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Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
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.
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.
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%.
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).
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.
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
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.
May, 2006, Vol. 06, Issue 05
To C or not to C? That Is the Question
By Elaine Stillerman, LMT
Part of the work of a prenatal massage practitioner is to support your clients' decisions about their pregnancies and birthing preferences in a nonjudgmental environment. Hopefully, we also can educate them about the ramifications, benefits and potential risks associated with their decisions.In other words, make sure they are making informed decisions based on all the facts (without imposing our own will on them.)
However, I find it rather upsetting to watch the elective C-section rate escalate (it's up 36 percent in the past five years),1 simply because women don't want to go through labor. When asked if they are aware of the risk factors involved in major abdominal surgery, the reply often is, "What risks? My doctor never said anything about risks."
There are a number of medical situations and emergencies that account for approximately 70 percent of all Cesareans. They might include failure of labor to progress, questionable fetal health, prior Cesarean, and fetal malpresentation or breech presentation. In other and less frequent instances, abnormal placentation, obstruction of the birth canal, maternal illnesses and infections and cervical cancer might be indicators of a surgical delivery.23,4
However, even in some of these medical cases, the diagnosis of a C-section might be based on false or incorrect interpretations of instrumentation, and many surgeries are performed when there is little or no risk to the fetus or laboring woman.
There is no question about the safety and benefits of a Cesarean section when the medical need is compelling. However, as with any surgery, a Cesarean section is not without its risks. Whether it is performed out of medical necessity or as an elective decision, women need to be informed about the potential dangers. Dr. Peter Bernstein, MD, the author of "Complications of Cesarean Deliveries," divides the risk of surgical deliveries into three categories: short term, longer term, and those that present risks to future pregnancies. He also recognizes that risk factors are heightened when the surgery is not planned or in an emergency, compared to when it is a planned surgical delivery. Dr. Bernstein's article features the work and research of the Maternity Center Association, New York City.
Some of the short-term risk factors involving a C-section include maternal death (although low),5,6,7 thromboembolism and stroke (deep-vein thrombosis resulting in pulmonary embolism is one of the leading causes of maternal mortality after a C-section),8 excessive bleeding and hemorrhage,9,10 infection,11,12,13 rare accidental surgical injuries, particularly bladder or to a lesser degree, intestinal injuries,14 longer hospitalization,1516 pain,17 and an unhappy birth experience with a longer period of time needed to bond with the baby.18 In the long run, complications from a Cesarean might include additional hospitalization or readmission after discharge,19 incision pain,20 scar and adhesion formation,2122 emergency hysterectomy, or difficulty conceiving another pregnancy.
Although most surgical deliveries are safe for the newborn, there still are some risks that must be explored. C-section newborns are four times as likely to die than vaginally delivered babies,23 experience a higher incidence of asthma and respiratory problems,24,25 the birth is more traumatic,26 and these babies often fail to breastfeed.27 In addition, future pregnancies might be affected, with such complications as uterine rupture at the site of the initial incision,28 abnormal attachment of the placenta,29 and the need for a hysterectomy.30
While it's true that modern sanitary conditions and surgical competence reduce the chances of many of these complications, clients should be advised about the risk factors when electing to have a Cesarean. While we can't make up their minds, we can offer documentation to give them a clear picture of what their choice could mean.
Click here for previous articles by Elaine Stillerman, LMT.
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