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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."
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.
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.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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.
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.
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.
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.
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.
January, 2005, Vol. 05, Issue 01
"Peek-a-Boo, I See You": Obstetric Ultrasound
By Elaine Stillerman, LMT
Expectant mothers ask for it by name. They often can't wait to get to their obstetricians to "see" how their babies are growing. A remarkable diagnostic tool called ultrasound enables mothers and doctors to peak into the mysterious world of the life and growth of the fetus in-utero.But is it safe and accurate? Are women being protected, or are they being offered a false sense of security about the health of their babies? And what about this burgeoning business of keepsake images and videos of unborn babies? Are eager mothers courting danger with this unnecessary exposure to ultrasound radiation?
Originally developed during WWII to help the military detect enemy submarines, this technology wasn't used in clinical obstetrics until the early 1960s. The use of ultrasound has now become a routine practice in prenatal care in most industrialized countries. Ultrasound uses ultra-high frequency sound waves that bounce off internal structures to produce images (sonograms) of organs, tissues, blood flow, or, in obstetric instances, the developing fetus. According to the Food and Drug Administration (FDA), there are legitimate medical reasons to use this prenatal test: to confirm pregnancy, assess fetal age, diagnose any fetal abnormalities or birth defects, evaluate the position of the placenta, and determine whether there are multiple pregnancies. Generally speaking, when a trained professional administers the test, it is assumed that its benefits outweigh any risks; however, some experts feel that even medical application of obstetric ultrasound has not been fully tested and is not without risks.
There is a lack of epidemiological studies on the risk of ultrasound on human fetuses, although animal studies have shown altered growth, low birth weight, diminished immune response and a deviation in genetic material from high doses of ultrasound. Studies on humans exposed to ultrasound have shown some serious side-effects, including pre-term labor or miscarriage, low birth weight, delayed speech, and fewer instances of right-handedness, which is viewed as brain damage to the developing brain. According to some doctors, ultrasound has its place in clinical diagnosis but not during pregnancy. Many physicians are losing their ability to confirm gestational age through a bimanual examination because they rely so heavily on technology, and medical schools rarely teach this palpatory skill.
Other concerns about the medical use of ultrasound include different powers of energy emanating from the equipment itself (the machines are becoming more powerful and there is inadequate data or control on levels of output) and the misreading of these tests by technicians or doctors. A study conducted on the accuracy of ultrasound at a major women's hospital in Brisbane, Australia, showed that ultrasound missed almost 40 percent of fetal abnormalities. Many genetic and physical disabilities, such as Down Syndrome, or heart and kidney disease, cannot be picked up from an ultrasound. False positives (an abnormality is detected when it does not exist) may occur, and uncertain interpretations can be extremely stressful for the expectant couple.
There are other serious considerations. The number of elective scans is increasing as doctor's routinely use the test at many prenatal visits, sometimes exposing their patients - and fetuses - to periods as long as one hour. The traditional transabdominal scan is now being replaced with the transvaginal scan, which probes even closer to the growing fetus. New developments, including the Doppler ultrasound, 3-D ultrasound and even 4-D (moving or dynamic 3-D) scanners are currently available to women.
The 3-D ultrasounds are also referred to as "entertainment scans" and provide clearer pictures of the fetal face and movements. What is of greater concern is that the technicians who perform these entertainment ultrasounds are neither regulated nor certified by the states where they do business. Appealing to their emotions, expectant parents are being courted by a number of new companies who claim that this 3-D technology is safe and can offer them the chance of a lifetime to photograph and video their unborn child (doctors use 2-D imaging.) They claim that these pictures help couples bond early with their babies. For a fee of about $80 for a short session, couples can learn the baby's gender. For $300, a half-hour session (exposure) will record fetal movements on a videocassette or DVD; color photos are included in this package. The recommended gestational age is between 28 and 32 weeks for the "cutest" images.
The FDA strongly cautions against the use of ultrasound for these keepsake memories. They insist that nonmedical use of ultrasound is not a wise idea. The FDA also regulates medical equipment and is trying to crack down on the "entertainment" use of ultrasounds. Along with the FDA, the American Institute of Ultrasound in Medicine and the European Committee for Medical Ultrasound agree that the nonmedical use of ultrasound must be discouraged and that the use of 3-D ultrasound for psychosocial or entertainment purposes is inappropriate and contrary to responsible medical care.
The use of a diagnostic ultrasound during pregnancy may provide some valuable information about the well-being of the fetus. It can also be emotionally comforting to see the fetus' heart beat. But the advance of technology needs to be kept in perspective and in the safe hands of those qualified to use it.
Click here for previous articles by Elaine Stillerman, LMT.
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