DOCSLIB.ORG

Electrical Stimulation Therapy and Home Devices

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Electrical Stimulation Therapy and Home Devices Medical Coverage Policy Effective Date ........................................... 09/15/2021 Next Review Date ..................................... 09/15/2022 Coverage Policy Number ................................... 0160 Electrical Stimulation Therapy and Home Devices Table of Contents Related Coverage Resources Overview .............................................................. 2 Acupuncture - (CPG 024) Coverage Policy ................................................... 2 Bone Growth Stimulators: Electrical (Invasive, General Background ............................................ 4 Noninvasive), Ultrasound Medicare Coverage Determinations .................. 55 Diaphragmatic/Phrenic Nerve Stimulation Coding/Billing Information .................................. 56 Electric Stimulation for Pain, Swelling and Function in a Clinic Setting - (CPG 272) References ........................................................ 62 Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions and Soft Tissue Wounds Gastric Pacing/Gastric Electrical Stimulation (GES) Headache and Occipital Neuralgia Treatment Injectable Bulking Agents for Urinary Conditions and Fecal Incontinence Omnibus Codes Physical Therapy – (CPG 135) Plantar Fasciitis Treatments Sacral Nerve and Tibial Nerve Stimulation for Urinary Voiding Dysfunction, Fecal Incontinence and Constipation Speech Therapy Spinal Cord and Dorsal Root Ganglion Stimulation Transcranial Magnetic Stimulation Vagus Nerve Stimulation (VNS) INSTRUCTIONS FOR USE The following Coverage Policy applies to health benefit plans administered by Cigna Companies. Certain Cigna Companies and/or lines of business only provide utilization review services to clients and do not make coverage determinations. References to standard benefit plan language and coverage determinations do not apply to those clients. Coverage Policies are intended to provide guidance in interpreting certain standard benefit plans administered by Cigna Companies. Please note, the terms of a customer’s particular benefit plan document [Group Service Agreement, Evidence of Coverage, Certificate of Coverage, Summary Plan Description (SPD) or similar plan document] may differ significantly from the standard benefit plans upon which these Coverage Policies are based. For example, a customer’s benefit plan document may contain a specific exclusion related to a topic addressed in a Coverage Policy. In the event of a conflict, a customer’s benefit plan document always supersedes the information in the Coverage Policies. In the absence of a controlling federal or state coverage mandate, benefits are ultimately determined by the terms of the applicable benefit plan document. Coverage determinations in each specific instance require consideration of 1) the terms of the applicable benefit plan document in effect on the date of service; 2) any applicable laws/regulations; 3) any relevant collateral source materials including Coverage Policies and; 4) the specific facts of the particular situation. Each coverage request should be reviewed on its own merits. Medical directors are expected to exercise clinical judgment and have discretion in making individual coverage determinations. Coverage Policies relate exclusively to the administration of health benefit plans. Coverage Policies are not recommendations for treatment and should never be used as treatment guidelines. In certain markets, delegated vendor guidelines may be used to support medical necessity and other coverage determinations. Page 1 of 84 Medical Coverage Policy: 0160 Overview This Coverage Policy addresses outpatient electrical simulation therapy (e.g., wound care therapy, auricular electroacupuncture, transcutaneous electrical modulation pain reprocessing) and the use of in-home devices, conductive garments and other related supplies for the treatment of multiple conditions. Coverage Policy Electrical Stimulation Therapies Chronic Wound Healing Electrical stimulation (HCPCS Code G0281) is considered medically necessary for the treatment of a chronic wound when ALL of the following criteria are met: • Presence of ANY of the following chronic wound types: Stage 3 or stage 4 pressure ulcer arterial ulcer neuropathic (diabetic) ulcer venous stasis ulcer • Failure to demonstrate measurable signs of improved healing (e.g., signs of epithelialization and reduction in ulcer size) with a 30-day trial of conventional wound management, including optimization of nutritional status, moist dressings and debridement. • Electrical stimulation therapy is performed under the direct supervision of a medical professional with expertise in wound evaluation and management. The use of electrical