By W. Kent. York College of Pennsylvania.

I stopped being a vegetarian purchase 60 caps ayurslim free shipping zenith herbals, I stopped worrying about my diet purchase ayurslim 60 caps with amex herbalsondemandcom, I started to eat what I want and ever since then that’s been my approach to healing in terms of diet and physical things. There have been times that I’ve craved fasting or I just haven’t felt like eating so I don’t eat. FELDENKRAIS METHOD According to the Holistic Centre Hamilton (1993:24), the Feldenkrais method “is a powerful way to improve the ease, grace, and comfort of our movements. Roger, another participant in this study, sees potential for this method of healing to go beyond the purely physical. In his words: “It’s work that’s used with athletes and dancers to improve neuromuscular organization, the ease and grace of movement, that sort of thing. Like homeopathy and naturopathy, herbalism rests on the assumption of self- healing. Hoffman (1988:19) writes: “The person who is ‘ill’ is in fact the healer. HOMEOPATHY Homeopathy was developed “in the early 1800s by Samuel Hahnemann, a German physician” (Northcott 1994:493). It is a system of healing based on the “law of similarities” or the principle of like cures like (Craig 1988). Homeopathic remedies most often come in the form of tinctures, granules, or tablets that have either an alcohol or lactose base. Homeopathic remedies are generally made up of “vegetable, animal, or mineral sources” (Craig 1988). These substances are diluted over and over, up to a million trillion trillion times, until imperceptible traces of them remain. The remedy is further “potentized by vigorous shaking at each step of the reduction or dilution” (Craig 1988). HYPNOTHERAPY According to Fulder (1996:xxii), hypnotherapy refers to “the use of hypnotic suggestion” to treat disease and psycho-social problems. IRIDOLOGY Often used by naturopaths, iridology is a diagnostic technique involving exam- ination of the iris, the membrane behind the cornea of the eye (Fulder 1996). MASSAGE According to Vickers (1993:86), massage is “the common root of all touch therapies. MEDITATION In meditation, health is engendered through the use of relaxation tech- niques and focussed breathing which clear the mind and promote both physical and spiritual well-being (Fulder 1996). MIDWIFERY Midwifery involves a holistic and non-invasive approach to childbirth where Appendix: The Therapies | 135 the midwife avoids the use of medical technology and does not “disempower the parents... According to Laura, “I wanted to deliver my baby and feel like I was in control of what was happening. Sickness is conceived of as a signal from the body that the person is in a “healing crisis” and therapy focuses on “stimulating the individuals’ vital healing force” (Clarke 1996:352). Naturopaths stress “natural, drugless healing” (Northcott 1994:494) and make use of a number of different therapies, including homeopathic remedies, nutrition, herbal remedies, massage, yoga, and lifestyle modification. PSYCHIC HEALING Psychic healing is a metaphysical form of therapy that incorporates clairvoyant diagnosis and the treatment of ill health through “the channelling of ‘psychic energy’... REFLEXOLOGY Foot reflexology is a system of diagnosis and healing that “recognizes the feet to be important indicators of the health/disease of the entire body” (Dychtwald 1986:60). For example, Hanna told me that Reflexology’s probably similar to acupressure where it’s stimulating the reflex pads in the head, hands, and feet that correspond to all the parts of the body. There’s about seventy-two thousand nerve endings in your feet and all the body has to function through those nerves. If an organ is unhealthy, the point on the foot corresponding to it will be “very sensitive to touch” and the organ in question can be healed through manipulation and massage of the relevant pressure point (Dychtwald 136 | Using Alternative Therapies: A Qualitative Analysis 1986:60). For instance, in telling me about foot reflexology, Lorraine describes her experience of a treatment given to her by her cousin. She can work on your feet and honestly she’ll hit spots and oh are they sore! So she’ll work that spot, she’ll work my toes and I’ll feel my sinuses draining.

