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An Article Review from Dynamic Chiropractic Jan 2018 Edition As we march forward into the year, I think it is important to stay up-to-date with what’s up in chiropractic.  So here we go:   Controversy at it’s Finest: Cannabis   I figure why not start off with a bang? I have to admit that it is my new favorite subject to discuss.  Which, in large part, is probably due to the enormous polarity you find when even mentioning it.  The response can range from something Cheech and Chong would be proud of to nothing short of moral indecency and criminal behavior. However, I think the truth and the medical usage of this controversial plant lies somewhere in the middle.  With more and more states moving to legalize marijuana, I think this is an issue that will come up.  If it grates down on your soul to even think about such a topic, you could always consider CBD.  CBD is the part of the hemp plant that is completely benign. It lets you operate heavy machinery and not only reduces pain, but a myriad of other ailments too. Also, CBD oils, tinctures, creams, etc. are great sells in a chiropractic office too.   You say Manipulate…I say Adjustment   Friend or foe, we have to live with physical therapists. They seem to have completely integrated themselves into the medical world.  What does that mean for us as chiropractors? It means we have to continue to be the best at adjustments.  Like I always say, PT’s manipulate while chiropractors adjust.  I think five academic years of just chiropractic school allow us to hold the title at being better at the finer mechanics and subtleties of getting the body to move.  We need to continue to be on top of our game and to let our patients and the community know we are better too.   You Dah Man…I Mean the Doctor   The buzzword I keep running across is ‘integrative.’ This fancy word says that patients want all of their doctors to work together for their betterment. I don’t think Mrs. Smith cares who administers her diagnosis- she just wants it relatively quick, accurate, sent to the right doctor for treatment, and the condition explained without the heavy medical jargon. Sit up Straight!   Here we go again, ‘integrating’ postural analysis and education during your physical examination.  I do it with almost every patient because let’s face it; the modern world is constantly changing.  Texting, sitting for hours at a time, and looking at screens all day is not helping anterior head carriage, lordotic or kyphotic curves in the least.   Outcome Assessment Tools   Not even my brain could come up with a catchy title for this one. The moral of this story is to use them.  These tools monitor patient progress, helps with diagnosis, treatment, exercise therapies, etc. Plus, insurance companies like to use them too.  Who doesn’t want to get paid more often and more timely by insurance companies?   Let’s Get Physical  High-intensity interval training (HIIT) is short, sweet and to the point.  Usually 15-30 minutes of non-stop “cardio” moves like jumping jacks, squats, burpees, pushups, etc which are performed in 15-45 second intervals in rapid fire succession.  Just think about someone who you find irritating, write down enough torturous exercises for them to perform, and then review the exercises to make sure it fits with your patient’s physical ability. The other nice part about HIIT is it combines body weight exercises so you’re getting two benefits for the price of one.   Slow Your Roll and Roll Out Your Mat   If #6 was a bit much, then why not encourage patients to slap on a Fitbit or Apple Watch to monitor their daily movement and heart rate?  Keeping a slower yet elevated heart rate is still a very important trend for patients to keep up with. Even exercises like yoga don’t have to be done in a studio. These can also be done in your own office so patients can do exercises during their visit. As a chiropractor, you can also provide your patients with exercises they can take home. What do you do if you run across a patient who is not an avid yogi? How about suggesting strength training to them? Slow controlled movements with gradual increments in weight can be a great addition to help with posture and core strength. Good news is, we can create, demonstrate, and educate our patients on all different kinds of fitness and exercise programs for them to perform.  As we know, the chiropractic world is always changing which often times is a response to the medical community. As long as medical practices continue to evolve, we as chiropractors will have to be on our toes.  We certainly can’t predict everything that is coming down the pipe, but these seven trends will at least give us a start to navigating the year ahead.  For more information please check out: Dynamic Chiropractic Volume 36, Number 1. Kassandra Schultz DC
