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NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
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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