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Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
October, 2010, Vol. 10, Issue 10
Premature Ovarian Failure (POF)
By Elaine Stillerman, LMT
The New York Times recently cited a 2008 report which showed that birth rates for women over 40 years of age rose 4 percent over the previous year and a 2009 survey indicated that 14 percent of people in their prime childbearing years decided to delay becoming pregnant due to the economic recession. For some of these women, this decision may have dire consequences on future pregnancies.
For nearly 1 in 1,000 women (1 percent to 4 percent, or 250,000 to 1 million) between ages 15-29 years old who delay pregnancy, it may already be too late. These women may have a condition called premature ovarian failure (POF). It is also referred to as primary ovarian insufficiency, premature menopause, or hypergonadotropic amenorrhea.
When girls are born, we generally have enough eggs in our ovaries to menstruate monthly from puberty until the supply is depleted and menopause ensues. But in women with POF, there either aren't enough eggs at birth or there is something genetically wrong or dysfunctional with the ones they have. (There is also a possibility of surgical intervention, such as removal of the ovaries, and radiation or chemotherapy that can bring on early menopause.)
When this occurs at an early age, it is considered a natural, yet premature menopause and the symptoms are the same as in older women: cessation of menstruation, hot flashes, night sweats, decrease in breast size (or lack of breast development in puberty), vaginal dryness, mood swings, loss of energy, dry eyes, low sex drive, painful sex, bladder control problems, and insomnia. While these symptoms usually accompany POF, some women with the condition have periods and hot flashes, or no periods and no other symptoms.
A simple blood test to check the levels of FSH (follicle-stimulating hormone) can indicate the presence of POF. High levels of FSH usually confirm the diagnosis. However, that same blood sample can be used to test for other genetic causes of POF, and these should not be overlooked. A positive result for any genetic causes may have a significant effect on the carrier's long-term health, if not her immediate fertility.
Genetic or chromosomal causes of POF may include: Turner syndrome (the absence of two functioning X chromosomes affecting 1 in 2,500 women), Swyer syndrome (a condition also called XY gonadal dysgenesis or the lack of functioning gonads), Androgen Insensitivity syndrome, or premutation of Fragile X (the most common inherited cause of cognitive impairment, global developmental delays, seizure disorders, carried by 1 in 259 women worldwide [and 1 in 800 men]. Approximately 20 percent of women who carry the defective gene have POF).
There may be a family history of early menopause or some enzymatic or metabolic defects such as galactosemia (when the body is unable to metabolize galactose), thalassemia major (an inherited blood disorder where the body makes an abnormal form of hemoglobin), or hemochromatosis (wherein the body cannot break down iron and blood levels escalate).
Autoimmune diseases may also be causative for POF: thyroid dysfunction, rheumatoid arthritis, polyglandular failure I and II, diabetes, pernicious anemia, adrenal insufficiency, vitiligo, and lupus erythematosus.
But missing a period and its fertility sequelae are only part of the concern with POF. Women with POF are at higher risk for osteoporosis and heart disease. And of course, infertility, although 6 percent to 8 percent of women with POF can become pregnant.
The current medical treatment for POF is hormone replacement therapy (HRT). The dose generally starts out low to give the woman's body a chance to acclimate itself. Then the dose is gradually increased to a level higher than menopausal women. Sometimes birth control pills are prescribed in lieu of hormone replacement therapy. About 1-2 months after the start of HRT, a menstrual cycle may begin, accompanied by increased breast size, cramps, and even PMS.
Acupuncture and massage can have palliative effects on the symptoms of POF, helping reduce the discomforts associated with this condition. Points that support the reproductive system and hormone production are very useful.
Having a baby is still not out of the question, however. IVF with donor eggs may work for some women, while adoption may be the better choice for others. And while there is no current cure, support groups can be a great help and benefit. With so many young women experiencing this dramatic change in their lives, it's wonderful to know you are not alone.
Click here for previous articles by Elaine Stillerman, LMT.
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