stimulation in the home setting for wound healing in the absence of direct supervision by a health care provider is considered experimental, investigational or unproven. Electrical stimulation therapy for any other chronic wound indication including but not limited to prevention of a pressure ulcer or pressure sore is considered experimental, investigational or unproven. Other Electrical Stimulation Therapies Each of the following electrical stimulation therapies is considered experimental, investigational or unproven: • auricular electroacupuncture (e.g., PStim™) (HCPCS Code S8930) • transcutaneous electrical modulation pain reprocessing (TEMPR) (e.g., Scrambler therapy, Calmare®) (CPT Code® 0278T) Home Electrical Stimulation Devices (Electrical Stimulators) Coverage for Durable Medical Equipment (DME) including in-home electrical stimulation devices varies across plans. Please refer to the customer’s benefit plan document for coverage details. If coverage for an in-home electrical stimulation device is available, the following conditions of coverage apply. Neuromuscular Electrical Stimulation (NMES) Neuromuscular electrical stimulation (NMES) (HCPCS Code E0745) and related supplies (HCPCS Code A4595) are considered medically necessary when used as one component of a comprehensive rehabilitation program for the treatment of disuse atrophy when the nerve supply to the atrophied muscle is intact. Page 2 of 84 Medical Coverage Policy: 0160 Neuromuscular electrical stimulation (NMES) and related supplies (HCPCS Code A4595) for ANY other indication (e.g., idiopathic scoliosis [HCPCS Code E0744], heart failure) are considered experimental, investigational or unproven. Transcutaneous Electrical Nerve Stimulation (TENS) A transcutaneous electrical nerve stimulator (TENS) (HCPCS Code E0720, E0730) and related supplies (HCPCS Code A4595) are considered medically necessary for in-home use as an adjunct to conventional post-operative pain management within 30 days of surgery. TENS (HCPCS Code E0720, E0730, K1016) and related supplies (HCPCS Code A4595, K1017) for ANY other indication, including a device for the treatment of migraine headaches (e.g., Cefaly), are considered experimental, investigational or unproven. Conductive Garment A conductive garment (HCPCS Code E0731) is considered medically necessary when used in conjunction with a medically necessary in-home NMES or TENS device for ANY of the following clinical situations: • The use of conventional electrodes, tapes or lead wires is not feasible either because the individual has a large area requiring treatment or a large number of sites requiring stimulation. • The site(s) requiring stimulation (i.e., back) is/are difficult to reach with conventional electrodes, tapes or lead wires. • A co-existing medical condition (e.g., skin problems) precludes the use of conventional electrodes, tapes, or lead wires. A conductive garment for any other in-home indication is considered not medically necessary. Other Electrical Stimulation Therapies In-home use of ANY of the following electrical stimulation devices is considered experimental, investigational, or unproven for the treatment of any condition: • bioelectric nerve block (electroceutical therapy) (HCPCS Code E1399) • combination therapy (e.g., Neufit Neubie, Flex-MT+) (HCPCS code E1399) • cranial electrical stimulation (cranial electrotherapy stimulation) (HCPCS Code K1002) • electrical sympathetic stimulation therapy (HCPCS Code E1399) • electrotherapeutic point stimulation (ETPSSM) (HCPCS Code E1399) • functional electrical stimulation (FES) (HCPCS Codes E0764, E0770) • H-WAVE electrical stimulation (HCPCS Code E1399) • high-voltage galvanic stimulation (HVG) (HCPCS Code E1399) • interferential therapy (IFT) (HCPCS Codes S8130, S8131) • microcurrent electrical nerve stimulation (MENS), including frequency-specific microcurrent (FSM) stimulation (HCPCS Code E1399) • pelvic floor electrical stimulation (PFES) (HCPCS Code E0740) • percutaneous electrical nerve stimulation (PENS) (HCPCS Code K1018, K1019) • percutaneous neuromodulation therapy (PNT) (HCPCS Code E1399) • percutaneous nerve field stimulation (PNFS) (e.g., NSS-2 Bridge, IB-Stim) (CPT Code 64999) • threshold/therapeutic electrical stimulation (TES) (HCPCS Code E1399) • transcutaneous electrical acupoint stimulation (TEAS) (HCPCS Code E0765) • transcutaneous electrical joint stimulation (HCPCS Code E0762) Note: For electrical stimulation therapies in the outpatient setting please refer to the Cigna/American Specialty Health (ASH) Coverage Policy “Electric Stimulation for Pain, Swelling and Function in a Clinical Setting”. Page 3 of 84 Medical Coverage Policy: 0160 General Background Electrical stimulation (ES) therapy involves the application of electrodes to affected areas of the body for the purpose of delivering electrical current.
