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Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
January, 2012, Vol. 12, Issue 01
The Potential Dangers of Taking Medications During Pregnancy
By Elaine Stillerman, LMT
We tend to think that if the Food and Drug Administration approves a medicine, it is safe for us to take. And we don't give a second thought to the potential side effects of over-the-counter (OTC) medicines since they don't require prescriptions.But are these popular medications safe for pregnant women and their developing babies? Since very few drug trials involve pregnant women, how can anyone be sure that there are no harmful side effects or birth defects from these seemingly innocuous medicines?
Conception occurs about two weeks before the next menstrual cycle is due, and a positive confirmation of pregnancy may take another few weeks, so there is a window of extreme vulnerability for the growing baby if mom takes certain medicines (drinks or smokes) during this sensitive time. OTC drugs are used by many pregnant women and, as a rule, are generally safe. Some, however, have what are considered to be unproven safety and/or potentially harmful effects on the growing babies. Since an estimated 10% or more of birth defects are a result of maternal drug exposure, the FDA has assigned a risk category to each drug.
OTC medications that are considered relatively safe during pregnancy include most antacids, Acetaminophen, Chlorphenramine, Kaolin and Pectin preparations - although all expectant women should discuss the use of any and every medication (and herb) with their care providers. As an example, seemingly harmless Vitamin A (Retinol) used for skin conditions has shown to contain powerful teratogens which may cause serious birth defects. On the other end of the safety spectrum are drugs like H2 blockers, Pseudoephedrine, and Atropine/Diphenoxylate, to name a few, which are dangerous for developing fetuses.
During the 1940s – 1970s, DES (diethylstilbesterol) was often prescribed during pregnancy to prevent a miscarriage. That was until the daughters (and sons) of these DES mothers developed all sorts of reproductive anomalies and cancers during puberty. Then the use of this drug during pregnancy was immediately discontinued. But not until after the reproductive lives of thousands were adversely affected.
And for those of us old enough to remember the 1960's when thalidomide was prescribed to treat nausea during pregnancy, the images of those deformed babies was seared into our collective memories (remember the picture on the cover of Life Magazine?). Its use was quickly stopped after nearly 10,000 babies (mostly in Europe) were born with major physical disabilities – phocomelia, or seal-like flippers for arms and legs. Of course, the way these drugs received approval was very different 50 years ago than it is now.
The general rule is to avoid all drug exposure (including herbs and aromatherapy) during the first trimester when the fetal organs are developing (organogenesis) to prevent structural and functional abnormalities. Most drugs can cross the placental barrier (this includes pain medications and nerve blocks received during labor) and expose the developing embryo and fetus to harmful effects.
There are certain factors affecting placental drug transference and teratogenic effects:
Even one intrauterine exposure can have harmful effects. Thalidomide, for example, had catastrophic effects after brief exposure. When it comes to over-the-counter medications, some of them have unproven safety records or are known to affect the fetus. More than 80% of pregnant women take OTC or prescription drugs during pregnancy. Pain medications are widely consumed during pregnancy for relief of common aches and pains. A Danish study reported a direct link between the use of prescribed NSAIDS and miscarriages. Kaiser Permanente Medical also concluded the use of NSAIDS during pregnancy increased the risk of miscarriage by 80%, particularly when they were taken around the time of conception.
Categorized for risk during each trimester (1/2/3), this is a list of common analgesics used in pregnancy: Acetaminophen (B/B/B), Aspirin (D/D/D), Ibuprofen (B/B/D), Ketoprofen (B/B/D), and Naproxen (B/B/D). All of these drugs cross the placental barrier. Cold medicines, such as decongestants, expectorants, and antihistamines, may be unsafe during certain trimesters or their risk profile is unstudied.
Since most drugs taken while nursing are found in breast milk, all drugs and medications should be used carefully, conservatively and under medical supervision. The good news is that the concentration of the drugs in breast milk is low and the baby's exposure is less than what would be considered to be a therapeutic dose. If medication has to be taken while nursing, it is advisable to take the dose 30-60 minutes after nursing and 3-4 hours before the next feeding. This provides adequate time for the drugs to clear out of mother's blood, so the concentration in her breast milk will be minimal.
Pregnancy is a time of excitement and change. As the baby grows, mother's body adapts to the posture of pregnancy which can lead to aches and pains. Instead of reaching for that pill bottle, if she can, mom would be well-advised to pick up her phone and make an appointment with a qualified prenatal massage practitioner. So much safer and so much more pleasant.
Click here for previous articles by Elaine Stillerman, LMT.
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