Troll through Facebook, turn on the news, or go to the main page of Yahoo and it’s all there.  Bold scary letters, threatening titles, and fingers being pointed in every direction of who to blame and how to control the most recent flu epidemic.  As a chiropractor, I have no doubt that my fellow colleges have our opinions on some of these hot topics like the flu vaccine, the CDC, mandatory vaccinations, etc. Today, we will steer away from the nitty-gritty details of those issues and will focus on how we can help our patients stay level-headed and informed so they can make the best decisions for their health and well being.   Tread Lightly but Tell Your Story Depending on your country, your state, etc. there is a very tight scope of practice when discussing medications, vaccinations and most medical procedures.  First, I share articles on my Facebook page.  I encourage my patients to “like it” and I start a slow creep of information through social media.  I have had more than one patient ask me if I get the flu shot or why I posted a certain article on Facebook. I gladly tell them why I do or don’t participate in certain medical procedures.   I try and stay away from emotionally charged or bold statements like, “The vaccine isn’t designed to prevent the fake flu, unless pigs can fly.” (Realfarmacy.com) In my mind, addressing this statement in any capacity won’t help. Now we sound just as crazy as mainstream media.  I like facts. For example, “[According to CDC statistics,] ‘influenza and pneumonia’ took 62,034 lives in 2001, of which 61,777 were attributable to pneumonia and 257 to flu. In only 18 of those cases, the flu was positively identified.” (Realfarmacy.com)  Isn’t that statement nice? This statement comes from the CDC which has numbers and shows some stats that are a quite a bit harder to find in the news.   Getting out of our Own Heads...Using other Sources   So are you trying to tell me that I can read articles, publications, and research papers from other countries? Are you kidding me; I am an American! Ok, all kidding aside, there is a massive amount of research and information coming out on all kinds of issues plaguing Western countries. Europe has different laws, regulations, and governing agencies that allow for different testing then what is being done in the US.  Let’s say your trying to educate patients on the other side of the coin, like with the flu vaccine (for chiropractors we usually have more than one topic we like to educate patients about). I like to give patients other sources to educate them.  My favorite place to start is in European journals.  I usually go for England.  Hey, why make life more difficult? No verb conjugating necessary.  Even concerning the flu epidemic, I went to bmj.com for the British Medical Journal.  They have research and articles from as far back at 2013, discussing the CDC, the flu stats, and different ideas concerning the vaccine.  Ultimately, going online for any kind of information can lead us straight down the rabbit hole of worry, fear, and disgust. This leads us into tip number three.   Hey, What about us?   I think, no matter what epidemic, media induced mania, health crisis, etc is overtaking the world at any given moment, we as chiropractors can be the beacon of reason and hope. Before the strong hold of western medicine, what did people do to stay well? What do you do to stay well?  Proper exercise, good nutrition, adequate sleep, and of course getting adjusted are part of my health care routine. Explaining how adjustments help the immune system is a great place to start. Do you have supplements or an herb line? My go to has been Standard Process, which has a great line of products for the winter season to help bolster the immune system.   It appears, at least in my mind, that as a whole, the western world has lost sight of how the human body works.  We all have this amazingly complex machine that requires a combination of basic needs to keep it running properly.  It just seems that the more we use western medicine, the more we have to do to counter its effects.  This is where we tell our stories, give them new sources of information to read and explain how through adjustments, we affect the nervous system, and in turn, the entire body.  I try never and speak ill of western medicine (because sometimes it is necessary). It’s up to us to help stop the complete reliance and blind following that I see in so many people in our Western cultures.   For more information please visit: Bmj.com Realfarmacy.com   Kassandra Schultz DC