Load more

Recommended publications
  • Chiropractic in Lancaster County by J
    Chiropractic in Lancaster County By J. Calvin Wenger, D. C. The Chiropractic profession was birthed nationwide in Davenport, Iowa in September 1895. It all started when a magnetic healer, Daniel David Palmer, noticed an unusual derangement in the cervical-thoracic spine of a deaf janitor by the name of Harvey Lillard. He performed a manipulation in this area and Mr. Lillard’s hearing was restored. Thus began a process of patient care that eventually evolved into what today is known as the chiropractic profession. A friend of Daniel Palmer, Rev. Samuel Weed, was fluent in Greek and suggested the procedure be called chiropractic, a practice performed by the use of hands. During the next decade the first chiropractic school was established which is still operating and known now as the Palmer University of Chiropractic. Dr. David Palmer's son, Dr. B. J. Palmer, was an unusual and charismatic leader who succeeded his father and became known as the developer of chiropractic. His son Dr. David Pamler became a 3rd generation leader in the profession and married a Lancaster County native, Dr. Agnes High Palmer. In recent years, two other Palmer higher educational institutions have been established in San Jose, California and Port Orange, Florida. Incidentally and interestingly, the other major manipulative health profession, osteopathy, was also discovered in the Mid-West in the latter 1800's in Swiftwater, Missouri by a practitioner by the name of Andrew Still. The major premise of the chiropractic profession is that dysfunctional spinal articulations and pelvic structures will initiate disturbances with the function of the nervous system in a particular spinal area which in tandem negatively influences the normal functions of the body in that particular area.
    [Show full text]
  • A Review of the Potential Therapeutic Application of Vagus Nerve Stimulation During Childbirth
    A Review of the Potential Therapeutic Application of Vagus Nerve Stimulation During Childbirth By Tanya Enderli A thesis submitted to the College of Engineering at Florida Institute of Technology in partial fulfillment of the requirements for the degree of Master of Science In Biomedical Engineering Melbourne, Florida March, 2017 We the undersigned committee hereby recommend that the attached document be accepted as fulfilling in part the requirements for the degree of Master of Science of Biomedical Engineering. “A Review of the Potential Therapeutic Application of Vagus Nerve Stimulation During Childbirth,” a thesis by Tanya Enderli ____________________________________ T. A. Conway, Ph.D. Professor and Head, Biomedical Engineering Committee Chair ____________________________________ M. Kaya, Ph.D. Assistant Professor, Biomedical Engineering ____________________________________ K. Nunes Bruhn, Ph.D. Assistant Professor, Biological Sciences Abstract Title: A Review of the Potential Therapeutic Application of Vagus Nerve Stimulation During Childbirth Author: Tanya Enderli Principle Advisor: T. A. Conway, Ph.D. The goal of this research is to show that transcutaneous Vagus nerve stimulation (tVNS) should be investigated as a possible modality for increasing endogenous release of oxytocin during childbirth. There have been many great advances made in the practice of modern obstetrics in the last century. The 1900s saw the discovery, isolation, and subsequent widespread use of the hormone oxytocin as an agent to prevent postpartum hemorrhage and to initiate or quicken labor during childbirth. There are significant risks to the fetus when synthetic oxytocin is used. While the medical administration of oxytocin during labor was being popularized, there was also research being conducted on its physiologic mechanism in labor.