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He was working on the third lished by his Yankee dislike of sham and by his edition at the time of his death discount ayurslim 60caps with amex lotus herbals 3 in 1 matte sunscreen. O’Connor organized and directed many teaching courses on the subject of arthroscopy buy cheap ayurslim 60 caps line herbals in tamil, the attendance at which was always capacity. He found time to write several papers, a monograph, and two books on arthroscopy. He demonstrated unusual courage, particularly during the difficult terminal period of his illness, and never gave up hope. O’Connor, a pioneer in the devel- opment of arthroscopic surgery, died on Novem- ber 29, 1980, in Bandon, Oregon, where he spent his last days, following a fight against cancer of the lung. O’CONNOR 1933–1980 Born in Chicago, Illinois, and educated at De Pauw University, Indiana, and Northwestern Medical School, Illinois, Dr. O’Connor began his medical career as a general practitioner in Telluride, Colorado. Later, returning to Louisville, Kentucky, he completed his orthope- dic training in 1968 under the supervision of Pro- fessor James Harkess, and settled in West Covina, California. O’Connor traveled to Tokyo, Japan, where he studied the arthroscopic techniques of Dr. Masaki Watanabe, and returned to the United States with a Watanabe arthroscope. Perceiving quickly the great potential of this instrument, he became its prime advocate in southern California. Overcoming the natural Hiram Winnett ORR resistance to new techniques, he persisted in his attempts to teach other orthopedists its value as a 1877–1956 diagnostic tool as well as its potential for intra- articular surgery. In the process he helped to Hiram Winnett Orr (the Hiram was replaced by develop the first operating arthroscope and the enigmatic initial H as soon as he learned to became the first to employ the instrument in sign his name) was born in West Newton, PA, meniscal surgery. After graduating est in intra-articular photography, including from the local high school at the age of 15 years, movies, 35-millimeter slides, and videotapes. In Lincoln, 249 Who’s Who in Orthopedics he lived with his maternal uncle, Dr. It remains, however, a viable option Winnett, a busy general practitioner. He gave his collection of more than 2,600 general practitioner, and in 1904 went to Chicago items to the American College of Surgeons, and where he fell under the spell of Dr. John Ridlon, it is now on permanent loan to the University of the Professor of Orthopedic Surgery at North- Nebraska College of Medicine. After spending a summer in tion of books on Anne of Brittany and her era was Chicago working with Dr. Ridlon, Orr returned given to the Love Library at the University of to Lincoln filled with enthusiasm for his new Nebraska. Orr had extensive experience as an editor, He then joined a group of individuals already including a short stint as editor of the progenitor lobbying for a crippled children’s hospital. In of The Journal of Bone and Joint Surgery, and as 1905 the legislature provided funds to open the an author of numerous papers and several books. He was president of the American Orthopedic This was only the third state-supported hospital Association in 1936. Orr was intimately in Lincoln, NE, where it was common knowledge associated with the work of this hospital, later among the children that if your parents took you called the Nebraska Orthopedic Hospital, for 50 to see Dr. During World War I, Orr was a member of the Goldthwait Unit of Young American Orthopedic Surgeons assembled by Dr. Goldthwait, and was sent to England for training under the aegis of Sir Robert Jones in preparation for service to American forces in France. Later, Orr was in charge of a base hospital in Savenay, France, where he was responsible for the care of thou- sands of patients with open fractures. Ridlon and Sir Robert Jones that gave Orr an appreciation of the work of Hugh Owen Thomas and his principle of rest, enforced, uninterrupted and prolonged, and it was his expe- rience with large numbers of open, contaminated fractures, that led him to develop his method of treatment. At the end of the war, Orr was dis- charged with the rank of Lieutenant Colonel.

