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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.
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.
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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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%.
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).
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.
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.
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).
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.
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.
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.
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.
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 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.
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.
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.
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.
January, 2012, Vol. 12, Issue 01
Nurturing Touch in the NICU
By Tina Allen, LMT, CPMMT, CPMT, CIMT
When a baby is born prematurely, parents and caregivers of babies in the Neonatal Intensive Care Unit (NICU) may face some serious challenges. One of the main challenges is likely providing appropriate tactile stimulation.This can be difficult given the number of doctors rounds, medical equipment and requirements for medical interventions. Not only are there the physical limitations, but also consider the emotional component of seeing your baby covered in medical tubes, much smaller in size than you imagined, and the insecurity of not knowing what would be appropriate or might cause harm. When baby does become stable enough for touch, what can a parent or caregiver do to provide comfort to their child? One of the best approaches can be infant massage.
Touch therapy research has demonstrated that nurturing touch for an infant is critical in establishing the foundation of their psychological well-being. When it comes to babies born prematurely, this can become even more important. Evidence has shown that massage therapy provided for neonates:
These recent research findings show there are significant benefits to infant massage that out weigh over-stimulation. Even a simple intervention of massaging a baby's leg prior to a heel stick might decrease pain responses. A nurse I trained at the Sutton's Children's Hospital used this very technique. With the parent's permission, she provided a gentle massage to a neonates lower extremities prior to rounds for blood draw. When the healthcare provider "poked" baby's heels and began to take the sample, he commented about how quickly it worked, and the need to only "poke" once. The nurse shared with me, how she smiled and let the healthcare provider in on her secret. A little massage goes a long way! Now, the healthcare provider plans to massage each baby's legs before administering a heel stick. Not only did it make his job easier, the baby cried less. Sounds like a win-win for all involved. Properly applied techniques produce increased benefits and should be used safely to ensure effectiveness.
Due to the baby's immaturity at birth, it is not appropriate to immediately begin providing massage therapy, but rather to implement nurturing techniques employed by parents and healthcare providers. Once the infant is stable enough, skin-to-skin contact should be utilized to provide appropriate stimulation and encourage bonding between parent and child. This skin-to-skin contact might be in the form of placing the baby securely on the parent's chest as is done with the technique of Kangaroo Care. Kangaroo Care can be a very simple, but powerful intervention providing the infant with stability in regulating heart rate, respiration and body temperature.
There are specific guidelines and protocols to follow prior to introducing infant massage in the neonatal intensive care unit. In addition to providing regular attentive care such as cuddling, holding and comforting, massage should be introduced slowly and with extra care. The baby must meet minimal weight and neurological requirements prior to introducing infant massage. However, as the baby shows stability in response to Kangaroo Care, nurturing touch and containment holds are the next steps to safely progress towards the introduction of infant massage therapy.
Containment holds are performed while always being mindful of the baby's states, cues and all verbal and non-verbal communication. Caregivers are encouraged to watch the baby closely for physiological cues (color changes, tremors, startles), motor state (tone, reflexes), behavioral state (alertness) and skin state (response to stimulation) responses. Whenever the baby exhibits any stress cues or overstimulation cues, it is time for the baby to have a break from tactile stimulation.
The best way to perform containment holds is to first ask the caregiver to relax and then proceed slowly. It is always optional for parents and caregivers to provide nurturing touch, as opposed to outside healthcare providers. This is due to the fact that the caregivers need to feel competent caring for their baby, as well as to encourage bonding to take place between parent and child.
The caregiver should always ask the baby's permission prior to beginning, by speaking gently, warming their hands and asking if it is okay to continue. Throughout the hands-on session, caregivers must watch baby's cues and follow their lead. Mindful of any medical apparatus, hands placed in two safe locations on baby's body. Common places to begin include head and feet, both arms/shoulders, and back/abdomen.
First, caregivers consider each baby's individual touch history and medical intervention history, and caution is used in areas where we believe the baby may have experienced discomfort. Especially on the heels, time must be taken before ever touching the heels. Due to the repetitive heel sticks these infants receive, touching this area might not immediately be well received.
It is imperative that any and all monitors are watched for changes, and that direct placement over medical apparatus is avoided. No lubricant is used on the hands while performing containment holds, as doing so may cause hands to slip, increase possibilities of infection or possible dislodgement of medical lines.
Parents are reminded to always watch baby's cues and make eye contact. Due to an infant's compact sensory receptors and their developmental immaturity, a little touch goes a long way. It can be very easy to cause over stimulation. This is never our goal. Sometimes, just placing your hands on two areas, then pausing and starting again another time, is the best route to safely introduce nurturing touch and containment holds without overstimulation.
Safety and precaution is always the best way to introduce touch in the NICU. Due to their baby's compromised health, many families with babies in the NICU have some delays in bonding. Delays in the bonding process might occur for a variety of reasons, and nurturing touch, along with infant massage, can be very beneficial in contributing to establishing the bond between parent and child.
Nurturing touch and massage contain all of the elements necessary to begin the process of bonding, introduce appropriate tactile stimulation and encourage healthy development. When provided safely, infant massage might be just the nurturing intervention an infant needs to cope with medical interventions and encourage optimum development.
Click here for more information about Tina Allen, LMT, CPMMT, CPMT, CIMT.
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