    [Show full text]
  • Multiple Chemical Sensitivity and Related Illnesses
    An Integrative Approach to Environmental Intolerances: Multiple Chemical Sensitivity and Related Illnesses What are environmental intolerances? In recent years, there has been an increase in the number of illnesses that may be caused by a reaction to something in a person’s environment. These illnesses include: Multiple chemical sensitivity (MCS) Sick building syndrome Post 9/11 syndrome Silicone breast implant intolerance Gulf War syndrome Toxic mold syndrome Electromagnetic field intolerance. This handout will focus mainly on multiple chemical sensitivity (MCS) because it is the best-studied of these environmental illnesses. But the causes, diagnosis, and treatment are similar for all of them. How does MCS affect people? People vary a lot in their reactions. For some people, these illnesses can be quite disabling. They can affect a person’s ability to work, accomplish daily tasks, and enjoy leisure activities. They can also increase the cost of healthcare. A study in 2003 of 1,582 individuals from the Atlanta area found that 12.6% reported being overly sensitive to common chemicals. Of that 12.6%, 13.5% of them (1.8% of the total group) had lost their jobs because of their sensitivities. Another 2003 study of 917 people with MCS, found that on average each spent $51,000 on health care, $7,000 in the past year. How does MCS start? MCS occurs after a person is near a chemical or chemicals in the environment. Some people report symptoms after just one occurrence. Others develop symptoms after they have been near the substance several times. After these first few times, they find that other chemicals can cause symptoms as well.
    [Show full text]
  • Sacral Nerve Stimulation for Urinary Voiding Dysfunction and Fecal
    Medical Coverage Policy Effective Date ............................................10/15/2020 Next Review Date ......................................10/15/2021 Coverage Policy Number .................................. 0404 Sacral Nerve and Tibial Nerve Stimulation for Urinary Voiding Dysfunction, Fecal Incontinence and Constipation Table of Contents Related Coverage Resources Overview .............................................................. 1 Biofeedback Coverage Policy ................................................... 1 Electrical Stimulation Therapy and Devices General Background ............................................ 3 Fecal Bacteriotherapy Medicare Coverage Determinations .................. 19 Injectable Bulking Agents for Urinary Conditions and Coding/Billing Information .................................. 19 Fecal Incontinence References ........................................................ 21 INSTRUCTIONS FOR USE The following Coverage Policy applies to health benefit plans administered by Cigna Companies. Certain Cigna Companies and/or lines of business only provide utilization review services to clients and do not make coverage determinations. References to standard benefit plan language and coverage determinations do not apply to those clients. Coverage Policies are intended to provide guidance in interpreting certain standard benefit plans administered by Cigna Companies. Please note, the terms of a customer’s particular benefit plan document [Group Service Agreement, Evidence of Coverage, Certificate of Coverage,
    [Show full text]
  • Complementary and Alternative Medicine by Rueleen Kapsch, RN, Quality Assurance Nurse Horizons in Hemophilia, Spring 2007
    Complementary and Alternative Medicine By Rueleen Kapsch, RN, Quality Assurance Nurse Horizons in Hemophilia, Spring 2007 Complementary medical treatment (or supportive therapy) is used along with conventional therapy your doctor recommends, such as using T'ai Chi or massage in addition to a prescription medicine to treat a problem. Alternative medicine is generally used instead of conventional medicine, and people who help with this are called practitioners. Basic philosophies of complementary and alternative medicine include: • Your body heals itself. Practitioners see themselves as helpers to encourage your own natural healing process. • Prevention is key. The practitioner may want to see you while you are not sick to make sure you are doing all you can to keep yourself healthy. • Education and learning. Practitioners see themselves as teachers or mentors who offer guidance. Many therapies are available in five broad categories: Healing systems are sets of theories and lifestyle practices which involve the power of nature or energy fields in the body. This may include some medications or noninvasive treatments to help your own body heal itself. Traditional Asian, Native Indian and Tibetan practices can also fall into the healing system. Mind-body connections strengthen the connection between the mind and your body. Complementary and alternative practitioners believe that these two systems should be in harmony for you to stay healthy. Examples of this might include yoga, aromatherapy, biofeedback, prayer, hypnosis, and relaxation therapy. Dietary, vitamin, mineral supplements, and herbs. These treatments use ingredients found in nature. However, just because a product is “natural” that does not mean it is safe to take if you have a bleeding disorder or other medical problem.
