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Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
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