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Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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 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.
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.
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.
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.
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%.
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.
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).
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
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 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.
May, 2011, Vol. 11, Issue 05
Obesity and Childbirth
By Elaine Stillerman, LMT
It's a sad fact that Americans are growing fatter every year as obesity rates are increasing faster than originally estimated. I am not referring to a few extra pounds or the pleasantly plump silhouette, but rather the serious health risks involved in carrying excessive weight.More than one in four Americans (72.5 million) were obese in 2009 and nine states (Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee, and West Virginia) reported 30 percent of their population was obese in 2009. In 2007, there were only three states that made that unfortunate claim. The highest rate was 34.4 percent in Mississippi. (Only Colorado and Washington, D.C. had obesity rates under 20 percent.)
The medical costs of obesity are estimated to be $150 billion a year. Obese people are more likely to die from heart disease, stroke, diabetes, and cancer than thinner people. The American Institute for Cancer Research projects there will be more than 103,000 cases of cancer caused by obesity in 2010. Forty-nine percent are expected to be endometrial cancer, 35 percent esophageal cancer, and 28 percent will develop pancreatic cancer. Nearly 112,000 deaths are caused by the complications of obesity every year.
The reason is simple enough: not enough exercise and too much of the wrong kinds of food. This epidemic is affecting our children too: one out of three children in the United States is now overweight or obese. This puts them at a higher risk for developing heart disease, diabetes, and cancer during their lifetimes. One-third of children born at the beginning of this millennium are expected to develop diabetes and the current generation is expected to have a shorter life span than their parents due to obesity rates. In addition, girls as young as seven or eight are developing breasts and reaching puberty much earlier, in part due to increasing rates of childhood obesity. I wrote for a PBS-TV show years back, and we did a segment on childhood obesity. I learned that for most six year olds in this country, the only 'vegetables' they ate were French fries.
And for pregnant women who are overweight or obese, the risks to them and their babies are of great concern. Obesity contributes to the increase in Cesarean section, more birth defects, and more maternal and neonatal deaths. Cesarean section rates increase tremendously the fatter the woman is. The National Institutes of Health reports that women with a 30-35 body mass index (with 20 BMI being the equivalent of a woman 5'6" weighing 124 lbs) have 25 percent more C-sections on average, 35-40 BMI equates to a 33 percent increase in C-sections, and over 40 BMI results in a 43 percent increase in surgical deliveries. (Body mass index is a calculation of body fat based upon an adult's height and weight. A BMI of less than 18.5 percent is considered underweight; 18.5-24.9 percent is considered average; 25-29.9 percent is considered overweight; an index of 30 percent or more is considered obese.)
In addition, obese women have few choices where or how to have their babies. For most, natural childbirth is not an option. Their heightened risk factors disqualify them from having home births or opting to have their babies in birthing centers. So a hospital birth is their only option. Hospitals have also had to adapt to the increase in maternal weight by purchasing longer surgical instruments, larger beds and gurneys, and increasingly more sophisticated fetal testing machines.
The birth experience for many of these women (and their babies) is far from ideal. Local anesthesia is difficult to administer because the additional bulk makes it nearly impossible to feel the spine and find the right place for an epidural, so general anesthesia has to be given. Doctors also find themselves in awkward, uncomfortable positions since they often have to stand on stools or platforms to reach over the patient's abdomen.
And the babies don't fare well. Babies of obese mothers are almost three times likely to die within the first month and obese women are almost twice as likely to have a stillbirth, which is the death of the baby after 20 weeks gestation. In New York State, between 2003-2005, 2 out of 3 maternal deaths were attributed to obesity.
Within New York City, a consortium of hospitals is considering creating specialized centers just for obese maternity cases. The maternity care the patients would receive would also include nutritional counseling and weight loss programs and would be staffed with sufficient medical personnel to handle emergency C-sections and intensive neonatal care. The cost of caring for these women and their babies can reach more than $200,000 as compared with $13,000 for a normal delivery.
From a massage point of view, these women are considered high risk for pregnancy and labor complications. And if they already have diabetes, signs of hypertension or blood clots, excessive swelling, thrombophlebitis, or cardiovascular disease, massage may have to be ruled out entirely.
Although the costs of obesity and its sequelae are staggering and add an unnecessary burden to health care costs, the bottom line isn't the bottom line. And it certainly isn't about fat-bashing. It's the health and survival of these women and their children that has to be of paramount concern. Making smart food choices and learning to eat nutritionally sound meals are small prices to pay for a long, happy, and healthy life with your child.
Click here for previous articles by Elaine Stillerman, LMT.
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