Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Online Marketing Basics: Google Ranking, Part 1
We all know there is so much opportunity with online marketing. And, let's face it, if you don't have a presence online with a website and social media, you are probably not where you want to be.
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
December, 2002, Vol. 02, Issue 12
Living in the Laboratory
By John Upledger, DO, OMM
One day in September 1998, I went to the dentist to have a cavity in a lower molar filled. I had a slate of patients that afternoon, so my dentist suggested I go without anesthetic.It took one shot of air into the cavity to convince me I was not of the ilk to have a non-anesthetized filling. That single squirt of air put me into orbit.
Consider that the right lower molar is innervated by the right mandibular nerve, which feeds into the trigeminal ganglion. This ganglion receives input from the other two branches of the trigeminal nerve: the maxillary and ophthalmic nerves. That shot of air sent a shock into my trigeminal ganglion, which then went straight into the trigeminal nuclei. These nuclei, which are bilateral, extend from the upper pons down through the medulla and into the upper spinal cord.
It just so happens that the trigeminal system has the most plentiful connections to the reticular alarm system of any of the 12 cranial nerve systems. My connections were obviously effective. I found myself in a ready-alert condition that wouldn't quit. I even tried to talk to my reticular alarm system to soothe it, but the relief was only temporary. Then I tried visualizing a gauge from 1 to 100, with the needle pointing at the number representing my level of alertness. My needle was at about 90, nearly to the max. With a lot of hard visualization I was able to get it down to about 30, but every time I got tight again the needle would shoot up to 90.
This went on until the dentist was able to see me again the next week. It was after hours, so he was slightly rushed. As he froze my jaw, he explained that he was doing a mandibular nerve block instead of the usual "infiltration," since it worked faster. Of course, my mouth was full of instruments, so I couldn't object.
As he injected the lidocaine near the medial aspect of my right mandibular ramus, I felt excruciating pain. It felt like he was sprinkling hot embers on my chin from the lip to under the mandible, and from the mandibular notch forward to the vertical midline of my chin. What went on for minutes felt like hours. My rational mind knew instantly that his needle point had pierced my mandibular nerve. In my mind's eye, I could see the two or three cc's of lidocaine fluid separating my nerve bundles and tearing apart the integrity of the supporting structures formed by the glial cells, as the hydraulic forces of the fluid wreaked havoc on my mandibular nerve. I could feel my trigeminal ganglion quivering with anxiety as it sent a continuous SOS message to my reticular alarm system.
At this point, I had to control an urge to run or attack my attacker. Instead I sat quietly, mouth wide open, with all the suction pumps and drills making their noises. I'm sure he did a nice technical job, but by the time he was finished nearly an hour later, I was on full alert.
That evening, the right side of my mouth stayed numb and lacked motor control for about five hours. Then, at about 3:00 a.m. I awoke with an extremely sore throat. It was on the right side, extending through all the hyoid-related tissues down to my right clavicle. The sore throat evolved into a cough which stayed in the throat, above the clavicle. By the next day, the pain was complemented by neck stiffness and right-sided temporal head pain, which involved the right occipitomastoid and the right temporoparietal sutures.
To make a long story short, I was a mess. Unfortunately, I had to fly to Detroit to do a three-hour CranioSacral Therapy presentation the next day. I did fine, but had to work harder to concentrate, and my throat, neck and head still hurt quite a bit. I flew home totally exhausted, which is unusual for me. Instead of recovering, I was deteriorating.
Over the next few weeks, I received sessions in a variety of modalities - CranioSacral Therapy, energy cyst release, SomatoEmotional Release, myofascial release, chiropractic -and started to feel some relief. Then came Sunday, September 27, 1998. My whole world opened up when the root causes of my troubles presented themselves. At this point, my wife Lisa was getting a bit concerned about me. I had never been so exhausted and miserable for such a prolonged period of time - three weeks. I called the dentist's office to find out exactly what he used to inject my mandibular nerve. It was lidocaine with epinephrine.
