A Resting of the Soul
In my pursuit of being a skilled health care provider, I focus on reading journals, attending classes, staying current on medicinal research, and choosing the correct billing codes. However, most of us would never have started down this career path if there wasn't something more.
End of Life Treatment
TCM looks death in the face. We do not camouflage it as if it were poisonous. "We must allow our patients to die but we cannot allow them to perish," was my first lesson the day I met my teacher as a teenager.
The Secondary Insurance Plan
I have a patient that has Medicare, but also has a secondary insurance plan that does cover acupuncture. How do I bill Medicare to get a denial so that I may bill this secondary payer?
Blockchain Health Records?
Keeping data secure has become a nightmare for the average consumer. Just consider general user account hacks on Yahoo (3 billion records compromised), eBay (145 million records compromised) and Facebook (87 million records compromised), to health record breaches involving Anthem Blue Cross (78 million records compromised) and TRICARE (almost 5 million records compromised).
Art of the Associateship: It's OK to Trust, But Verify
Trust is a valuable part of any business relationship. It serves as the foundation for all business operations and ultimately long-term success for owners, employees and customers. This is especially true in the world of health care.
Reducing Hip, Knee & Shoulder Replacements (Part 2)
In the first article in this series, "Early Detection Reduces Hip, Knee, & Shoulder Replacements," I described time tested screening procedures and perspectives as indicators of when to encourage your patients to seek further medical evaluation.
Autoimmunity, Gut Health and Diet: Connect the Dots
According to the National Institute of Health (NIH), autoimmune disease is recognized in approximately 24 million individuals in the U.S., consisting of more than 80 various disorders that contribute to the top 10 causes of death in female children and women of all age groups.
Doc, Are You a Social Media Holdout? Your Future Is Now
Whether you like it or not, to compete in any business, even chiropractic, you really should know and consider using social media. It is no longer a small, sleepy, local world we live in; it has become a far-reaching community.
Confessions of a Former Drug Rep: Statins Are Endangering Your Overweight Patients
As I sit at my desk on the sixth anniversary of my successful liver transplant, I can't help but reflect on what caused that life-threatening ordeal. Looking back on my personal situation, I want to offer my insight into what is happening routinely to many patients.
Why Take X-Rays When You Already Have an MRI?
Let's clear up the issue regarding the efficacy of plain-film studies when an MRI study has already been performed. I review imaging studies primarily for chiropractors, and often their patients have been to other health care providers before finding their way to a DC.
#TechPain: Causes, Solutions
For the past several decades, the science of ergonomics has blossomed. The workplace is much safer and life is generally more pleasant thanks to the application of ergonomic principles.
The Certified Practitioner
Certified Chinese herb practitioners often identify themselves with the credentials "LAc" (Licensed acupuncturist).
Help Shape the New Neck Pain Best Practices Guideline
The Clinical Compass (originally the Council on Guidelines and Practice Parameters – CCGPP) has issued a call for interested chiropractic clinicians to help shape a new best practices guideline for chiropractic care of neck pain.
News in Brief
WFC Among Founding Members of Global Rehab Alliance; HealthSource Selects GoChiroTV as Exclusive Digital Signage Partner; Western States' Online Degree Programs Among Best in the Nation; Logan University, University of Missouri-St. Louis Forge Partnership.
Facebook Marketing 101
Many of the health care practitioners we work with have smaller practices. The provider tends to wear many hats – office manager, salesperson and healer.
It's All About That Ki
As an industry are we shifting too much toward a Western mind set? We strive to understand how acupuncture works using imaging and extensive studies. We spend numerous hours of our training learning Western medicine and learning to speak their language. What happened to our core though?
A Bold Strategy to Take Chiropractic to New Heights
Building public awareness of an entire profession requires strategic planning – especially when it pertains to the exploration of ground-breaking marketing tactics that target new audiences with key messaging about the value of chiropractic care.
NCCAOM: A Route to National Certification
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is offering a route to achieve national certification—without having to take any of the NCCAOM exams. This is specifically for California licensed acupuncturists that meet the eligibility requirements.
Trending: CBD / Hemp Oil
A recent survey of DCs regarding cannabidiol (CBD) / hemp oil provides food for thought as to the viability of CBD-based products as a component of chiropractic patient care. Here are some observations from the executive summary of the survey:
"Community Care" for Vets: It's Really a Big Deal!
As a preamble, while I regrettably never served in the military, I have the highest respect for those who did and those who currently serve.
Why the Automatic Denials for Modifiers 25 and 59?
Your experience is one shared by many chiropractic providers who bill through those plans. It appears to be the national trend, but by far is more prominent in Texas and Illinois.
The Classical Texts & Integrative Medicine
The acupuncture profession has been undergoing many changes in the past years. There has been a shift towards a more integrative approach to medicine as more hospitals include integrative departments.
UnitedHealthcare Can't Seem to Keep Chiropractic Down
AA decade ago, UnitedHealthcare announced changes to its chiropractic services policy that declared manipulative therapy for headache unproven.
Vaccines & Autism (Part 1)
It turns out chronic inflammation is the driver of autism expression. Unfortunately, those who emotionally embrace the vaccine issue rarely, if ever, consider this relationship, which hinders a rational view of the vaccine issue.
Treating Pain With Nutrition
Back in 1910, when D.D. Palmer published The Chiropractor's Adjuster and introduced the world to what he called the "triad of health" – thoughts, trauma and toxins – he explained that the body can only be made optimally healthy if all three aspects of health are addressed.
