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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
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.
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.
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.
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.
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.
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.
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.
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.
Have We Created a Touch Deprived Society?
I recently attended a memorial service for a long-time friend of my husband's. There were lots of people there; some I knew well, others were strangers. Mingling at the reception I noticed how much people were touching. I bet I gave and received 25 hugs, not to mention handshakes and greetings that included touching an arm or shoulder. Since I was in the midst of writing this article, I wondered why we are so much more open to touch in this personal situation when, as a society, we're disconnected from it. Come to find out, I'm not the only one asking. Scientists and researchers in neuroscience and human behavior are, too. Touch is getting its due attention. Bit I wonder, have we created a touch deprived society?
Hard wired for touch
It's long been acknowledged that touch is the first sense babies develop in the womb and that holding the baby at birth cements a bond between mother and child and that babies need physical contact to develop and thrive. My training in occupational therapy included how to assess and treat tactile and sensory dysfunction, a common symptom of disease or trauma of the nervous system. I could tell you all about a patient's ability to feel a pin prick in precise tactile tracks in the body (dermatomes) or distinguish a comb from a fork just by feel (sterognosis). But I don't recall ever discussing the emotional impact of human touch. Denworth (2015) tells us, [Scientist's] growing body of research has uncovered another dimension of touch that is separate from its discriminative function. This newly recognized system, known as affective or emotional touch, consists of nerve fibers triggered by exactly the kind of loving caress a mother gives her child. It is possible that these neurobiological foundations of attachment might play a far more significant role in human behavior that has been recognized, forging connections and increasing our chance of survival. "Hertenstein et. al., (2009) investigated our ability to distinguish or decode distinct emotions from touch alone, without the context of facial expression and body language. They found that people reliably decoded emotions of anger, fear, disgust, love, gratitude and sympathy when touch was the only means of communication. I wonder if our current social habits detach us from this potent means of communication and human connection.
I've thought some about the use of various technologies and how they enhance the lives of our elders. Many grandparents have discovered the "Skype visit." These long-distance visits can help families stay connected or help family members monitor how grandma is doing. While I believe that these "Skype-visits" are a good thing, I do question if some families will skip the trip to grandma's and substitute a Skype-visit instead. There's no substitute for a real visit where people share an experience; where grandparents feel and touch their grandchildren who then can remember what grandma's wrinkly skin felt like or the smell of her Jergen's lotion; where grown children take time to simply show up and be present. Technology will play a huge role in aging baby boomer's lives, but maybe we should keep some good old fashioned visits along with it. As a new grandmother, I can tell you there's no substitute for holding that little baby boy who will someday call me Nana.
The Daycare Dilemma
I was a working mom and was really lucky that my workplace had an excellent daycare center and preschool on-site. For the babies, they had volunteer "grandmas" whose only job was to sit in rocking chairs and hold the kids. One grandma took a liking to my baby son and held him a lot. I loved that! Even the older kids swarmed around these women. I would like to think those ladies would still be there. But I wonder when the notion of touching kids in daycare and schools is laden with fear and anxiety in today's risk-avoidance culture. Piper, H. and Stronach (2008) examined this issue in depth and found that daycare workers and teachers "hands are tied" by policies aimed at protecting children but their sensible instincts suggest the rules are an unnatural way of caring for kids.
The Doctor/Patient Relationship
A favorite story of mine is told by Dr. Abraham Verghese in a 2013 TED talk. Dr. Verghese appeals to physicians the importance of a hands-on physical examination of their patients at a time when MRI's, CAT scans, blood tests, and tele-medicine have replaced the ritual of palpating and listening. I share an excerpt from his presentation as he tells it because I think his words are so powerful.
"I recall one patient who was at that point no more than a skeleton encased in shrinking skin, unable to speak, his mouth crusted with candida that was resistant to the usual medications. When he saw me on what turned out to be his last hours on this earth, his hands moved as if in slow motion. And as I wondered what he was up to, his stick fingers made their way up to his pajama shirt, fumbling with his buttons. I realized that he was wanting to expose his wicker-basket chest to me. It was an offering, an invitation. I did not decline. I percussed. I palpated. I listened to the chest. I think he surely must have known by then that it was vital for me just as it was necessary for him. Neither of us could skip this ritual, which had nothing to do with detecting rales in the lung, or finding the gallop rhythm of heart failure. No, this ritual was about the one message that physicians have needed to convey to their patients. Although, God knows, of late, in our hubris, we seem to have drifted away. We seem to have forgotten as though, with the explosion of knowledge, the whole human genome mapped out at our feet, we are lulled into inattention, forgetting that the ritual is cathartic to the physician, necessary for the patient, forgetting that the ritual has meaning and a singular message to convey to the patient. And the message, which I didn't fully understand then, even as I delivered it, and which I understand better now is this: I will always, always, always be there. I will see you through this. I will never abandon you. I will be with you through the end." I relate to this story very much. I have a hospice client now that I've seen for three years. We have a ritual to our session. She likes having her back massaged with lotion or powder and, although it's an effort for her, she lowers her robe so she can feel my hands on her skin covering her emaciated back. After the massage, her face, and my heart, is filled with gratitude.
I believe that perhaps our real work as massage therapists, regardless of your clientele, is to help usher in a new age where human touch returns to its rightful place in our world. There are lots of signs of hope such as these telling lyrics in Greek electropop band the Berlin Brides' song, Ballad for the Touch Deprived:
I'm living my life in perfect bliss