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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).
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.
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.
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%.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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.
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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