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Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
May, 2006, Vol. 06, Issue 05
Celiac Disease, Part 2: What Is Going on Here?
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
In the March issue (see www.massagetoday.com/archives/2006/03/16.html), I introduced the basic concepts behind celiac disease (also known as celiac sprue), a disorder involving an inflammatory reaction to gluten.When people with celiac disease eat gluten-containing products (which is hard to avoid in processed foods), the body launches an immune response that damages or even destroys the intestinal villi. This makes it impossible to absorb nutrients, not just from gluten-rich foods, but from everything else as well.
One point that came up in reader responses to part 1 of the article was a need to clarify the difference between wheat allergy and gluten sensitivity. A wheat allergy is an immune response to anything with wheat in it; this is typically rare, and is detected in infants and young children who experience inflammatory reactions when they include wheat products in their diet. Gluten sensitivity, by contrast, is a reaction to incompletely broken-down gluten in the GI tract. The symptoms are not immediate, and they are not limited to wheat products, because gluten is found in many other grains as well.
Symptoms and Complications of Celiac Disease
Celiac disease can be mild or severe, depending on the severity of the inflammation and the extent of damage to the villi. Very severe cases are diagnosed in young children as "failure to thrive," since the affected child can derive little value from food. More often, it occurs as a subtler problem that is easily misdiagnosed as irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, hypothyroidism, lactose intolerance, candida, depression, or other chronic, multi-system conditions. Some people don't develop symptoms until adulthood, often after a stressful trigger such as an infection, surgery or childbirth.
Signs and symptoms of celiac sprue usually are arranged around malabsorption and malnutrition. Pain, gas, bloating and diarrhea are common. Stools tend to be high in volume, oily and very foul smelling. Anemia, irritability, depression, osteoporosis and muscle cramps are other frequent signs or complications of celiac disease; any one of these can be traced to poor absorption of nutrients, including iron, B12 and vitamin D. Poor absorption of folic acid can lead to neural tube defects (i.e., spina bifida) in infants of pregnant women with celiac disease.
Other dangerous complications of celiac disease are associated with chronic inflammation in the GI tract: Adenocarcinoma or lymphadenoma are cancers of the small intestine linked to celiac disease. Non-Hodgkins lymphoma is another type of cancer with a statistical connection to this disease.
Research is underway that would create a drug to limit intestinal T-cell hyperactivity in the presence of incompletely broken-down gluten. This might eventually open the door to a less limited diet for celiac disease patients. In the meantime, the best treatment option is to avoid gluten in any form, which is a considerable challenge. Flour made from corn, potatoes, beans or soy can be used as a wheat flour substitute. Fruits, vegetables, fish, and meats (that are neither marinated nor breaded) also are gluten-free. It's possible to have a varied and well-balanced, gluten-free diet, but eating processed foods or at restaurants might be problematic.
The good news is that the majority of celiac disease patients who can avoid all sources of gluten for months or years heal completely, and achieve the complete rebuilding of their intestinal villi. However, a person with celiac disease must commit to a lifelong dietary adjustment to accomplish this.
Massage has some specific cautions in the context of gastrointestinal tract problems. Because many symptoms of GI problems (gas, bloating, indigestion, constipation) can be related to stress, many people find that massage, even if not administered directly to the belly, has a positive effect. Most of the time, this is wonderful, but not always. GI symptoms are notoriously vague. The complaints of a person with irritable bowel syndrome (a functional problem that, although painful and inconvenient, is not life-threatening) can be similar to the symptoms of a potentially dangerous problem, such as ulcerative colitis or diverticulitis. Therefore, if a person finds that massage relieves symptoms, even temporarily, an accurate diagnosis might be delayed. Massage therapists should encourage clients who report new or persistent GI problems to seek medical advice, regardless of whether massage temporarily relieves symptoms.
In relation to celiac disease specifically, massage has no direct impact on the health of intestinal villi. Consequently, massage can neither improve nor exacerbate celiac disease. However, its ameliorating effects can make the transition to a gluten-free diet easier to take - if you can't have chocolate cake anymore, at least you can have a wonderful massage!
For Next Time
I've been receiving inquiries lately about MRSA: methicillin-resistant staphylococcus aureus, the causative agent behind some difficult and stubborn skin injuries. Massage therapists exposed to this pathogen are at particular risk for spreading it to others. If you have experience with this condition, write to me and let me know: What's on your table? Until then, many thanks and many blessings.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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