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How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
July, 2006, Vol. 06, Issue 07
Are You Feeling Hot, Hot, HOT?
By Elaine Stillerman, LMT
Humorously referred to as a "power surge" or "my own private Florida," hot flashes are no laughing matter. They probably are the number one symptom of menopause in Western societies. It's interesting that these sweats are not as common in some Asian countries or Mexico where only about 10 percent of menopausal women suffer from hot flashes.1 One theory postulates the reason Japanese women have such low rates of hot flashes is due to their high fiber, low fat and high consumption of soy diet.
It's estimated that anywhere from 50 to 90 percent of American women of a certain age experience hot flashes; referred to medically as vasomotor flushes.2 Nobody really is sure what causes them, but there are a number of speculations.The most common explanation is that lower estrogen levels and declining ovarian function are causative. (This also can explain the profuse sweating a postpartum woman experiences when her estrogen levels dramatically drop after the baby is born.) But this theory cannot apply to women with low levels of estrogen who do not have hot flashes or women with estrogen excess who get them. The fact that almost 30 percent of women treated with placebos have an improvement in hot flashes also might indicate there is more involved than estrogen.
Other factors that might trigger hot flashes can be explained by the complex neuroendocrine reactions to thoughts and emotions. Spicy food, hot drinks, alcohol, sugar, caffeine, stress, heated environments and tobacco also might be triggers.
Another theory suggests they are brought on by a dramatic, sudden downward normalization of the body's internal core temperature. Since estrogen and progesterone are significant in regulating temperature, a decrease in their levels might contribute to a shift in the body's ability to control temperature. Studies with both natural progesterone creams and prescription estrogen show a significant reduction in hot flashes.3
As our clients reach peri-menopause, menopause and post-menopause, these flushes or hot flashes can be very uncomfortable, not to mention embarrassing. They seem to occur at the most inopportune times and can be very disruptive of restful sleep. They start as mild to intense heat that spreads through the upper body and face. Red blotchy skin might appear on the face, arms and back or the face might appear flushed. Cardiac rate increases and often copious amounts of perspiration appear, followed by a chill as the hot flash subsides.4
They can be short, lasting only a few seconds or as long as 30 minutes, although most diminish after 5 minutes. They can occur every hour or occasionally. They can disturb sleep at night or creep up at any time during the day. And they can drag on for years, well into menopause.
Lifestyle changes are an integral part of any natural approach to treating hot flashes and the massage therapist's first line of defense in treating hot flashes is a soothing massage that increases endorphins and allays stress. Pressing Spleen 3, found at the medial aspect of the feet, posterior and inferior to the head of the first metatarsal, can help balance hormones. Your client should discuss all these suggestions with her doctor before deciding which suits her best.
Some medicinal plants have been used for centuries as female tonics. (Author's note: It's essential that your client discusses any herbal remedies with a naturopathic physician or some medical authority with a knowledge of herbs who can determine which herbs are beneficial and at what doses. Herbs are medicines and it's outside the scope of our practice to diagnose and prescribe medicines.) Herbs that have palliative, soothing effects on the female reproductive system and endocrine glands are black cohosh, motherwort, chaste berry tree, blue cohosh (can potentially raise blood pressure to dangerously high levels when too much is taken; must be avoided by any woman with high blood pressure); red clover, ginseng, dong quai (rich in estrogen), licorice, sarsaparilla and false unicorn.5
The effects of black cohosh in treating menopausal symptoms has not received extensive research in the U.S., although the herb has
Soy and red clover have plant-derived, estrogen-like compounds called isoflavones that mimic a weak form of the body's estrogen. This might explain why women who consume soy-rich diets have fewer hot flashes. Clinical trials in the U.S. have yielded inconclusive results. There also is a concern that isoflavones could cause cancer and those women with breast cancer, or who have had breast cancer, should discuss the efficacy of taking isoflavones with their doctor.
Simple lifestyle changes include wearing layers of loose clothing made of natural fibers; exercising daily; sipping a cool drink at the onset of a hot flash; avoiding excess alcohol; avoiding spicy food and caffeine; employing stress reduction techniques such as yoga, meditation or a massage; quitting smoking; taking vitamin E; increasing soy intake; taking evening primrose oil capsules; sleep in a cool room; drinking plenty of water throughout the day.
There are many women who choose hormonal therapy when natural approaches are unsuccessful or symptoms are extremely severe. Estrogen or progesterone therapy can relieve symptoms, but personal risks and benefits have to be considered. Taking certain antidepressants might decrease hot flashes, especially when they are from a class known as selective serotonin reuptake inhibitors (SSRI). Brand names might include Paxil, Prozac, Celexa, etc.7
An off-label use of the medication Gabapentin (Neurotonin) that is FDA-approved to treat epileptic seizures and the pain
Women can't avoid menopause. Whether it was chemically or surgically induced, or just a matter of normal aging, these power surges are an annoying part of it. But women can be more in control of their bodies by adopting simple lifestyles changes and understanding that this, too, shall pass. Now, open a window. Is it hot in here, or is it me?
Click here for previous articles by Elaine Stillerman, LMT.
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