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First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
May, 2003, Vol. 03, Issue 05
Applications of CranioSacral Therapy in Newborns and Infants, Part I
By John Upledger, DO, OMM
CranioSacral Therapy has proven effective in identifying a number of disorders affecting children, including dyslexia, hyperkinetic behavior and motor-control problems.It's also good at alleviating such conditions when they're caused by restrictions in the dura mater membranes of the craniosacral system. I believe the few minutes necessary to conduct a craniosacral system evaluation in the delivery room, or shortly after birth, is a worthwhile investment in any child's future health and well-being.
In 1977, we did a great deal of clinical work at Michigan State University (MSU) to discover how the newly discovered craniosacral system affected patients. For research purposes, I had to develop a standardized evaluation tool. By that time, I had done enough hands-on work that it was fairly simple to come up with the 19-step protocol, which was used by four different examiners to see whether or not the findings were in agreement. The examiners were unaware of each other's findings until each statistician had completed his work. Using this protocol, we examined 25 nursery-school children and found an 85- percent agreement among the four examiners, which took their individual subjective findings out of the realm of chance. Clearly, we were dealing with a craniosacral system that could be evaluated reliably using only the hands of a trained examiner. Based on this study, I considered the evaluation protocol a valid research tool.
I went on to use this protocol on 203 grade-school children. An independent statistician-psychologist correlated my results with the childrens' academic and behavioral performances, and with the medical/obstetrical history of each mother and child. Statistical data analysis revealed that the process was capable of identifying children suffering from dyslexia, hyperkinetic behavior, seizures and motor-control problems. It also could identify babies delivered by Caesarean section or forceps, and those who had suffered oxygen deprivation at the time of delivery.
Based on those results, we opened a clinic at MSU for brain-dysfunctional children. We also received funding to research relationships between autism and craniosacral system dysfunction. The clinic opened in late 1977, and the autistic research was carried out from September 1978 through June 1981. All of this work led to the following impressions and conclusions regarding the effects of craniosacral system dysfunctions on central nervous system (CNS) function.
Maternal Illness or Toxicity During Pregnancy
Maternal illness or toxicity during pregnancy usually results in a generalized tightness of the fetal dura mater, which makes the membrane less able to comply with the rhythmic volume changes of cerebrospinal fluid flowing within the craniosacral system. Frequently, this is a consequence of a maternal viral infection during the last six months of pregnancy. (Maternal bacterial infection is a less likely cause.) We've also seen cases in which tight membranes seemed related to the mother's respiratory difficulties, such as asthma, or to toxin problems, whether from a single experience or ongoing exposure. The toxins could be taken in as food, drink, medicines or street drugs, or inhaled as air pollutants or airborne allergies.
Usually, such a generalized tight-membrane syndrome manifests as gross dysfunction of the child's central nervous system: Sensory and motor deficits, while extremely variable, are obvious. Most often, CranioSacral Therapy greatly affects or completely corrects these problems. The treatment is particularly effective when applied during the first few weeks of an infant's life. If allowed to persist, the noncompliant-membrane syndrome may be severe enough to become a strong contributing factor to the development of autism. Other problems, such as maternal injury, emotional upset or fetal malposition in the pelvis over a prolonged period, are more likely to produce specific clinical symptoms related to craniosacral system dysfunctions that can be discovered quite easily. Proper application of CranioSacral Therapy - the earlier the better - usually is quite effective.
Craniosacral System Dysfunctions Related to the Delivery Process
Delivery of the newborn involves passage of the child through a convoluted birth canal. I believe vaginal delivery represents a child's first CranioSacral treatment, spinal mobilization, myoneural system treatment and sensory-stimulation session. In my opinion, all of these serve to prepare the infant for the rapid transition from life inside the womb to the outside world. Nature seldom makes design errors, and I certainly don't believe the birth canal is one of them.
The bones of the vault of the fetal/newborn skull are hard places in the membrane. There is ample room between their edges for overriding and changing of the head's shape so it can pass through the birth canal. This passage represents a "manipulation" of the skull bones by the birth-canal walls; it ensures their proper mobility, so that after delivery, the bones are able to comply with the motion of the craniosacral system.
