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Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
Image Is Everything: The Power of Branding
Successful businesses use color and design to attract people to their service. They understand how important image is and hire experts to create an attractive package. Starbucks works hard to create an atmosphere that is warm and inviting.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
News in Brief
Major Organizations Announce Joint Conference; Fighting for Section 2706; New Vice President of Chiro. Program at Parker; Two Families, One Chiropractic Dynasty.
The Wisdom of the Second Office Location (SOL)
There are some things I never want to do again, like riding a motorcycle 100 mph. I call these things my "negative bucket list." Other things I have on that list include water skiing, riding a roller coaster and eating habanero peppers.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
November, 2005, Vol. 05, Issue 11
By Elaine Stillerman, LMT
Approximately $5.2 to $5.5 BILLION is spent on adult diapers per year in this country and almost 12 million adults, mostly women over the age of 50, suffer from urinary (or fecal) incontinence.Don't laugh. You might wet yourself, or worse.
Postpartum women also might suffer this embarrassing condition after childbirth as a result of a traumatic birth, multiple births, directed pushing during the second stage of labor, perineal swelling, episiotomies or the use of forceps during delivery.
For the majority of women over 50, menopause causes the skin in the vagina or urethra to lose tone, thin and dry out, creating weakened pelvic floor muscles. Constipation and build-up of stool in the intestines, certain medicines, urinary tract infections, diabetes or high calcium levels and immobility are other possible causes. For men, add an enlarged prostate, tumor or prostate surgery to the mix.
Normal urination involves two phases: the filling and storage phase and the emptying phase. During the filling and storage phase, waste from the kidneys fills the bladder that stretches to accommodate the rising amounts of urine. When the bladder is filled with about 200 ml of urine, the first sensations to urinate occur. The average person can hold 350-550 ml of urine. The ability to fill and store urine properly necessitates a functional sphincter and detrusor muscle (bladder wall muscle).
Emptying the bladder requires the contraction of the detrusor muscle to force the urine out of the bladder and simultaneous relaxation of the sphincter muscle to let the urine pass. Incontinence is the inability to control urine, resulting in either occasional leakage or complete lack of bladder control. Medical literature describes four types of incontinence:
There are certain medicines, such as oxybutynin (Ditropan) that can relieve urge incontinence and too-frequent urination. Estrogen creams inserted in the vagina are used to treat mild stress incontinence. Surgery is another option to treat incontinence. This procedure attempts to return the bladder and urethra to its normal position in the pelvis. It is performed transabdominally or transvaginally requiring either general anesthesia or a local or regional (spinal) anesthesia.
While surgery can be helpful for some people with stress continence, one of the most effective methods of treating incontinence, and avoiding invasive surgery, is strengthening the muscles of the pelvic floor by using Kegel exercises. These exercises were developed in 1948 by Dr. Arnold Kegel to treat postpartum incontinence by restoring functional integrity to the pelvic floor and improving urethral and rectal sphincter function.
Over a third of women begin Kegels by tightening the wrong muscles and have to be taught to identify the correct muscles. The abdominal, back, buttock and thigh muscles have to remain relaxed and only the pelvic floor muscles should be involved in this process. One way to identify the correct muscles is to have the woman stop urinating while on the toilet. Let the muscles relax and tighten again until she can identify the muscles she has to use. Another way is for the woman to place her finger in her vagina and try to tighten around it.
Biofeedback can help a woman (or a man) identify the pelvic floor muscles or electrical stimulation involving a low-voltage electric current can stimulate the correct group of muscles. Physical therapy also might be very useful.
The exercises should be performed three or four times a day, with 10 to 20 repetitions each time.
It might take several weeks before most people notice a difference, but it's well worth the effort. When done correctly, Kegel exercises are 50% to 80% effective in improving urinary incontinence. That sure beats the alternatives.
Click here for previous articles by Elaine Stillerman, LMT.
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