    [Show full text]
  • ISM White Paper on Chiropractic
    Institute for Science in Medicine WHITE PAPER CHIROPRACTIC PREPARED BY JANN J. BELLAMY, JD EDITED BY STEPHEN BARRETT, MD AUGUST 2012 Institute for Science in Medicine (ISM) is an international, educational and public-policy or- ganization comprised of health care professionals, scientists, and researchers who agree that the best science available should be used to determine health policy and to establish a standard of care that both protects and promotes the public health. We necessarily oppose policies which erode a science-based standard of care and thereby significantly expose the public to fraudulent, worthless, or harmful medical practices and products. AFFILIATIONS Jann J. Bellamy is presently a Fellow, Director, and Secretary of the Institute for Science in Medicine. She is an attorney, and also a columnist for Health News Florida. She founded and heads a non-profit, Campaign for Science-Based Health- care, and is a contributor to Science-Based Medicine. Stephen Barrett is presently a Fellow, Director, and Vice President of the Institute for Science in Medicine. He is a retired psychiatrist who operates the Quackwatch website. Copyright 2012 by Institute for Science in Medicine, Inc. Permission to reproduce in its entirety is hereby granted, provided that it is not altered, not distributed for commercial purposes, and this notice is includ- ed. All other rights are reserved. WP-2 Chiropractic is a licensed health care profession in the United States. Its core principle is that misalignments (“subluxations”) of the spinal bones (vertebrae) cause ill health and disease and that detecting and correcting them can relieve symptoms and improve overall health.
    [Show full text]
  • An Investigation Into the Effect of Cupping Therapy As a Treatment for Anterior Knee Pain and Its Potential Role in Health Promotion
    An investigation into the effect of Cupping Therapy as a treatment for Anterior Knee Pain and its potential role in Health Promotion. Kaleem Ullah MSc Physiotherapy Ahmed Younis Mohamed Wali University of East Anglia Principal Lecturer St Georges University of London St Georges University of London Citation: K. Ullah, A. Younis & M. Wali : An investigation into the effect of Cupping Therapy as a treatment for Anterior Knee Pain and its potential role in Health Promotion. The Internet Journal of Alternative Medicine. 2007 Volume 4 Number 1 Abstract Objective : To investigate the effect of Cupping Therapy at a patho-physiological level for anterior knee pain and its impact on Quality of life and well-being. Method: Experimental survey utilising clinical trial and a questionnaire. A three week follow-up was conducted to determine longer term carry over of treatment effects utilising both objective and subjective assessment. This method enables the researcher to examine how much the independent variable causes participants to change (Dane, 1990). Results: There was statistically significance difference between the level of pain, well being and Range of Motion for patients with anterior knee pain pre and post Cupping (P <0.05). Conclusions : The efficacy of the treatment of Cupping Therapy for Anterior Knee Pain, well being and range of motion has been researched and results reveal improvements in participants as a result of Cupping Therapy. It is recommended that further studies are conducted with larger study samples and of longer duration. Introduction Cupping is an ancient method of treatment that has been used in the treatment and cure of a broad range of conditions; blood diseases such as haemophilia and hypertension, rheumatic conditions ranging from arthritis, sciatica, back pain, migraine, anxiety and general physical and mental well-being.
    [Show full text]
  • Painful Polio Our Fight Against Polio—A Vaccine- Preventable Infectious Disease—Is at Its Peak
    Feature Article UNMET HEALTH NEEDS Painful Polio Our fight against polio—a vaccine- preventable infectious disease—is at its peak. Ensuring complete immunization of every child is the key to oust the deadly polio virus from our planet.. P. CHEENA CHAWLA HILDREN are beautiful gifts of Nature. Sheer neglect of hygiene in the early days of life can play havoc in the Cinfant body, letting germs of a wide Although polio was well the capsid. Besides protecting the variety make home in the tiny organs recognized as a human affliction for genetic material of poliovirus, the playing a dangerous game of life and long, it was only in 1908 that the culprit capsid proteins enable this virus to death. The aftermath of an infectious bug for this disease, the polio virus, infect certain types of cells. childhood illness is most appalling if was identified by Karl Landsteiner. Three different serotypes of polio survival is at the cost of living with a Polio spread widely in Europe and the virus are known to cause the disease — crippled body for whole life. This United States in late 1880s and as the poliovirus type 1 (PV1), type 2 (PV2), exactly happens when the deadly virus, virus circulated rampantly around the and type 3 (PV3) — each having a known to cause polio, strikes! globe, polio cases dramatically slightly different capsid protein. One of the most dreaded childhood increased. It was in the face of such Although all these viral serotypes are diseases, polio mostly strikes children epidemics in early 1900s, paralyzing extremely dangerous and result in the under five years of age.
