A Simple Miracle: Treatment for Mysterious Foot Pain
Under the old ICD-9 diagnosis codes, there was actually a diagnosis for "adventures in medical mismanagement" to describe patients who had been run down the rabbit hole of poor case management and care. I encountered one of those patients in my office today.
VA Choice Claims Denied? Here's How You Can Get Paid
The VA Choice Program (PC3 as well) indeed pays for chiropractic care including manipulation (CMT 98940-98943) and some physical medicine services.
A Soy Isoflavone That Packs a Punch: Genistein
Soybeans contains unique substances called isoflavones, most notably genistein and daidzein, which have been shown to block the buildup the dangerous type of testosterone in the prostate gland linked to prostate enlargement and prostate cancer.
Malpractice Insurance: Understanding the Cover Letter
Purchasing medical liability insurance is quick, easy and not terribly expensive. The benefits are clearly listed on a certificate—but do you really know what you are getting with that peace of mind?
2018 Gallup-Palmer Report: Key Findings
The fourth annual Gallup – Palmer College report is out; here are some of the key findings excerpted directly from the executive summary regarding Americans' experiences with chiropractic care relative to the management of neck and back pain:
VA Chiropractic Reduces Veterans' Use of Opioids?
Utilization of pain medication – particularly opioids – has been massively high in among veterans for decades, but Veterans Administration guidelines that recommend nonpharmacological first-line treatment options create a greater opportunity than ever for VA chiropractors to make a dent in the opioid and overall pain-management crisis.
A Guide to CBD Dosing: The Correlation Between Dose & Potency
There is an abundance of information available about the daily use of whole plant hemp CBD oil to help maintain and support a healthy lifestyle, however there remains a lack of sound guidance on CBD oil dosing.
Dietary Supplements That Help Restless Leg Syndrome
It is estimated that 7-10 percent (possibly up to 15 percent) of the U.S. population has restless leg syndrome. It is a bit more common in women than men.
Goodbye, Year of the Dog: Two-Thousand-Eighteen Comes to a Close
As Year of the Dog (2018) comes to a close we can look back and see the progress this profession has made. For example, the International Classification of Diseases (ICD) added traditional medicine codes, which were released in June.
The Truth About Malpractice Claims Against DCs (Pt. 1)
Over the past 20 years of active practice, I have seen a number of scary case scenarios regarding signs, symptoms and patient presentations in my office. These presentations scream, This patient is going through an event or This patient does not need chiropractic care, they need emergency care.
Exercise Therapy Following Motor Vehicle Trauma (Pt. 2)
In cases of cervical spine trauma, particularly trauma related to a motor vehicle accident, my plan is to teach the patient one exercise per session and build a progression. This is an effective approach I call an "activation circuit."
Bad for the Back! Exercises That Can Prevent Healing
The questions "Who gets well? Who doesn't? Why?" prompted the following observations based on my close to 40 years of chiropractic practice.
Year in Review: DC's Best of the Best for 2018
As 2018 winds down, let's highlight the most popular articles in Dynamic Chiropractic by month (December – this issue – excluded, of course).
Acupuncture in Hospital Systems: Transitioning From Tolerated to Celebrated
I've had the pleasure of working with Susan Luria, Director of University Hospitals Health Systems Connor Integrative Health Network (CIHN) for the past year on the Integrative Health Policy Consortium (IHPC) Board of Directors and Federal Policy Committee.
Reaching for Our Roots: Healing Digestion With a Simple Traditional Therapy
Are you ignoring a powerful tool in your doctor's bag? Many acupuncturists realize that Spleen Qi deficiency has reached epidemic proportions in the U.S. Yet, we don't prioritize educating our patients about the importance of warm, cooked foods.
Reality Check: Do We Need to Try Harder?
While waiting for a flight to a recent chiropractic event, I overheard the ticket agent at the gate next to mine on his cellphone. His side of the conversation went something like this: "Where are you now? How long before you think you can be at the gate? OK, that will work, see you soon."
A New President for AOMA: A Conversation With Mary Faria
Dr. Faria was formerly a health care executive for over 30 years, the last 17 of those years as vice president and chief operating officer of Seton Southwest Hospital in Austin. She chairs the board of Austin Mayor's Health and Fitness Council.
Knocking Down the Doors: Big Media Success for F4CP
Three articles authored by a DC or a chiropractic organization and promoting the value of chiropractic care – par for the course if you're Dynamic Chiropractic, but if you're Forbes, BOSS Magazine and Becker's Spine Review, three media outlets tailored toward high-level executives and decision-makers, we're talking about an entirely different story.
Acupuncture is a Science-Based Medicine
A longstanding patient of mine came in for a routine treatment after she recently began seeing a chiropractor for neck pain. She saw him a couple of times and wasn't getting the relief she had hoped for, so he recommended she let him do dry needling.
