Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Peaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
May, 2012, Vol. 12, Issue 05
Gestational Diabetes: Does She or Doesn't She?
By Elaine Stillerman, LMT
Nearly every pregnant woman is tested for gestational diabetes (GD) (or gestational glucose intolerance - GGI) at some point during her second trimester. But what constitutes a "normal" blood glucose level during pregnancy and when maternal or fetal morbidity occurs is controversial.
What is evident in cases of confirmed gestational diabetes is that babies grow larger, weighing over 4000g at birth (fetal macrosomia) or are in the 90th percentile for large-for gestational-age (LGA). And that often increases the likelihood of a surgical delivery and newborn monitoring for hypoglycemia. In the long term, these elevated levels appear to contribute to obesity and diabetes later in the child's life and an increase in the risk of the mother developing type 2 diabetes. On average, however, the rate of confirmed glucose intolerance is small and varies among different ethnic groups. Caucasian women are affected 1% to 2%, Afro-Caribbeans 2% to 3%, and Asians 4% to 5%.
The etiology of defining GD as a medical condition began in the 1950s with a study on women with high sugar values during pregnancy. It was "validated" in 1964 when Drs. O'Sullivan and Mahan, medical researchers, performed a 100g 3-hour oral glucose tolerance test on more than 700 pregnant women who were already hyperglycemic. Their study was to determine if these women were at greater risk of developing diabetes in the future. To no one's surprise, they were. And that led these two men to conclude that the "metabolic stress of pregnancy" exposed women to a "pre-diabetic status." But keep in mind, their research subjects had preexisting high blood glucose levels.
They also made an erroneous correlation that since insulin-dependent diabetes is a known risk to developing babies, this "pre-diabetic status" was as well. But their theory is unfounded. Diabetes types 1 and 2 are completely different in their manifestations and dangers than GD (GGI). For instance, both type 1 and 2 may result in blood vessel and kidney damage, the sequelae of which could be hypertension, insufficient circulation to the lower extremities, possible limb amputation and kidney disease. GD carries none of these risks.
Vacillating levels of high and low blood sugar during early pregnancy in type 1 diabetes might cause congenital malformations or miscarriage. Again, none of these serious complications are caused by GD. The only thing diabetes 1 and 2 share with GD is that the excess glucose goes directly to the babies, making them larger than they would be without the elevated blood sugar levels.
During pregnancy, the pancreas usually produces adequate amounts of insulin to regulate blood sugar levels. However, the hormone HPL (human placental lactogen) inhibits the maternal body's ability to transport the insulin properly out of the bloodstream and into cells, where it is used as fuel, resulting in elevated levels of glucose in the blood - or GD. So, in essence, there is more circulating blood sugar which the baby uses to grow and develop. And as pregnancy progresses, this delicate balance between adequate insulin levels and circulating blood sugar becomes trickier. After eating, blood sugar levels rise and by the time the third trimester comes, blood glucose levels are higher after eating than a woman who is not pregnant. (After a night's sleep, excess insulin goes to work to balance out the extra blood sugar, so morning levels of glucose are actually lower during pregnancy than in nonpregnant women - hypoglycemia.)
But there is a difference between elevated blood sugar levels and diabetes. And current research has not determined when high blood glucose levels, just shy of diabetes, cause harm to mothers and their babies. So screening for GD should come with an understanding, by both mother and her care provider, that the results may or may not be an indication of a serious problem.
Women can actively participate in their health during pregnancy by eating healthy, wholesome foods. They can avoid or control GD by consuming a diet rich in whole foods, high protein and high complex carbohydrates. They can start by eliminating empty calories - soda, white flour, white sugar, fructose and limit sweet desserts. Any food with a sugar content of more than 6 grams (read the label) should be accompanied by a protein source. Milk, often recommended by care providers for the necessary calcium it provides, and yogurt are filled with (milk) sugar and lactose is known to increase blood sugar levels. So consuming excessive dairy products might be contributing to high glucose values.
When eating cereals, the protein and fiber content should be more than 5g per serving and there should be less than 10g of sugar. One third of protein should come from complex carbohydrates. A glycemic index will help some women make healthier choices. And think color when it comes to food choices - the more varied and deeper the pallet, the healthier meals will be.
Clients with GD can still enjoy the benefits of massage. However, it is important to remember that massage, in general, lowers glucose levels. So you have to make sure your client's blood sugar level doesn't get too low, which can lead to impaired judgment and potential accidents. By providing your clients with a nourishing snack, it will raise their blood glucose level enough to get home safely where they can enjoy a healthful, wholesome meal.
Click here for previous articles by Elaine Stillerman, LMT.
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