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Preparation for Your AppointmentTandem Point
Food:
Eating a lot of freshly-prepared protein (fish, meat, eggs, raw nuts) before your session is critical for you to get the best result from Tandem Point therapy. Have plenty of protein, ideally freshly-cooked ocean fish or other seafood, in the 24-hour period before an appointment. On the day of your appointment, eat a large breakfast including plenty of protein, ideally freshly-cooked ocean fish. However, do not eat within two hours of your appointment. Individuals with low blood pressure and/or low blood sugar should pay special attention to eating well throughout the day of an appointment. Bodywork therapy, especially scar tissue release, may cause toxins to leave local tissue and enter the digestive tract. One physician recommends consumption of apple pectin in advance of treatment to absorb and facilitate excretion of such toxins. Apple pectin is found in apples or may be taken in supplement form.
 
Water:
Please drink plenty of water the day before and the day of an appointment. The definition of plenty varies: one physician recommends that you take your body weight in pounds, divide by two, and consume that many ounces of water in a day. According to this formula, a 120-pound person would drink 60 ounces of water, or 7.5 cups, daily. Alcohol and caffeine are diuretics (they will work to eliminate water from your body) so if you consume alcohol or caffeine in the two days before an appointment, please drink extra water. Please continue to drink a lot of water after an appointment also. Please do not drink distilled water.
Soup broth:
Please bring two pints of soup broth to your appointment, as consumption of soup broth during session (instead of water) is associated with a clearly superior result in approximately 85% of clients, possibly due to protein and electrolytes in the soup broth. The Oriental Pearl, 215 East Kings Highway (five doors closer to Haddon Avenue than 225 East Kings Highway), will sell you chicken broth made in-house for $1 a pint plus tax or vegetarian miso broth for $1.25 a pint plus tax. These items are not on the menu. Please ask for broth, not soup; please purchase two pints, not one quart. The Oriental Pearl is not open for the 11 a.m. Sunday appointment but is open during all other Tandem Point appointment hours. The soup broth is always on the stove, so there is no need to phone an order in advance. If you will prepare your own soup, please bring it hot in a thermos if possible. Salt-free soup is associated with a relatively poor result; if your physician has placed you on a limited salt diet, please consult with your physician as to whether you could have soup broth during Tandem Point therapy.
Vitamins:
If you normally take vitamins, please remember to take vitamins on the day of an appointment. Bernard Filner, M.D., a Maryland physiatrist who studied with Janet Travell, M.D. and treats trigger points using her methods, requires his patients to take 2 grams (2000 milligrams) of timed release vitamin C per day for at least three days before their first visit (unless the patients have kidney stones). The timed release is important: Dr. Filner holds the opinion that 2 grams of timed release vitamin C is more useful to the body than 18 grams of regular vitamin C. In addition, he requires all his patients to start taking B-complex (50 milligram) vitamins, one pill daily, for six weeks, starting at least two weeks before the first appointment. In the B-complex vitamins, he requires the niacin to be in the form of niacinamide. Carol McMakin, D.C., an Oregon chiropractor who treats trigger points with microcurrent therapy (she presented this treatment strategy at the National Institutes of Health in April 2000), recommends that her patients to take complex low-dose anti-oxidant vitamins two hours before and immediately after a patient visit. For patients who do not have access to such vitamins, Dr. McMakin suggests an ordinary multi-vitamin two hours before and immediately after the patient visit.

Vitamin D Testing:
Consider asking your physician for a prescription for a 25-hydroxyvitamin D test (you can request this test by calling your physician’s office). Plotnikoff and Quigley, published in Mayo Clinic Proceedings, found that 93% of 150 patients with chronic musculoskeletal pain had vitamin D levels below 20 ng/mL. The authors concluded: “All patients with persistent, nonspecific musculoskeletal pain are at high risk for the consequences of unrecognized and untreated severe hypovitaminosis D. . . . screening all outpatients with such pain for hypovitaminosis D should be standard practice in clinical care.” As only 23% of Americans have Vitamin D levels considered sufficient (greater than 30 ng/mL), and because low Vitamin D levels are associated with a broad range of serious diseases as well as suboptimal athletic performance, the case can be made for testing all white Americans who do not have an outdoor job and testing all persons of color. The U.S. National Institutes of Health has identified 2000 IU/day Vitamin D as a tolerable intake level for individuals over age one.

Anti-inflammatory diet:
Recent research at the National Institutes of Health has linked localized myofascial pain syndrome with systemic inflammation. Andrew Weil, in his book Eating Well For Optimum Health, recommends the following dietary changes to reduce inflammation naturally, without medication:
  • "Eliminate polyunsaturated vegetable oils, margarine, vegetable shortening, all partially hydrogenated oils, all foods (such as deep-fried foods) that might contain trans-fatty acids.
  • Use extra-virgin olive oil as your main fat.
  • Increase intake of omega-3 fatty acids.
  • Eat more fruits and vegetables.
  • Eat ginger and turmeric regularly."
  • David Seaman, author of Clinical Nutrition for Pain, Inflammation and Tissue Healing, has similar recommendations, noting also the value of fish oil (not for individuals taking blood-thinning medications), Vitamin D, magnesium, and probiotics.

    Practice deep breathing exercises:
    Research has shown that combining deep breathing training with cutting-edge bodywork is significantly more effective in reducing chronic myofascial pain than bodywork alone. In a randomized controlled clinical trial, patients were taught to breathe at 5 to 6 breaths/minute, with equally-spaced inhalation and exhalation cycles, for 15 minutes at a time, twice a day.

    Exercise:
    Please do not engage in vigorous exercise on the day of an appointment.
    Medication:
    Do not stop any prescribed medication for an appointment. However,if you are choosing to take an over-the-counter anti-inflammatory drug such as aspirin, naproxen, acetaminophen, or ibuprofen, please avoid the use of such medication on the day of an appointment.

    Alcohol:
    Avoid the use of alcohol before an appointment.

    Caffeine:
    On the day of your appointment, please avoid or reduce the use of caffeine-containing products, such as coffee, black tea, and some sodas. Do not entirely eliminate caffeine from your diet if that will give you a headache.
    Sleep:
    Get plenty of sleep the night before an appointment.

    Clothing:
    Tandem Point therapy is done with the client dressed. Wear loose-fitting cotton clothing (not jeans) for Tandem Point therapy: loose cotton pants, sweatpants, or gym shorts, and a T-shirt. Corduroy or other ribbed clothing may hinder the work. During scar tissue release work, your clothing may become damp, so if painful or restricted scar tissue is part of your pattern, please bring a change of clothing. Clothing should be suitable for yoga class.

    Jewelry:
    You will be asked to remove your watch as well as all rings and other jewelry you wear to session. Therefore please avoid wearing jewelry to your appointment.

    Electrolytes:
    Women with very low blood pressure may benefit from consuming extra salt or an electrolyte complex before an appointment, especially if (a) they normally avoid salt, (b) they normally drink more than two quarts of water each day, and (c) they regularly engage in vigorous exercise that causes sweating.

    Book on stretching:
    Frequently an underlying cause of pain is a flawed stretching regimen. If you bring a stretching book to your appointment, appropriate stretches can be identified for you. One excellent stretching book is Active Isolated Stretching by Aaron Mattes.

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    P.O. Box 1023, Haddonfield, NJ 08033