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The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
December, 2009, Vol. 9, Issue 12
Heating Up Your Practice Safely, Part 1
By Dixie Wall, Contributing Editor
Over the last decade, many bodyworkers have begun using stones, not to replace human touch but as an additional relaxing and leveraging technique. Traditionally used by Egyptians, Shamans and American Indians, stones have a long history of therapeutic use and spiritual healing.Today, incorporating stones in one's practice offers this ancient tool, to not only relax clients but also give our hands a rest. Hot stones are a form of thermal and magnetic therapy, requiring a unique trust between the client and practitioner. A respect for the trust bestowed in us by our clients need to be developed by a safe and meticulous protocol to perform this primal technique.
After attending a hot stone seminar this summer, I was immediately reminded how splendid hot stone massage is, not only for the client but also for the therapist. Throughout my years of practice, I was always hesitant to use any type of tool, I never cared for the way the tools felt on my skin, either giving or receiving. Yet with rocks, especially smooth and warm ones, the feeling is different. There is an instant primal connection to a real rock from the ocean or a riverbed, which is relaxing to the spirit and nurturing to the soul.
Hot stone massage is usually done with basalt lava stones, which contain high levels of calcium, magnesium and iron. These minerals can facilitate balance within our energy centers or chakras, and they can move stagnation within our channels and meridians. Many therapists use cold stones as well. These may be smaller marble stones or quartzite crystals. Cold stones are commonly used on the face.
Stones and heat are both very powerful. When not treated with respect and vigilance, they can actually injure the client. Other types of heat therapy to keep in mind include hydroculator wet packs, water bottles, herbal compress bags and infra-red heat lamps.
Last fall, I published a three-part series on malpractice and liability claims. Many of these claims frequently involve burns from hot stones, cupping and hydroculator packs.
And while we are well aware of all the benefits of hot stones and other heat therapies. Over the winter months, we will discuss several treatment procedures, contraindications and cautions of which we should be aware as we provide therapeutic heat, especially hot stones to our clients. This month, we will discuss treatment procedures, skin typing and informed consent.
It is of utmost importance to have set procedures. We must follow a methodical, yet simple, protocol in our treatment rooms to ensure the safety of ourselves and our clients. Sloppy procedures and little or no training are the number one causes of burns in the treatment room. Why do client's get burned? Usually because stones are too hot.
According to Michael Schroeder, vice president of the American Massage Council, "The most common problem with hot stones is the method therapists are using to cool down the stones. If they are too hot, therapists often use cold water to cool them down, but this only cools the external layer of the rock.
"After placing them on a client, the superficial layer of the stone quickly becomes hot again, sometimes burning the client. The therapist doesn't realize they have only temporarily cooled the external layer. This means if the stones are too hot, the only way to cool them down is time. We can put them on a washcloth next to the heater, turn down the temperature and wait for them to cool."
Additionally, always test stones on your own forearm before placing them on the client. Our own hands may not be a safe temperature gauge because they are less sensitive to heat than the rest of our bodies.
Never give a hot stone massage using silicon gloves. If you use a glove rather than tongs or a skimmer to remove the stones out of the water, never put them straight onto client. If the palm of your hand cannot hold the stone, most likely the client will not tolerate the heat. Again, test the temperature on your own forearm first.
Always use a temperature gauge in the water while heating up the stones. Warm stones (90 F - 110 F) are used for those with sensitivity to heat or for large stones that are going to compress the body without a sheet or towel. Hot stones (110 F - 125 F) are used for active massage. Temperatures will vary according to client, always test your equipment, set the heater at low without a cover and go from there.
It's better to start on tougher (yang) areas first (back and lateral portions of the body), then work toward medial and anterior portion (yin).
In general, "stones do not care for bones". We should avoid all bony clefts and spinal processes. No stones should be placed on the eyes if the client wears contact lenses.
Fitzpatrick Classification Scale
Another tool we can use to keep our clients and ourselves protected is becoming familiar with skin typing. The Fitzpatrick Classification Scale (developed in 1975 by Thomas Fitzpatrick, a Harvard Medical School dermatologist) classifies a person's complexion and tolerance of sunlight. The scale is used by several different health practitioners to determine how their patients will respond to heat therapies.
We can educate our clients by including a skin typing chart in our initial examination documents or by incorporating it into our informed consent documents.
Another important facet of a long-term successful practice using heat therapies is always having the client sign an informed consent document, specifically for hot stone therapy, before receiving treatment. This document may explain benefits and risks of hot stones therapy, contraindications and cautions, and explain the skin-typing procedures.
By enlightening our clients through a professional intake procedure, we further establish a foundation of love and trust that facilitates their healing.
In the chilly months ahead, heat therapies may be suitable to offer your clients as a seasonal special or a holiday gift. When incorporated into practice with a healthy respect and awareness, we can securely integrate these healing modalities into our current practices. In the coming months, we will discuss contraindicated diseases, conditions and medications for heat therapies.
I would love to hear your experiences or comments. Please feel free to contact me at .
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