    [Show full text]
  • Smedimnic INFORMATION for PRESCRIBERS Medtronic Interstimo Therapy
    InterStim lBowelenlcvm W141/08 1:40pm Medtronic Confidential US Mlar1elRelease er 4.5 aS6nches (114 mma 152Mm) NuoFO SMedimnic INFORMATION FOR PRESCRIBERS Medtronic InterStimO Therapy Rx only M925905AW3 Rev X Inter~fir Sowan c.ahtm W/l4/0 1:40 M Medtronic Confidential US Mautt Release 4,5x 6inchesa(114 mm x 152 mm) NeurolPO m Medironic * and InlerStim' are registered trademarks and SoftStartStop ' is a trademark of Meduronic, Inc. Additional Information available for the InterStin, Therapy system Documents packaged with this product: * For therapy-specific information, refer to the Indications Insert. * For Information regarding device compatibility, refer to the System Overview and Compatibility Insert - For information on the clinical study resuita for InterStinm Therapy and for a complete summary of adverse events, refer to the Clinical Summary. * For warranty Information, refer to the Limited Warranty and Special Notice Insert Documents packaged with the clinician programmer software application card: *For neurostimulator selection, battery longevity calculations, and specific neurostimulator specifications, refer to the System Eligibility Battery Longevity, Specifications Reference Manuoal. M925905AC03 Rev X InterSdm_ oeIenTOCm B11408 1:40pm Medtronlc Confidential USMat Release 4.5 x inches (114 mm a I5 ramm) NeurolFPROO Contraindications 5 Warnings 5 Electromagnetic interference (EMI) 5 Case Carnage 7 Effects on other implanted devices 7 Precautions 7 Clinician programming 7 Clinician training 9 Patient activities 9 Patient programming
    [Show full text]
  • Medical Policy
    Medical Policy Joint Medical Policies are a source for BCBSM and BCN medical policy information only. These documents are not to be used to determine benefits or reimbursement. Please reference the appropriate certificate or contract for benefit information. This policy may be updated and is therefore subject to change. *Current Policy Effective Date: 5/1/21 (See policy history boxes for previous effective dates) Title: Sacral Nerve Neuromodulation/Stimulation Description/Background Sacral nerve neuromodulation (SNM), also known as sacral nerve stimulation (SNS), is defined as the implantation of a permanent device that modulates the neural pathways controlling bladder or rectal function. This policy addresses use of SNM in the treatment of urinary or fecal incontinence, urinary or fecal nonobstructive retention and chronic pelvic pain in patients with intact neural innervation of the bladder and/or rectum. Urinary and Fecal Incontinence Urgency-frequency is an uncontrollable urge to urinate, resulting in very frequent, small volumes and is a prominent symptom of interstitial cystitis (also called bladder pain syndrome). Urinary retention is the inability to completely empty the bladder of urine. Fecal incontinence can arise from a variety of mechanisms, including rectal wall compliance, efferent and afferent neural pathways, central and peripheral nervous systems, and voluntary and involuntary muscles. Fecal incontinence is more common in women, due mainly to muscular and neural damage that may occur during vaginal delivery. Treatment Treatment using SNM, also known as indirect SNS, is one of several alternative modalities for patients with fecal or urinary incontinence (urge incontinence, significant symptoms of urgency- frequency, or nonobstructive urinary retention) who have failed behavioral (e.g., prompted voiding) and/or pharmacologic therapies.