Does Dairy Cause Dampness?
The topic of dairy consumption was brought up at a scalp acupuncture seminar I recently attended.
CBD for Athletes: The Advantages of Cannibidiol
For athletes, pain is often part of their sport or activity. And to a certain extent, it is to be expected. However, after pushing themselves to the limit, soreness and fatigue set in, hampering their ability to perform and recover.
Valuable Adjunctive Therapies
Based on the latest CDC statistics, more than 795,000 Americans have strokes per year, 140,000 of which are lethal. Approximately 87 percent of all strokes are ischemic with an estimated health care and missed work cost of $34 billion annually.1
October, 2003, Vol. 03, Issue 10
CranioSacral Therapy and Scientific Research, Part I
By John Upledger, DO, OMM
I cannot count the number of times I have been told by well-meaning friends and harsh critics that CranioSacral Therapy (CST) should be investigated using scientific methods. Many people say CST would be a real boon to health care - if only there were more scientific proof.In a recent article (www.massagetoday.com/archives/2003/03/07.html), I explained why I believe CST can never be adequately evaluated within the confines of the laboratory. In addition, many people don't realize that research has indeed been done. For you skeptics, I offer the following overview:
In the mid-1970s, I was approached by Michigan State University (MSU) to uncover the scientific basis for a premise put forth by William Sutherland, DO, in the 1930s: that the joints and sutures of the cranium do not fully ossify, as was once believed. From 1975 through 1983, I was a professor in the department of biomechanics at MSU's College of Osteopathic Medicine, where I led a team of anatomists, physiologists, biophysicists and bioengineers to test and document the influence of the craniosacral system on the body. Together we conducted research - much of it published - that formed the basis for the modality I went on to develop and name CranioSacral Therapy.
I first worked with neurophysiologist and histologist Ernest Retzlaff, PhD, to prove that under normal conditions, cranial sutures do not calcify before death. We studied numerous bone and suture samples taken from neurosurgery patients between the ages of seven and 57 years. Not only did these samples show living sutures completely free of calcification, but they were chock full of collagen and elastic fibers; arteries; arterioles; capillaries; venules; veins; nerves; and neuroreceptors.
After in-depth examinations, we demonstrated definitive potential for movement between the cranial sutures. Yet these results appeared to contradict anatomy-lab samples taken from cadavers whose skull sutures were calcified. These seemingly conflicting findings suggested that the calcification of skull sutures seen in preserved cadavers was due to postmortem changes and reactions to chemical embalming agents. Our findings supported those published in Anatomica Humanica by Italian professor Guiseppi Sperino, who noted that cranial sutures fuse before death only under pathological circumstances.
Once we saw the potential for motion in living sutures, our next step was to demonstrate that the motion we had hypothesized actually existed in the living skull. With the assistance of biophysicist Richard Ropell, PhD, we began using head (band) strain gauges on living subjects. These gauges demonstrated rhythmical expansion-contraction movements of the cranial circumferences at eight to 12 cycles per minute; however, there were other variables that could discredit these measurements as solid evidence of sutural movement, so we had measure the movements of one skull bone in relation to another. While we could not use humans for studies like this, we were able to use live monkeys from the university's pharmacology department.
In pain-free experiments, we anesthetized the monkeys and did minor surgery to cement an antenna directly to each parietal bone, about two centimeters lateral to the sagittal suture, and two centimeters posterior to the coronal sutures. We then wired these two 10-inch antennae so that we could broadcast a radio signal between them. In the recorded wavelengths, we discovered as the parietal bones moved independently of each other, the distances between antenna times changed. These changes demonstrated interparietal movement of about 12 cycles per minute. At one point, I placed a fingertip on the monkey's coccyx. With minimal pressure, I was able to stop the parietal bone motion.
Now we had evidence of a system that could move parietal bones rhythmically - and be stopped by pressure on the coccyx. This and a multitude of other factors caused me to deduce that the coccygeal pressure influenced the parietal motion via the hydraulic force of cerebrospinal fluid (CSF) moving through the dural membrane and myofascial system related to the spinal column and the cranium.
My first inkling that such a hydraulic system existed came some years earlier during a neck surgery I assisted. The lead surgeon had removed the spinous processes and part of the laminae of the middle cervical vertebrae (C4 and C5) in order to expose the meningeal dura mater and keep it intact. At that time, I witnessed a rhythmical rise and fall of CSF pressure at about eight cycles per minute. It became clear that a fluid pressure deep to the dura mater was causing its continual movement. This fluid had to be cerebrospinal, and its volume had to be increasing and decreasing cyclically. Why hadn't this phenomenon been noticed in surgeries before? The answer is surprisingly simple: In most cases, the dura mater was incised. (Fortunately, that's not always the case.) I recently received a letter from Professor Charles Probst, a prominent Swiss neurosurgeon. He reported seeing,
In the case of lumbar-puncture procedures, when the needle enters the CSF compartment, the fluid enters the manometer via the needle and an elbow apparatus. When the fluid rises to its peak pressure, a valve is opened to take a specimen. It was generally assumed that the CSF specimen that was removed accounted for the reduction of pressure in the manometer. Any cyclic drop in fluid pressure was thus overlooked.
Editor's note: Look for the conclusion of this article and its relevant references in the November issue.
Click here for previous articles by John Upledger, DO, OMM.
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