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Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
May, 2013, Vol. 13, Issue 05
The Top 5 Supplements You Need for Self-Care
By Tori Hudson, ND
To propose a mere five supplements for self-care is a presumptuous task. But indeed, those of us in a position to advise others about their health, and offer healing touch, must attend to the proverbial "health thyself," if not heal, at least attend to.Dietary supplements I might recommend in everyday clinical practice depend on a patient's age, family history, medical history, current health issues and any disease burden they already carry, medications, lifestyle habits and personal and economic ability to follow my advice are all front and center variables in how I would approach each situation. With that disclaimer in mind, I offer five supplements that cover a broad range of considerations and what I might assert offer the most bang for the buck and can have some specific connection with a very physical job and close contact with many people. This list includes fish oil, rhodiola, vitamin D, turmeric and echinacea.
It is estimated that approximately 80 percent of Americans consume a diet deficient in essential fatty acids (EFAs). This is thanks to processed foods, high saturated fat diets, higher meat diets and low fish diets. The balance of fats in the typical North American diet is dramatically out of sync with the needs of our bodies. An insufficiency of fish and fish oils in our diet has led to a decrease in our intake of omega-3 fatty acids by 80% during the last century.
EFAs play crucial roles in the body on a minute-by-minute basis. They produce hormone-like compounds (prostaglandins); maintain cell membrane function; regulate pain, inflammation and swelling; dilate and constrict blood vessels; mediate immune response; regulate smooth muscle responses; prevent blood clots; regulate blood pressure and nerve transmission; regulate cholesterol levels; and even much more. Deficiencies of EFAs, which are so vital to many of the body's most basic functions, can lead to many health problems. Diseases linked to EFA deficiency include depression, anxiety, childhood developmental and behavioral problems, rheumatoid arthritis, diabetic neuropathy, cardiovascular disease, osteoporosis, breast cancer, allergies and skin conditions such as eczema.
Supplementing the diet with fish oil supplements has been shown to prevent and/or improve these health issues. The research that is the most robust for fish oils is in heart disease - reducing heart attacks, improving blood pressure, lowering triglycerides, regulating heart rhythms and much more. A high quality fish oil supplement is money well spent and the more you know, the more you will assure a product with proven purity and freshness, adequate concentration of the two fatty acids in the fish oil (EPA and DHA), and dosed according to the specific health needs she has.
Turmeric, or Curcuma long, is a common spice native to India, China and Indonesia. The main constituent group that has been identified in turmeric is polyphenolic curcuminoids, which is what is responsible for the bright yellow pigmentation. The curcuminoids represent 2% to 5% of the root which is 85% curcumin, the most well researched constituent. Properties of the curcumin include antioxidant effects, suppressant effects on mutagens, anti-inflammatory mechanisms, immune influences, inhibition of platelet aggregation and a wide range of cancer prevention actions. Curcumin also has the ability to alter lipids, improve digestion and support liver/gall bladder function. Clinical indications include generalized chronic inflammation, uveitis, chemoprevention with specific abilities to reduce the risk of colorectal and pancreatic cancers as well as multiple myeloma, cardiovascular disease, osteoarthritis, irritable bowel syndrome and gastric ulceration. My main reason for including it in this list of top five self-care supplements is due to its wide range of action and its particular research in improving joint function by improving osteoarthritis pain, stiffness and physical function. Choices of optimal turmeric products should be based on curcuminoid content and demonstration of superior absorption into the blood stream.
Rhodeola rosea, or "golden root," has been used in Eastern Europe, Scandinavia and Asia for centuries. Traditionally, R. rosea was used in folk medicine with a reputation to increase physical endurance, productivity, longevity, resistance to high altitude sickness, fatigue, depression, anemia, impotence, gastrointestinal ailments, infections and disorders of the nervous system. The roots were used as bouquets to enhance fertility in young Siberian couples prior to their marriage. The tea was used for colds and flus during the hard winters in Asia.
The Vikings of Scandinavia used the herb to enhance their physical strength and endurance - something they came to be famous for. All of this folklore first led to investigations of its phytochemistry in the early 1960s that identified adaptogenic compounds in the roots of the plant. These adaptogens, as well as the later discovered antioxidant and stimulating compounds in Rhodiola rosea, are responsible for its medicinal properties. Rosavin is the constituent currently selected for standardization of extracts.
