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Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
February, 2013, Vol. 13, Issue 02
Following a Road Less Traveled
Finding the cause of chronic shoulder pain where you least expect it.
By Debbie Roberts, LMT
What do you think a shoulder injury, breast augmentation, lymphatic system, mammograms and orthopedic assessments have in common? A road less traveled would be the answer.I never dreamed when I added another tool to my tool box of Manual Lymphatic Drainage that it would lead me down a path to help thousands of women and, specifically, my very best friend. The information I am about to relay to you will not only help you be aware in your every day practice, but will hopefully bring about a global warming effect to the importance we can play in a women's life.
The Shoulder Injury
My dear friend is a personal trainer, yoga instructor, egoscue practioner, and a gyrotonics trainer. She is also one of the healthiest people I know, but she was suffering from a should injury that just would not heal. The injury was caused by slipping off of a stability ball while performing a tricep dip. Being a trainer, she immediately iced, took arnica and rested. She went to see her chiropractor and naturopath for additional help and examination. After doing three to four months of exercises for shoulder rehabilitation, she still lacked complete range of motion and there was an ongoing dull, nagging pain.
She began thinking there must be a myofascial component to the injury, so she made an appointment to come see me. I performed ROM and manual muscle testing to the shoulder joint. I found loss of flexion by 10 degrees, loss of external ROM by 20 degrees, a positive impingement sign and some weakness to supraspinatus and infraspinatus (indication of a possible partial tear). Based on these assessments, I suggested making an appointment with an orthopedist, to hopefully get a MRI done so the rehabilitation process has a complete picture and nobody is guessing. This wasn't the route she wanted to take. She wanted to try some soft tissue work first and continue the shoulder rehabilitation exercises. I explained that in four visits or less we would know if massage therapy, combined with her doing her own physical therapy, would help. In two weeks, there was improvement happening with the range of motion, but there was still this dull pain.
Anytime I see a patient, in the back of my mind is always Hilton's Law. Hilton's Law as espoused by John Hilton in a series of medical lectures given in 1860-1862, is the observation that the study of anatomy often finds that a nerve that innervates a joint also tends to innervate the muscles that move the joint and the skin that covers the distal attachments of those muscles. Not ready for the traditional medical route, she sought more chiropractors care. He adjusted the shoulder and rib cage which made her pain increase, reduced her range of motion, and now she had a burning in the sternum. Be sure to read on because it wasn't his technique that was the problem. She was in so much pain from the adjustment that she came back to see me to try to calm down the symptoms and now there was a palpable place along her sternum that was mobile and felt like a piece of calcium. I performed again the orthopedic assessments to determine where we were from the last time I saw her, and this time in addition to loss of external range of motion, there was an audible clicking sound (possible labrum tear). I begged her to go seek out an orthopedist's opinion and possible MRI. She ignored me yet again and another couple of months went by with her still in the same place.
Here is where the breast augmentation comes in. Another symptom appeared in her opposite breast from the shoulder problem. The right breast had begun to sag and take on an odd appearance. This finally forced her into seeking out medical care in the form of a plastic surgeon. He did an ultrasound and found that both breast implants had ruptured and had been leaking for what appeared to be a very a long time. This contributed to the underlying cause of why she could not heal. The surgeon found tremendous calcification in the chest wall underneath her breast, which had to be scrapped in order to add a new implant. If a woman's silicone gel implant ruptures, it might feel less full or flatter, and may bulge where the rupture is. This can be accompanied with pain or tenderness, swelling, numbness, burning or tingling. Her implants had been in for more than 23 years.
He put new implants back in and sent her home to rest. The right breast did fine, but the left breast stayed swollen. After one MLD session, the breast immediately became softer. Her surgeon was impressed and told her to continue the MLD. In the meantime, she went back to work and when I saw her on the next visit, her breast was back to square one swollen and uncomfortable. Red Flag! She also didn't feel well and was experiencing flu-like symptoms and her axillary lymph nodes were swollen and tender to touch. Another Red Flag! Lymphatic overload. Another trip back to the doctor and he had to remove the implant because the underlying tissue was just not healing. She will get the implant eventually, but not until the chest wall has time to heal. I can report finally that without the implant, she is back to her usual good state of health.
What a lymph node does is filter the lymph and fight infection and in which lymphocytes, monocytes and plasma cells are formed. Most lymphatic nodes are clustered in areas such as the mouth, the neck, the lower arm, the axilla and the groin. The lymphatic network and nodes of the breast are especially crucial in the diagnosis and treatment of breast cancer.
The suspected mechanisms of breast-implant rupture are:
What to watch out for and how you can contribute to patient education:
And finally, remember Benjamin Franklin's great quote: "By failing to prepare, you are preparing to fail."
Click here for more information about Debbie Roberts, LMT.
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