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Private insurers also rarely reimburse exercise services (Manning and Barondess 1996 buy discount ayurslim 60caps on-line herbs lung cancer, 61) generic ayurslim 60 caps on-line himalaya herbals 100 tabletas. Some Medicare managed care organizations (MCOs) have offered free memberships at fitness clubs, al- though these benefits may erode with tightening costs. Although private and public health insurance plans document their cov- ered benefits, enrollees often remain unaware of the details. But, as the medical director said, “It’s the insurance company that gets the blame when there’s a discordance in expectations. Es- ther and Harry Halpern can’t agree on who pays for the home-health aide who helps them with grocery shopping and routine tasks around the house—their supplemental Medicare insurance or themselves, personally. We’re told all about it, but it takes special information to know how to work the system so it can help you. Medicare cov- ers two pair of shoes for anybody with arthritis or diabetes. Debates about “medical necessity” wend throughout all health-care settings, from disease-oriented acute services to chronic care, and often pit patients’ personal physicians against health plans. For persons with progressive chronic impairments, the issues are especially vexing. Was it medically necessary that people like Erna Dodd leave their homes, en- hance their safety, independently conduct their daily activities, possibly improve their quality of life? Medicare’s medical necessity language ties directly to the statutory def- inition of covered services quoted earlier—“diagnosis or treatment of ill- ness or injury” or improvement of functioning. In the pamphlet Medicare & You 2001, the Health Care Financing Administration (HCFA, renamed the Centers for Medicare and Medicaid Services, or CMS, in June 2001), which runs Medicare, informs beneficiaries that Part B covers physical and occupational therapists and supplies that are “medically necessary” or that • are proper and needed for the diagnosis or treatment of your medical condition • are provided for the diagnosis, direct care, and treatment of your medical condition • meet the standards of good medical practice in the medical community of your local area • are not mainly for the convenience of you or your doctor (HCFA 2000a, 70) The prohibition against “convenience” items, in particular, compromises efforts to obtain assistive technologies and other devices. Medicare proba- bly turned down Erna Dodd because it viewed her requested scooter as a convenience item; it was clearly not “medically necessary” to diagnose or treat her many medical conditions. While some Medicaid programs closely follow Medicare’s definition of medical necessity, others set their own standards. For Medicaid managed-care contracts with health plans, most states have put together definitions of medical ne- cessity, if not details of decision criteria (Rosenbaum et al. Medical necessity definitions from three states underscore the diversity of lan- guage. Their language about medical necessity is often vague or open to interpre- tation. The standards of medical necessity vary widely, and private plans’ decisions on medical necessity ultimately come from physicians, typically the insurers’ medical directors (Singer and Bergthold 2001). In making de- cisions, medical directors depend to varying degrees on contractual lan- guage, expert opinions, scientific evidence, professional experiences, local practices, and the enrollee’s characteristics and preferences. For mobility-related services, questions about scientific evidence show- ing the effectiveness of interventions loom large. Although the activities of physical and occupational therapists make theoretical, clinical, and practi- cal sense, few clinical trials or large observational studies have analyzed the outcomes and effectiveness of these services. Research on OT outcomes is especially rare, particularly for home-based services. PT has a larger evi- dence base, focused primarily on inpatient rehabilitation or short-term outcomes. Mobility aids attract little research; studies generally involve small numbers of nondisabled volunteers in laboratory settings. The scarcity of research evidence about the effectiveness and clinical outcomes of therapy and assistive technology compromises efforts to make objective medical necessity decisions about the merit of mobility-related items and services. Medical necessity decisions frequently appear idiosyncratic and subjec- tive. As one disability rights activist said, “Health plans are pretty much free to manipulate the definition of medical necessity. Conflicting motivations heighten concerns: The need to control costs and generate profits also brings into ques- tion the reliability and soundness of decision making by insurers. The sine qua non of scientific research is the production of objective results, and objectivity is ensured through a process of open and vig- orous debate among persons who have no financial stake in the out- come. Yet much of the decision making about insurance coverage is based on unpublished, proprietary, and unreviewed data.

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