Three Ways to Help Our Patients Stop the Madness   Here we are again, the start of another year.  “New Year, New You,” “Make 2018 the best year yet,” “2018 is the year it finally happens,” blah, blah, blah.   It does not take much looking around to see these mantras posted all over social media, TV, and radio ads. Year after year, hearing the same worn out adages makes it like living in the Peanuts cartoons.  We are like Charlie Brown, attempting to kick the football, and at the very last minute Lucy, pulls the ball away and we go flying through the air.  After totally missing the ball, we land square on our backs. No matter how many “pinky promises” and “cross my hearts” Lucy does, Charlie Brown never learns his lesson and he gets the same results every time- nothing changes.  Sound harsh? Let me explain.   Chiropractic is not my only gig.  Along with my chiropractic office, I am also in the fitness business.  I have been in the martial arts world almost my entire life and now I own and manage three boutique fitness kickboxing studios.  Between patients wanting to feel better and get healthier and kickboxers wanting to get skinnier and more ripped, I have seen the full gamut of New Year’s resolutions.  You know what I have found with New Year’s resolutions? They don’t work. Kickboxers come in on January 2nd to make it their best year yet and within a week, the instructors are calling them to help them get back to class.  Patients do the same thing with missing appointments or falling off the wagon during a detox or cleanse, only a few days after proclaiming their new convictions towards a healthy lifestyle. Forbes.com says that over 40% of Americans will make some kind of New Year’s resolution with only 8% of these people actually achieving them.  How can we, as part of their health care team, help our patients reach their healthier lifestyle goals?   1. Let’s Get Real and Raw with Our Goals There is a fine line between being able to dig deep about what somebody wants and coming off as a jerk.  In my office, when a new patient comes in, of course I do a case history. In the case history, I like to ask why somebody wants what they are looking for.  At first, it is usually straightforward, “to get out of pain,” “to feel better,” or “to be able to turn my head from side to side,” etc.  After a patient has been with me for a while, I start to ask more difficult questions.    A. What do you really want? B. How long have you wanted to do that?                    Ex: How long have you wanted to lose those extra 20 pounds?                           Did you write this goal down last year? C. How will your life be different if you lose 20lbs, get your diabetes under control, switch to an anti-inflammatory diet, etc.? These simple questions can really be delved into.  I make them give me three reasons why they want that particular goal.   2. Being Ruthless about what Matters The big thing here is, does the patient really need to work on losing 20 pounds, or do they need consistency in going to the gym  three times a week? Or do they need follow through, to make sure that even when they have a bad day, the patient doesn’t go home and smash a bunch of food and totally ruin a good day.   Here are a couple ideas I like to throw out at patients when they want to make a health or fitness lifestyle change: A.   Commitment: Are you really ready to make this change? B.   Realistic: Is losing 20 pounds in 20 days realistic, or would it be better to make small changes in a 20 day period to help build better lifestyle and habit changes? C.   Letting people help you: Do you have spousal support? Can someone watch your kids? A healthy lifestyle is not done alone. D.  Follow-through: Would an accountability partner or group be helpful? What about putting a red “X” on the calendar for every day they went to the gym, ate healthy, or got adjusted?   3. Give Yourself Permission to not be Perfect    I don’t know about you, but there are sometimes and even days when having businesses/jobs, houses, spouses, kids, animals, etc. just seem to get in the way of taking care of us. Imagine this; it has been a rough day, and now a patient has only 30 minutes to complete a workout instead of an hour.  Many people wouldn’t still go to the gym.  Here is where commitment, consistency, and follow-thru come into play.  A 30 minute workout is better than no workout at all. One crappy meal (going out to dinner with drinks) is better than over-doing every meal.  Most of the time, “bad days” can be salvaged with good habits thrown in.  It’s never a waste to try and eat healthy and workout even if it’s not perfect.  I had one patient this morning who was very stressed out.  We changed the date and time of his appointment.  Not a big deal right?  He is coming back for treatment and we can still keep him on his once a month wellness visit. It is the little habits that over time define who we are.  As their doctors, we can help influence our patients into choosing healthier habits at every appointment they come to.  We do not need to be zealots with how we think patients should live their lives.  By us showing them how to live through how we live- with healthy eating, working out, stress management, getting our own adjustments, etc.- we can be the positive force.  Using our positive force in their lives, we can slowly start to shift New Year’s resolutions into real, meaningful goals.  Cheers to 2018!   Kassandra Schultz DC.  
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