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Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
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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