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Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
May, 2005, Vol. 05, Issue 05
"V-Back" to the Dark Ages
By Elaine Stillerman, LMT
The popular belief that "once a Caesarean section, always a Caesarean section" came from a paper printed in 1916 called "Conservatism in Obstetrics," which cautioned doctors to avoid a primary C-section for fear that it would cause surgical deliveries in future births.At that time, the national C-section rate was two percent. Further support of avoiding C-sections and urging vaginal births after C-sections (VBACs - pronounced "vee-back) came during the 1980s when studies at large urban hospitals indicated that a vast majority - nearly 80 percent - of women had safe vaginal births after C-section(s).
While not every woman is a candidate for VBAC, eligible candidates were overwhelmingly sought to have vaginal births when given the option. In 1996 in the United States, vaginal births after C-sections went up from 19.9 percent to 28.3 percent, and in Europe to 50 percent in 1997. In this country, government health experts supported VBACs as a way to minimize and control rising C-section rates, which reached 24.4 percent in 2001. The report published in 2000 gave a goal of increasing VBAC rates to 37 percent of births by the year 2010.
But instead of following these guidelines, just the opposite occurred. The rates of VBACs dramatically dropped from 28.3 percent in 1999 to 10.6 percent in 2003. Today, at hundreds of small hospitals across the country, women are being told that they have no choice in the matter and must undergo a surgical delivery or be sent to larger medical centers, often miles away from their homes, families and doctors, to give birth vaginally. This even includes women who have already had successful VBACs. "Once a C-section, always a C-section" has come back to haunt us.
What went wrong? It seems that during the late 1990s, reports started coming in, particularly from rural settings, about women who had ruptured their uterus during labor without the presence of medical staff to deal with the emergencies. This caused widespread panic among doctors and hospitals and compelled the College of Obstetrics and Gynecology to revise their VBAC guidelines and stipulate that a doctor should be "immediately" available, rather than the previously worded "readily" available, in the event of an emergency. In other words, it required small, understaffed hospitals to have a medical team present at all times just in case of labor complications. Since many of these hospitals don't have that kind of medical staffing, they decided instead to ban the practice of VBAC altogether regardless of a woman's wishes. The other, and possibly more insidious reason, was the rampant fear of lawsuits.
In the majority of instances, the uterine scar from a previous C-section is very tough and able to withstand the contractions of an arduous labor. The rate of uterine rupture occurs less than two percent during a VBAC, the same degree as in repeated C-sections. None of this seems to impact the decision, however.
What doctors are failing to address is why the uterus might rupture in the first place. Some data (although inconclusive), suggests that the use of hormones to induce labor, or speed it up, such as prostaglandins and pitocin (synthetic oxytocin), increases the chances of rupture as much as 15 times. In midwifery practices, where labor augmentation is not used, VBACs are performed without any complications in the majority of cases. Uterine dehiscence (asymptomatic separations of the uterine scar) in a non-induced labor occurs in the same proportion as repeated C-sections, but some doctors and hospitals are still not willing to take the chance on a vaginal birth.
In third world and developing countries where sanitation is questionable, cephalopelvic disproportion (large fetal head size to small maternal pelvis size) is common, and access to medical care may be hours away, dehiscence of the scar may cause further uterine tearing and threaten the life of mother and child. But in the United States, which ranks 11th out of 117 in the world of the best countries to have a baby according to the 2003 survey "The Complete Mothers' Index and Country Rankings," published by Save the Children Foundation, serious rupturing is rarely a problem, particularly if labor-inducing and augmenting medications are not administered.
There are many reasons why women seek a VBAC. There is certainly less trauma to the body and a vaginal birth is easier to recover from than major abdominal surgery. The risks of surgical complications, including hysterectomy, increase with each C-section and the emotional satisfaction derived from a vaginal birth is unsurpassed. When a woman prefers a more family-centered, natural birth experience, she should be able to have one. The choice must belong to the women. Many women are more than willing to assume the risks and responsibilities of a vaginal birth after a C-section and believe that their decisions are being undermined by hospitals whose primary concern is the bottom line, a fear of lawsuits, and doctors who find surgical births more lucrative and easier to manage than vaginal births.
Little by little, women's reproductive rights are being whittled away by doctors who refuse to learn the necessary, life-saving medical procedure, D & C (dilation and curettage), because it can be used to perform abortions; by insurance companies who put birthing centers and dedicated doctors out of business as a result of their unaffordable malpractice premiums; by misogynistic extremists in Washington who use our bodies as legislative fodder to take away our reproductive choices; and by small-minded hospitals who force women to cede ownership of their bodies and dictate to them how to have their babies. We are indeed going back to the Dark Ages.
Click here for previous articles by Elaine Stillerman, LMT.
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