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
January, 2006, Vol. 06, Issue 01
Prenatal Massage During the First Trimester
By Elaine Stillerman, LMT
Among some of the myths and old wives' tales surrounding prenatal massage is the misguided belief that massage should be avoided during the first trimester. It's fair to say that under the skilled hands of a certified prenatal practitioner, massage during the first trimester is not only safe, but can be especially supportive during the transitional first months.
One of the reasons many practitioners and spas refuse to massage first-trimester clients is the fear of causing a miscarriage.Miscarriage is defined as a spontaneous loss of a pregnancy before the fetus is viable, which generally means before 20 weeks gestation. (An early spontaneous abortion occurs within the first 12 weeks; a late spontaneous abortion happens within weeks 12-20.) Almost 90 percent of miscarriages occur within the first eight weeks, so the reasoning concludes that if you avoid the massage, you will avoid the miscarriage. Unfortunately, this logic is not based on science, but rather on litigious concerns.
Miscarriages occur very frequently, perhaps in as often as half of confirmed pregnancies, and most miscarriages can't be avoided. They rarely are caused by anything expectant women do or don't do. In nearly half of all known losses, the embryo was chromosomally abnormal and not viable or able to sustain life. Other possible risk factors include genital and reproductive structural abnormalities (retroversion of the uterus, bicornuate uterus, fibroid tumors, etc.), infections (chlamydia, rubella, listeria, ureaplasma, mycoplasma), maternal disease (diabetes, renal disease, thyroid conditions, nutritional deficiencies), ectopic pregnancies, hormonal imbalances, immunological rejection, maternal age (the older the gravida, the greater the risk of miscarriage), and environmental factors such as first- or second-hand smoke, excessive alcohol consumption, exposure to organic solvents, and excessive radiation. Massage is not a contributing factor in any of these physical or environmental circumstances, and is not causative in a miscarriage.
In early pregnancy, symptoms of a miscarriage include bleeding, abdominal pain or cramping, and lower back, thigh or pelvic pain. In late pregnancy, a miscarriage is accompanied by heavy bleeding, including the passage of blood clots and intense uterine contractions. If a client presents any of these symptoms, massage obviously is contraindicated.
The other explanation practitioners use to avoid first-trimester massage is the issue of morning sickness. Nearly 85 percent to 90 percent of pregnant women experience morning sickness and nausea in early pregnancy; for 10 percent of them, the problem persists beyond the first trimester. While it's clearly accepted that massage for anyone nauseous or vomiting is contraindicated, you can make appointments to massage your pregnant clients when they are not experiencing symptoms. These treatments effectively can reduce the severity of symptoms.
There are other suggestions you can make to your pregnant clients to reduce morning sickness. They should eat small but frequent meals throughout the day. Eating a protein-rich meal or snack before bed will reduce morning nausea. Protein takes a long time to digest, and they won't wake up with an empty, gnawing feeling in their stomachs. Cut up a fresh lemon into wedges and put the wedges in a plastic bag. They can inhale the lemon as needed. One drop of peppermint oil in honey water every hour helps some women. Other women find ginger tea, ginger ale and ginger candies very soothing. Drinking red raspberry-leaf tea or sucking on the pit of an umeboshi plum (found in health food stores or Oriental groceries) can settle the stomach. Stimulation of acupuncture point Pericardium 6 by wearing motion sickness "sea bands" or with digital stimulation is extremely effective in eradicating or minimizing nausea. This point is located on each forearm, 1 1/2 inches below the wrist, in the middle of the inner forearm.
Press for a count of 6-10 and repeat a total of 6-10 times.
Another concern regarding first-trimester massage includes avoidance of abdominal massage due to the fear of dislodging the placenta. This is another unfounded fear. It's strongly advised to ask the client's permission before massaging her abdomen at any stage of the pregnancy, and the abdominal massage always should be done with an open palm, light pressure and gentle effleurage following a clockwise direction, but the placenta is attached firmly to the uterus and appropriate massage will not damage or dislodge this strong attachment.
Properly trained prenatal massage practitioners can safely and effectively address first-trimester concerns. For those of you who work in establishments where first-trimester massage is avoided, liability is a major contributing factor to this decision. Since this business policy has been set by the management, you have to adhere to what management decrees. In private practice, however, you can base your decision on science and appropriate training, not fear or misconceptions.
Click here for previous articles by Elaine Stillerman, LMT.
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