    [Show full text]
  • Families, Patients, and Health Care During Manitoba's Polio Era, 1928
    ‘It has impacted our lives in great measure’: Families, Patients, and Health Care during Manitoba’s Polio Era, 1928 – 1953 By Leah Morton A thesis submitted to the Faculty of Graduate Studies of The University of Manitoba in partial fulfilment of the requirements of the degree of Doctor of Philosophy Department of History University of Manitoba Winnipeg Manitoba Copyright © 2013 by Leah Morton Abstract This dissertation examines the broad social impacts of the multiple polio epidemics that occurred in Manitoba between 1928 and 1953, a period I refer to as the epidemic era. It argues that examining the six major polio epidemics as an era, and the disabilities it engendered are useful windows into twentieth-century social history, particularly in terms of the capacities and limits of the state to control and manage disease, illness, and health, and the myriad ways the family negotiated discourses about disability and the intersections of disability and gender. It also examines the changes to nurses’ labour during the epidemic era, particularly in terms of the introduction of two new technologies of care – respirators and the Kenny method – both of which led to nursing shortages in the later epidemic, exposing the lingering gendered conceptions about women and voluntary nursing. This project also considers the post-war development of rehabilitation programs, and argues that they worked to discursively transform people with an illness into people with disabilities, in need of reformation in order to become useful, contributing citizens. Finally, this dissertation examines the impact of polio-related disabilities on the lived experiences of a number of Manitobans, and argues that while polio and ideologies about disability worked to shape their lives in many ways, these were not the only forces to impact people’s lives and that people with polio-related disabilities negotiated the quotidian aspects of life much like anyone else.
    [Show full text]
  • Advanced Fundamentals of Chinese Acupuncture Deveg›Eāceefcekeāe
    A Treatise On Advance Acupressure/Acupuncture (Part XVI) - Advanced Fundamentals of Chinese Acupuncture Deveg›eâceefCekeâe ( Index ) efJe<eÙe he=‰ mebKÙee Chapter-1 Allopathic System Vis a Vis Tradional Chinese Medicine 1 Allopathic System Traditional Chinese System of Medicine (TCM) 2 Chapter-2 Fundamentals of Qi Mechanism Tpee& keâer keâeÙe&ØeCeeueer kesâ cetueYetle efmeæevle 3 Spleen and Stomach 6 Liver and lungs 7 Heart and Kidney 8 Transformation of Qi by triple warmer Chapter-3 Laws Relating to Stagnation of Qi Tpee& keâer ®keâeJeš mecyevOeer efveÙece 10 i) Attack of liver Qi on brain 13 ii) Attack of liver Qi on throat iii) Attack of liver Qi on lungs iv) Attack of liver Qi on spleen 14 v) Attack of liver Qi on stomach vi) Attack of liver Qi on head vii) Attack of liver Qi on small intestine causes 15 small intestine Qi stagnation viii) Attack of liver on small intestine causes obstruction and appendicitis 16 ix) Attack of liver on urinary bladder causes burning in urination 17 x) Attack of liver on uterus causes premenstrual syndromes xi) Attack of liver on gall bladder causes jaundice Stagnation of Qi in various organs and their symptoms & treatment 18 Chapter-4 Laws Relating to Contravection of Qi or Rebelious Qi 19 Tpee& kesâ ceeieexuebIeve mecyevOeer efveÙece Ùee GheõJeer Tpee& mecyevOeer efveÙece i) Contravection of the stomach qi causes nausea, vomiting, belching and hiccup. DeeceeMeÙe keâer Tpee& keâe ceeieexuebIeve efceÛeueer, Jeceve, [keâej SJeb efnÛekeâer hewoe keâjlee nw~ 22 ii) Contravection of the spleen Qi causes prolapses, varicose veins 23 and hemorrhoids. hueerne keâer Tpee& keâe ceeieexuebIeve mLeeveÛÙegefle, efMejemHeâerefle SJeb yeJeemeerj hewoe keâjlee nw~ iii) Contravection of the lungs Qi causes cough and asthama with 25 problems in exhaling.
    [Show full text]