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A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
July, 2008, Vol. 08, Issue 07
Age-Related Changes and Conditions, Part 2
By Ann Catlin, LMT, NCTMB, OTR
Last month, in part one of this article, we explored the typical changes that occur in physical and mental condition and function as people age. If you serve older adults in your practice, it's important to have a working understanding of signs and symptoms that might point to an underlying disease.Although we certainly aren't in the role of diagnosing any condition, we do have the responsibility to be watchful of changes and to refer to other health practitioners when appropriate. While some age-related changes generally are thought to be "normal," others might be signs of disease. Being informed about and anticipating such changes will strengthen your ability to assess your clients' needs, initially and on an ongoing basis.
Assessing the needs of elder clients might require you to modify your approach to fit individual differences in functional abilities. The purpose of any assessment is to determine four things:
Being willing to change how you conduct your assessment is critical to accommodate an older clientele. With a few practical adaptations, you will be able to gather the information you need to serve your clients with confidence.
Develop keen observation skills. Use you eyes, ears and intuition to gather information. By tuning in to both the person and the environment, you learn about functional abilities, posture, movement and pain. The client's reason for having a massage and their goals will determine the extent of the assessment. First, find out why they are getting a massage and go from there. The information you need will be different if they are there because their doctor referred them due to shoulder pain or because their daughter gave them a gift certificate.
Make the assessment process "user friendly." Simply asking your client to fill out your intake form might not be the best way to get the information you need. Many elders have difficulty writing due to arthritis or tremor. Even reading the small print of your form might be daunting to some. A few simple changes will save time and frustration for you and your client:
Even if a family member or friend accompanies your client, direct your questions and other communication to your client, not the companion. This empowers and honors the elder, and helps to establish a therapeutic relationship.
Signs of Possible Disease
The information you gather on your assessment form is only part of the story. Older adults often experience changes in physical or mental states that can be observed by looking, listening and feeling. If you sharpen your observation skills, you might pick up on important information not only during the initial assessment, but also during each visit. You then can make sound professional choices about how to proceed. The following changes might indicate an underlying condition or disease.
Vision: Sudden change in vision; eye pain, redness or swelling; or excessive discharge.
Hearing: Severe or abrupt hearing loss; ringing in the ears; or loss of balance.
Skin Conditions: Itching that causes sleep loss; new skin lesions or ulcers; mole that changes; bleeds, oozes, changes color or shape, or becomes larger; scars from past surgery; rash; edema; or red, shiny appearance (inflammation).
Bones and Joints: Pain that decreases mobility and range of motion; inflammation; scars from past surgery; recent fracture; or postural deformity (e.g., kyphosis of the spine).
Mobility: Physical pain, stiffness or swelling that inhibits the ability to accomplish daily activities; balance disturbance; decreased coordination; or a recent fall.
Urinary System: Burning on urination; urgency to urinate; "leaking" and stress incontinence; pain in the side or back; or incontinence.
Cognitive: Abrupt change in personality or signs of confusion or disorientation.
Being informed and ready to adapt to a client's changing needs will give you greater confidence in your skills, allowing you to enjoy the rich rewards of serving older adults in your practice.
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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