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
April, 2009, Vol. 09, Issue 04
By Ruth Werner, LMP, NCTMB
In this issue we will discuss a common, frustrating, but not particularly threatening condition – acne rosacea. Sometimes called “adult acne,” this idiopathic condition is usually benign but it has some complications that are worth noting. Imagine being a fair-skinned man in your 50s. You have noticed that over time, much of your face now appears to have become permanently reddened—like a sunburn that never fades. You outgrew adolescent acne 30 years ago, but now you see bumps and pimples over your cheeks and on your chin. Occasionally they sting or itch. Your nose has become enlarged and the skin has become thick and bumpy. Tiny red lines appear on your face: these are especially noticeable when you drink hot beverages or eat spicy foods. Worst of all, some friends and acquaintances assume that your skin is a sign of chronic alcohol abuse: you find yourself constantly defending yourself against that prejudgment. These are the signs and symptoms of acne rosacea.
What is acne rosacea?
Acne rosacea is a skin condition that affects mostly middle-aged, fair-skinned adults. It is most common among 30 to 60-year-olds. Although it is diagnosed in women slightly more often than in men, men tend to have it in a more severe form. Rosacea is very common; estimations suggest that about 14 million Americans may have it, although not always so severely that treatment is required.
Despite being common, acne rosacea remains mysterious. It runs in cycles of flare and remission, but does not appear to be auto-immune in nature. It can lead to the appearance of pustules that clear up with antibiotic use, but it is not a specific bacterial infection that can be cultured and identified. Some research points to two microbial infestations, but research on these factors remains inconsistent and inconclusive. Because the cause or causes of this condition remain elusive, its treatment is limited to addressing symptoms only. Acne rosacea is considered to be a manageable, but not curable, condition.
Symptoms of Acne Rosacea
Acne rosacea typically affects the skin of the face, focusing especially on the cheeks, forehead, and chin—often the places that acne vulgaris (“common” acne associated with the changes in testosterone secretion that occur during puberty) appears. Many people find that their skin becomes reddened and bumpy or even pimply, and may stay that way for weeks and months. Then, for no known reason, symptoms resolve and the skin goes back to normal for an undetermined period of time. Other people find that the changes are permanent and progressive. Acne rosacea usually spares the skin around the eyes, but one version can affect the conjunctiva and even lead to the risk of corneal damage.
Causes of Acne Rosacea
Causes of acne rosacea are mainly unknown. One of the frustrating things about this condition is that triggers may vary widely for people, and that the tissue changes seen in skin biopsies of people with this condition are inconsistent. Some of the features that occur often include:
Types of Acne Rosacea
In 2004, a committee of specialists convened to compare notes and create some clear guidelines for subtypes of acne rosacea in an effort to create more awareness and to strategize the best treatment options for each type. The types of rosacea that they identified are:
This idiopathic disorder has no permanent cure, and so is treated palliatively. Patients are taught to recognize their specific triggers, and to avoid them when possible. Acne medication like Accutane is often prescribed. If mites are suspected, patients may be counseled to try the same skin cream recommended for scabies infestation. Photodynamic therapy (combining oral medication with careful doses of UV radiation) works for some patients. Laser surgery or dermabrasion may help the appearance of the skin and mask telangiectasias. Plastic surgery may be considered for a person with advanced rhinophyma. None of these interventions are considered to be a permanent solution for acne rosacea, however.
What about massage?
Specific massage promotes local blood flow as the skin warms and capillaries dilate in the area being addressed. For most clients this is a benefit, but for clients with acne rosacea facial massage could be a trigger for uncomfortable flushing and redness. As long as no infection is present, lymph drainage modaliies may help decrease fluid retention and any local edema. Therapists must be careful about using a lubricant that doesn’t irritate the skin or lead to a hyper-reaction.
Massage is unlikely to make any direct or specific changes to acne rosacea, but the chance to receive educated, non-judgmental touch may be an important positive factor in the life of someone who lives with this common and frustrating condition.
Well readers, do you have questions about medical issues that are presented in your contact with clients? Let me know – what’s on your table? Until then, many thanks and many blessings.
Click here for previous articles by Ruth Werner, LMP, NCTMB.
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