Cases of skull-bone overriding usually self-correct as the child's head expands and reshapes after exiting the birth canal. Should this not occur within minutes, a CranioSacral therapist can correct these situations easily. Left uncorrected, override problems can contribute to seizure tendencies. We often find a persistent override between the parietal and frontal bones in spastic conditions such as cerebral palsy. When corrected, these conditions usually improve or disappear entirely.
The squeezing of the child's head during delivery also may act as a circular wringer that encourages the permeation of cerebrospinal fluid into and throughout the brain tissue, down the spinal canal and throughout the subdural spaces. This squeezing motion helps the venous blood drain from the skull vault, so that as soon as the head is delivered from the birth canal, fresh arterial blood can enter the vault and further activate the circulatory systems of the brain. It also offers the first scalp massage.
Most infants are delivered face-down, with the mother in the supine position and the child's occiput coming out under her pubic bones. Many well-meaning delivery attendants feel a need to speed up the process. Obstetrical lore contends that when the head comes out, we must hasten to complete the delivery, since the birth canal may be squeezing the umbilical cord against the infant's body. This cord compression is thought to potentially occlude blood flow to the infant, which may result in brain damage due to hypoxia. In other words, the attendant's good intention translates into grasping the child's head and pulling; in doing so, the head can be hyperextended, which may create a "jamming" of the skull's occipital bone forward into the V-shaped receiving-joint surfaces, located on the superior surface of the 1st cervical vertebra (atlas).
When there is danger of injury, the soft tissues of the body contract or splint. If splinting occurs with the child's occiput jammed in this forward position, it will stay that way. In that case, the contracture of soft tissues at the juncture of the skull base and the top of the neck may compromise areas of the jugular foramena on the right side, the left side or both. If the jamming is more severe, it may compromise the foramen magnum.
The jugular foramena allow several important structures to pass out of the skull, including the jugular veins that drain most of the venous blood from the head into the neck. The foramena also afford passage to the IXth, Xth and XIth cranial nerves. The glossopharyngeal (IXth) and vagus (Xth) cranial nerves work jointly to help control swallowing, airway function, and the larynx, pharynx and esophagus. The glossopharyngeal nerve also works along with the hypoglossal (XIIth) cranial nerve to control the tongue and oropharynx. Additionally, the vagus nerve helps maintain a normal heart rate and is involved in stomach and bowel function. When dysfunctional, the vagus nerve can contribute to a sense of dizziness.
The hypoglossal (XIIth) nerve exits from the skull through the hypoglossal canals, located beside and beneath the joint surfaces of the occiput as it articulates with the atlas. Consequently, jamming can easily result in tongue control problems, such as tongue thrust. The spinal accessory (XIth) cranial nerve innervates some of the major muscles of the neck; when dysfunctional, it may create spasm of the sternocleidomastoideus and/or the portion of the trapezius muscle in the neck. This may continue after birth due to ongoing compression/irritation of the nerve as it exits the jugular foramen, which may then produce a torticollis.
We call this type of craniosacral system dysfunction "occipital base compression." If both sides of the occipital base are severely compressed, it's common to see colic; food regurgitation; esophageal reflux; respiratory difficulties; rapid heart rate; and compromised bowel function (constipation or diarrhea). There also may be spasm of the neck muscles. If left uncorrected, the situation may result in hyperactive child syndrome and attention deficit disorder. When the occipital base jamming is less severe, or only on the right or left side, any combination of these symptoms may be present.
Fortunately, occipital base compression can usually be corrected by a skilled CranioSacral therapist in a matter of minutes, if the child is treated during the first weeks of life. Treatment is most effective when performed during the first few days of life - or even in the delivery room, after the umbilical cord has been cut and the child has been suctioned and wiped clean. The sooner the child is seen, the less treatment normally is required.
If neck-muscle spasm is allowed to persist, it can cause temporal bone dysfunction in the craniosacral system. This has been shown to be a strong contributing factor in children with dyslexia and other reading problems. Interestingly, correcting these dysfunctions in school-age children often allows them to catch up to normal reading levels in a matter of weeks, unless psychological and/or emotional scars are in the way. If they are, psychoemotional therapeutic modalities must be incorporated into the treatment program.
Click here for previous articles by John Upledger, DO, OMM.
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