central muscle of the leg, with fibers originating from the tibia, fibula and interosseous membrane.
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.
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.
How We Can Help the Injured Brain
The majority of patients with mild traumatic brain injuries recover within seven to 10 days. If concussion signs and symptoms continue beyond seven days, the diagnosis changes from acute concussion to post-concussion syndrome.
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.
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.
The Role of Massage Therapy in Dementia Care
Our aging population is having a major impact on hospitals, nursing homes and hospice providers. Clinicians and front-line staff will serve more people over age 75 than any other age group and prevalence of dementia is being seen in every sector of senior services.
About one-quarter of all older hospital patients are people with dementia. People with dementia constitute about half of all nursing home and assisted-living facility residents. An estimated 15 million family and friends in the U.S. provided care to a loved one with dementia in 2013.
Federal and state initiatives aimed at changing dementia care are calling upon providers to integrate practical tools that create positive outcomes for elders with dementia and their caregivers. One such initiative strives to reduce unnecessary use of anti-psychotic medication by replacing or supplementing them with non-pharmacologic approaches and strategies.
The Role of Massage
At the core of each of these initiatives is human interaction. Care for people with dementia rests on relationships, underpinned by a strong evidence base. Massage is a powerful, yet under-utilized means to address the urgent need to find alternatives to medication to ease behavioral symptoms common to dementia.
Some forms of massage are evidence-based, relationship-centered, practical and pro-active. As a tool, massage can help establish holistic dementia care while helping providers meet regulatory requirements. Skilled human touch brings together the world of medical technology with the human side of care.
Lack of human touch is real for the medically frail elder, leading to feelings of isolation, anxiety, poor trust in caregivers, insecurity and decreased sensory awareness. Older adults living with serious conditions are often especially receptive to touch. Unfortunately, they are least likely to receive expressive human touch from health care providers. Nursing students have been shown to experience anxiety about touching older patients. Yet elders report that touch communicates safety, care, reassurance and makes them feel more trust in caregivers.
Since touching the hands is so familiar, hand massage may be gladly accepted by elders living with dementia. Even five-minutes of hand massage have been shown to elicit a physiological relaxation response and decreases cortisol levels. Cortisol is a stress hormone that is produced by the adrenal glands during prolonged stress and is often used as an objective marker of stress. When cortisol levels are lowered it enhances sleep quality and the immune system. Massage has also been shown to increase serotonin levels. Serotonin is a neurochemical that regulates mood; feelings of calm; and subdues anxiety and irritability.
A five or ten-minute hand massage protocol has resulted in:
One study by Suzuki (2010) evaluated the effects of hand massage on physical and mental function and behavioral and psychological symptoms consistent hand massage protocol. Both aggressive behaviors and stress levels decreased significantly.
Slow-stroke Back Massage
Slow-stroke back massage uses effleurage, moving the palm of the hand in long, rhythmic, firm strokes. One method applies effleurage in a figure-eight formation on both sides of the back. Massage stimulates production of endorphins which are compounds produced by the body that suppress pain and uplifts mood. Massage also has a generalized effect on the autonomic nervous system, producing a relaxation response.
Three-to-five minute protocols have shown slow-stroke back massage to:
Mok (2004) investigated the effect of slow-stroke back massage (SSBM) on anxiety and shoulder pain in hospitalized elderly patients who had suffered a stroke. The study compared scores for pain, anxiety, blood pressure and heart rate of two groups of patients. The intervention consisted of 10 minutes of slow-stroke back massage (SSBM) for seven consecutive evenings. The results revealed that the massage intervention significantly reduced the patients' levels of pain perception and anxiety and blood pressure and heart rate changed positively, indicating relaxation.
Foot massage is considered "boundary-safe" and frail older adults may readily accept having their feet rubbed. Evidence reveals that foot massage:
Moyle (2011) explored the effect of a 10-minute foot massage on agitated behaviors in older people with dementia. The most common agitated behaviors observed in the research group were verbal aggression, wandering and repetitive movements. Results showed that daily foot massages reduced agitation after just two weeks, irrespective of gender. Changes were maintained for at least two weeks without massage.
Skilled, compassionate human touch helps ease physical, emotional and psychosocial distress that leads to behavioral symptoms of dementia and is a feasible intervention to curb the use of medication. When used proactively, elders experience greater satisfaction in their care. A hand massage, back massage or simply holding a person has the power to elicit positive, life-affirming feelings and responses. For the person with Alzheimer's, touch becomes a language of the human heart and a remembrance of his place in the world.