First synthesized in 1937, lidocaine is a stable local anesthetic, also used intravenously to treat cardiac arrhythmias, especially during catastrophic events such as myocardial infarctions. As an anesthetic, it prevents the generation and conduction of the nerve impulse. The main site of action is in the nerve cell membrane. Supposedly, there is little or no residual effect upon the neuron when lidocaine is used in the small doses required to interrupt impulse generation and conduction. Conventional thought is that when the gross effect wears off and sensation returns, the drug is gone. However, in our Upledger Institute workshop "The Brain Speaks," we have gotten the distinct impression that local anesthetics are stored for long periods of time between the lipid layers of the neuronal membranes. This, in turn, has a long-term effect on the neurons in question: it produces post-anesthesia hyperexcitability.
If you think about your teeth - their crowns, root canals, fillings and things that just don't feel right, or remain hypersensitive to heat, cold, sugar, what have you - it could be that the innervation to these teeth has remained hyperexcitable because of residual effects of the local anesthetics in the neuronal membranes.
Now, let's consider the epinephrine. A synthetic version of a natural hormone that comes largely from the adrenal gland, it's used with local anesthetics because one of its effects is to constrict the blood vessels with which it comes in contact. This keeps the local anesthetic from being too rapidly cleared from the site of injection. The result is a prolonged anesthetic effect. Functionally, epinephrine is adrenalin. Whatever the name, it has a powerful effect upon the sympathetic nervous system. It raises heart rate, increases blood pressure, inhibits visceral activity, and generally increases the alertness of the reticular alarm system. But my reticular alarm system was already riding high. It did not need an epinephrine boost.
Now, back to that Sunday in 1998, when my concerned wife treated me with CranioSacral Therapy. She began by "arcing" from my feet, then coming up to my mandible just to the right of the midline. As she placed her hand there, I began to experience the same strong taste I had in my mouth when the dentist injected me with lidocaine and epinephrine. The taste remained for most of the session. Soon Lisa was releasing a tremendous "energy cyst" from my anterior mandibular region just to the right of the midline, and from the ramus of the mandible on that side. I felt the effects of her work in my right ear, all of my lower teeth on the right side to the anterior midline, some of my upper teeth on the right side, into my head and neck, down into the hyoid and into the right clavicle and shoulder. The related muscles were all very much involved.
The overwhelming sensation was deep ache and pain in all these structures and tissues. In my imagery, the right mandibular nerve had been damaged by the injection. It was also clear that Lisa was removing energy and subatomic particles that were residual within the nerve. As I visualized this energy ,I saw electrons derived from the nerve injection material that had spread throughout the course of the mandibular nerve into the trigeminal ganglion. The ganglion was trying to contain these toxic energies and electrons, but wasn't completely successful. Some of these energies and electrons had spilled into the maxillary and ophthalmic nerves, as well as into the spinal cord, thus creating effects in the neck and throat.
Much of the cranial dysfunction was the result of the toxic effects upon the meninges, especially by challenging the magnetic crystals located in the dura and the pia mater. It has been shown that there are 100 million single-domain magnetite crystals in a single gram of both dura and pia mater membranes, and five million per gram of brain tissue. I'm sure errant energies and electrons or other subatomic particles could easily stress these systems and result in pain and dysfunction.
After Lisa cleared most of this toxic residue, I experienced remarkable relief. I thought we were finished. No sooner did I get that thought than a crown on the 2nd molar on the lower right side began to hurt again. This crown had been less than comfortable for the decade I'd had it. It had felt hypersensitive and somewhat out of place. Lo and behold, the same thing happened. In my imagery, residue of the local anesthetics began to clear and more energy cysts released. As this occurred my crown began to feel more comfortable in my mouth.
That's when I started feeling much less tired, more comfortable, and less wired. Certainly there was a more to go, but by that time I was well on the road to recovery.
So, what's the moral to this story? There is perhaps no better way to learn than by living in your own laboratory.
Click here for previous articles by John Upledger, DO, OMM.
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