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Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
June, 2002, Vol. 02, Issue 06
Mighty Joe Defies the Odds
By John Upledger, DO, OMM
By most doctor's accounts, Joseph Polk shouldn't be here. He was born on October 15, 1998 with arthrogryposis, an extreme case of congenital joint contractures. His condition had been diagnosed through a level-two ultrasound while he was still in the womb.
"Doctors first told me he had trisomy 18," said Joe's mother, Mary Polk, a long-time critical care nurse and lactation consultant.Trisomy 18 indicates the presence of an extra chromosome, which creates a condition normally incompatible with life.
Doctors advised Mary and her husband Wally to immediately terminate the pregnancy. They decided to fall back on their faith, a choice they believed had served them well in the prior births of four healthy children. Mary simply refused further prenatal testing.
It turned out the doctors were wrong about much of Joe's diagnosis. This was just the first of many ways they would underestimate the spirited little boy who became known as Mighty Joe.
As expected, Joe was born with severely contracted, hardened limbs. "He looked like a pretzel," Mary said. "His arms were straight and hard. His elbows weren't discernible. His wrists were bent in full flexion and his fingers were completely crippled. On top of that, his feet were flipped up."
Fortunately, Joe didn't have the trisomy 18 doctors had diagnosed, and his other vital signs were all healthy. He cried heartily, sucked strongly and scored high on both Apgar tests. Yet all those positive signs barely softened the blow of the overwhelming obstacles now facing Joe and his family.
"Right away doctors told me his arms were paralyzed and he'd need at least seven surgeries," Mary said. "They even suggested a drastic move that would fix one arm in a state of flexion so he could feed himself. Then they wanted to permanently place his other arm down to accommodate his toiletry."
Two leading Chicago specialists confirmed this course of treatment, agreeing it would leave Joe severely handicapped. While both parents agreed to foot surgery for Joe to avoid long-term use of leg braces, they were reluctant to take such radical steps with his arms and hands. That's when Mary got the idea to pursue another form of therapy she had heard about.
"I had taken a board-certified lactation course before Joe was born," Mary said. "The instructor mentioned something called CranioSacral Therapy for suck disorders. I had no idea if it would help in Joe's case, but I read up on it and thought it couldn't hurt." So when Joe was five months old, Mary took him to a CranioSacral therapist in their Wisconsin hometown. "After the first session, he started moving his fingers and his arm muscles softened a bit," Mary said.
Encouraged, she then brought Joe to see me when I was in their area teaching a symposium. After examining Joe, I told Mary that I felt he would regain full use of his arms and hands. How did Joe's surgeon react to the news? "He just laughed," Mary said.
Refusing to be discouraged, Mary brought Joe to The Upledger Institute's HealthPlex Clinical Services in South Florida. He received three days of concentrated CranioSacral Therapy from staff clinicians Roy Desjarlais, LMT, CST-D, and Rebecca Hunt, OTR.
"We did a lot of dural tube mobilization to free up the spinal cord segmentally as well as globally," Roy said of his sessions with Mighty Joe. "His nerve roots were then able to relax and work more efficiently, which in turn facilitated releases in the contractures in his hips and elbows.
"We also balanced his reticular alarm and autonomic nervous systems to help free up the cranial membranes. And there were significant sessions releasing the maxilla and vomer that helped with Joe's cranial base, brain stem, and again, his alarm system. Of course, all the work helped facilitate fluid exchange between Joe's central nervous system and the rest of his body, which did a great deal to increase body efficiency overall."
"The change was dramatic," Mary said. "Joe's whole body posture and physical appearance changed. His face filled out. He started obtaining more range of motion in his wrist joints and elbows, and he was moving all his fingers." Back home a week later Joe began bringing his arms and hands to his face to play peekaboo, and he was finally using a sippy cup on his own. "Our whole family celebrated," Mary said.
Since his first visit, Joe has been to UI HealthPlex once again, and has seen Wisconsin therapists Dodie Corcoran, CMT, and Molly Oakford, PT, for ongoing CST. Mary she said Joe can now feed himself, color with crayons and cut with scissors -- and the doctors no longer suggest surgery.
Indeed, Joe has already gone far beyond what anyone had predicted. "He's an incredible little child," Mary said. "He's very intelligent with an extensive vocabulary. He's also loving and kind and very, very sensitive. He's just a wonderful person."
Mighty Joe's biggest strength may well be his will to fight. "Despite all the odds, he's pulled through," Mary said. And what lesson has she taken from all this? "No matter what body or mind we are given," she said, "the soul is precious and vital. You can't devalue that perfectness in any person, in any living being. That's what I've learned that's profound."
Click here for previous articles by John Upledger, DO, OMM.
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