The properties of Rhodiola rosea have been attributed primarily to its influence on the levels and activity of serotonin, dopamine and norepinephrine in the brain. It may be that the plant inhibits the breakdown of these chemicals and facilitates the neurotransmitter transport within the brain. In addition to these effects on the central nervous system, Rhodiola has been reported to increase the chemicals that provide energy to the muscle of the heart and to prevent the depletion of adrenal catecholamines induced by acute stress.
Historically, Rhodiola was observed to act in humans as a tonic, increase attention span, memory and work performance. Two human studies were able to show that individuals with fatigue, irritability, insomnia and decline in work capacity responded favorably to a Rhodiola extract dose of 50 mg three times a day. In one of those studies of 128 patients aged 17 to 55, Rhodiola alleviated fatigue, irritability, distractibility, headache and weakness in 64 percent of the cases. In a study of students, physicians and scientists, Rhodiola was given for 2 to 3 weeks beginning several days before intense intellectual work such as final exams. The extract improved the amount and quality of work and prevented decrease performance due to fatigue. Using Rhodiola during final exams appears to be beneficial as well. Medical students took a Rhodiola extract for 20 days and had significant improvements in mental fatigue, general well-being, final exam grades and physical fitness.
Several studies have shown that Rhodiola increased physical work capacity and significantly shortened the recovery time between bouts of intense exercise. In one study, work capacity was increased by 9 percent and the pulse slowed to normal much more quickly. Biathlon athletes given Rhodiola also have shown statistically significant increased shooting accuracy, less arm tremor and better coordination. Improved recovery time, strength, endurance and cardiovascular measures were also significantly better in those who took Rhodiola. While it is uncertain as to what is responsible for these effects, animal studies suggest that Rhodiola increases essential energy metabolites in the muscle and brain cells.
The reference files that take up the most space in my home library second to fish oils, is vitamin D. Vitamin D deficiency is a very common problem in the U.S., and especially in an aging population. Most of our vitamin D comes from sun exposure, and only a small amount typically obtained from food or supplements. Due to our decreasing exposure to sun, with spending so much time indoors, wearing clothing and/or sunscreen, the majority of us just don't get enough vitamin D anymore, whether we live in Alaska or Arizona.
Vitamin D deficiency is associated with osteoporosis and increased risk fractures. Lower levels of vitamin D is also associated with risks of cancers of the colon, breast and ovary. Vitamin D deficiency has other serious implications and has been associated with several autoimmune diseases, asthma, cognitive decline, depression and even increases in the risk of hypertension and cardiovascular disease. Supplemental vitamin D is being used to prevent and treat osteoporosis, depression, fibromyalgia, multiple sclerosis, breast cancer patients and much more. The most recent Recommended Dietary Allowance (RDA) recommended by the Institute of Medicine is now 600 IU per day for people ages 1 to 70 and 800 IU per day for those 71 and older. The updated safe upper limit is 4,000 IU a day for those 9 years old and above, pregnant or not. Most practitioners and a studious group of consumers realize that there are scores of studies on the many other potential health benefits of vitamin D and more individualized testing and dosing can easily occur.
The reason that Echinacea deserves a spot on the top five list is due to its ability to defend against the common cold and other upper respiratory infections. Several species of Echinacea plant are used to make preparations from its leaves, flowers and/or root. Echinacea can be taken at the first sign of a cold, after cold symptoms already start, or even routinely especially in fall/winter due to the propensity of colds and upper respiratory infections during this time. Modern research demonstrates that Echinacea can have an ability to reduce cold symptoms and shorten the duration of a cold. Echinacea can also be used for many other infections including flus, urinary tract infections, gum disease, tonsillitis, strep infections, skin infections and more. Commercial Echinacea products are available in liquid extracts, herbal tinctures, tablets, capsules and teas. There are nine species of Echinacea but the most common preparations are Echinacea purpurea and Echinacea angustifolia.
These top five supplements of fish oils, vitamin D, turmeric, rhodiola and echinacea can offer a vast and significant array of health benefits. Not only are these five supplements attractive due to the significant research that has been done, they are also appealing due to the broad scope of benefit, safety and reasonable affordability. I encourage all massage practitioners to attend to one's health, not only with important supplements, but the basics of a healthy whole foods diet, regular exercise, rest, stress management, time in nature and fun!
Dr. Tori Hudson is a naturopathic physician, national lecturer, author, award winning researcher and educator with more than 25 years of experience and expertise in women's health. She is currently in private practice serving as the Medical Director of A Woman's Time clinic and is the Program Director at the Institute of Women's Health and Integrative Medicine. Dr. Hudson also serves as a Nordic Naturals Advisory Board Member.
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