Cynicism and Burnout: It Can Happen to You
Trying to achieve fulfillment as a doctor in today's health care environment is a "rigged game" and physicians are programmed to burn out. At least this is the opinion of Dike Drummond, MD, in his thehappymd.com blog.
The Top 5 Strategies to Manage Your Reputation Online
You don't need an acupuncture website anymore! Okay, maybe that statement is a little over the top. But it's not that far from the truth. A recent study on Google searches revealed that 34 percent of all searches resulted in no clicks at all.
The Raw Food Debate: Practitioners Discuss Nutrition & TCM
Licensed acupuncturist and fellow blogger Elissa Gonda joins this month's column for a conversation about raw food diets. She brings her perspective on the healing potential of a raw primal diet.
Electrotherapy Gives Hope for Patients With Spinal Cord Injury
There has been little optimism for recovery from a spinal cord injury because the central nervous system does not repair itself well. The severity of the injury depends on the affected area.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
Map It: Understanding the Customer's Journey
One of the biggest marketing mistakes most practice owners or administrators make is not putting themselves in their prospective or current patients' shoes. How do they think and feel about you and your practice? What makes them take action?
September, 2004, Vol. 04, Issue 09
Metabolic Syndrome: A New Way of Thinking About Long-Term Risk
By Ruth Werner, LMP, NCTMB
The votes are in, and metabolic syndrome is the choice this month. This condition is not really a specific illness. Instead, it is a collection of features that, individually, are not great, but not particularly alarming.Together in various combinations, however, diabetes and cardiovascular disease are almost a certainty. Since cardiovascular disease and its corollaries (heart attack, stroke, heart failure, aneurysm, etc.) are responsible for nearly 40 percent of deaths in the United States, it behooves massage therapists and other bodyworkers to be familiar with this health-risk profile.
What makes metabolic syndrome especially interesting, in my opinion, is that it is a proactive approach to dealing with disease risks. Identifying when a person has some of the components of metabolic syndrome gives a person the chance to undo those processes before they progress to a more advanced and serious disease state. This idea of identifying and treating an illness before it creates significant problems is unusual in our allopathic medical community; however, this shift indicates good changes in the future.
Demographics: Statistics for the incidence of metabolic syndrome vary. Some researchers suggest it affects some 16 million Americans (about .06 percent), the majority of which are unaware of its existence. The Cleveland Clinic Department of Endocrinology, Diabetes and Metabolism indicates that the incidence is 22 percent, or about 47 million people. The National Cholesterol Education Program suggests that up to 44 percent of all people over 50-years-old meet the diagnostic criteria for metabolic syndrome. These inconsistencies may have to do with the age of the target group studied, differing diagnostic criteria, geographical region and other variables.
Metabolic Syndrome Features: Most of the features of metabolic syndrome are silent and go undetected without the appropriate blood work.
Metabolic syndrome is diagnosed when at least three of these five features are present. Therefore, while a person may have a large waist, if the other components are absent, the risk of cardiovascular disease is low. Other features sometimes seen with metabolic syndrome include a high risk of blood clotting, and polycystic ovary disease in women.
Treatment: The first, best option for a person with metabolic syndrome is to exercise and lose weight. Reducing body weight by 5 to 7 percent (this is only 10-14 pounds for a 200 pound person) significantly reduces the risk of complications due to insulin resistance; exercise improves insulin action and decreases blood glucose. Limiting alcohol use and quitting smoking are other important steps. If these lifestyle changes are insufficient to control this disorder, medications that improve insulin uptake and/or stimulate more insulin production may be prescribed, along with agents that work to lower blood pressure and/or cholesterol.
The role of the massage therapist who works with clients that are not perfectly healthy is to maximize the benefits of bodywork, while minimizing risks. This may mean changing tactics or adapting techniques to accommodate for the fragility of a client with a compromised circulatory system.
One way to make this determination is to get an idea of the client's activities of daily living (ADL). Does the client exercise regularly? Is it safe for the client to elevate his or her heart rate? Does the client huff and puff while climbing the stairs to the massage clinic? Has a doctor suggested avoiding aerobic exercise? This data informs the decisions about what kinds of bodywork are most appropriate. Techniques that focus on fluid movement may be less tolerated by a client whose circulatory system is challenged, but energetic or reflexive techniques that don't focus on fluid flow may be safe and welcome.
Metabolic syndrome patients who exercise rigorously and successfully control blood glucose, hypertension, and other features, are likely to be fine candidates for more vigorous circulatory-based techniques like Swedish or sports massage.
For next time: I have recently received a surprising number of letters requesting an article on contagious skin diseases like warts and herpes. Because I usually teach this material whenever I go on the road, I'd gotten it into my head that most therapists were pretty much at home with these topics. Clearly, I am mistaken! Unless I hear otherwise, I plan to focus my next column on herpes simplex. Do you have any stories you'd like to share? Let me know, so we can all benefit from your experience.
Until then, many thanks and many blessings.
Click here for previous articles by Ruth Werner, LMP, NCTMB.
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