Randy Ferrance, DC MD, bridging the gap between chiropractic and medicine

Podcast with chiropractor medical doctor who bridges the gap between the two professions

Dr. Randy Ferrance is a medical physician who was a practicing chiropractor when he entered medical school. Raised in an evangelical chiropractic family, he wasn’t vaccinated as a child. He speaks on bridging the gap from chiropractic to medicine, on his experiences making the transition from chiropractic to medicine and on how chiropractors can best develop working relationships with medical doctors.

Does Dr. Ferrance experience prejudice for being a chiropractor/medical doctor? Yes…but it’s not from whom you’d think.

Interview conducted with Dr. Brett L. Kinsler.

Get the podcast here or look for OnTheOtherHand Podcast on iTunes.

This podcast episode was sponsored by XSite Pro website design and management software. The software I use for my own office website.  Try their software with a 30 day money back guarantee.

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Edzard Ernst, CAM Critic, Talks with Dr. Brett Kinsler on Chiropractic and Bias

Book by Edzard Ernst complementary and alternative medicine

Professor Edzard Ernst, MD, PhD, FRCP, FRCP holds the Laing Chair in Complementary Medicine at the Peninsula Medical School, University of Exeter and is the Editor-in-Chief of two medical journals. He has also been seen as a major public opponent of chiropractic and alternative medicine. He has devoted most of his career to publishing articles that are critical of complementary and alternative medicine….an unbelievable number of papers. Like 1500 or so. He’s been especially critical of chiropractic and, in the opinion of many researchers, has glossed over important research and exaggerated results. To me, what’s most interesting about Ernst is that he claims objectivity and lack of agenda. This podcast asks some tough questions of Prof. Ernst.

You can get the podcast episode on iTunes by searching the podcast section for “On The Other Hand” or you can just click here.

Thanks to this episode’s sponsor: Audible.com, the audiobook company. Get a free audiobook download just by trying their service free for 14 days.

New Podcast Episode: Alternative Dentistry

Ellie Phillips, DDS spoke frankly with me about the dental profession and how it can and must adapt from a drill and fill to a systemic and truly preventative model.  She is the author of the book Kiss Your Dentist Goodbye and a most interesting person to listen to.  I assure you, you have never heard a dentist like Dr. Ellie.

Find this episode in the podcast section of iTunes by searching for “On The Other Hand” or go to our podcast site here.

New Podcast Episode: Dr. John Ventura on NCQA Back Pain Recognition Program

Dr. John Ventura stopped by to discuss the NCQA’s Back Pain Recognition Program with me.  This episode of On The Other Hand as well as the others can be found on iTunes or at www.ontheotherhand.podbean.com

Our Podcast is Coming!

I just wanted to let you know that the podcast episodes are coming along nicely.  Today, I posted an introductory episode to make sure everything is working properly. It should be available in iTunes very soon.

The series is called On The Other Hand and it will contain interviews, commentaries and rants with responsible, scientific people in chiropractic, alternative medicine and healthcare.  Most of the interviews will stem from West Hartford Group members (the chiropractic think tank) but there are others as well from within and in other professions.

I’m just getting started so there will be a learning curve; I will have to play with the audio settings until it all sounds right, but hopefully it is something you will enjoy.

Episodes can be found at iTunes soon but will also be posted, along with show notes and links, at:  http://ontheotherhand.podbean.com/

So far, only the test episode is there but I do have complete episodes on their way!  Let me know what you think and please vote for me on iTunes to ensure rational, scientific information predominates when someone searches for “chiropractic podcasts.”

Dr. Brett L. Kinsler is a fulltime chiropractor, a sometime blogger and a first time podcaster.

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On the Wire: TENS Unit Controversy

A recent headline on WebMD, a popular source for online medical information, states that TENS is no longer recommended for chronic low back pain.  The article quotes Richard M. Dubinsky, MD, MPH, of Kansas University Medical Center, “from the systematic review of the literature, based on the strength of the studies, we can say that TENS does not work for low back pain.”  TENS stands for transcutaneous electrical nerve stimulation.  This means it applies electrical current through the skin (via electrodes) for pain control.  Most sources consider the use of TENS to be a non-invasive safe treatment that has very few side effects when used as directed (not over the eyes, broken skin, pregnant uterus, etc.).

TENS is often confused with Electric Muscle Stimulation (EMS).  The confusion is understandable as they both are electrical devices applied using two or four electrodes to the affected area.   TENS is for blocking pain pathways while EMS is for stimulating muscles to relieve muscle spasm, hence reducing pain and improving function.

Here lies the problem with this headline.  Dubinsky is also quoted as saying, “We can’t say that TENS will not work in any patient with chronic low back pain.  We can say there is proof it doesn’t work in groups of patients with chronic low back pain.”   So, it probably works for some patients but not a large enough proportion to be recommended.  Why not?  Here is a safe non-invasive treatment with very few side effects that may work for some patients.  If there was a long, scary list of side effects it wouldn’t be worth the risk.  For patients that have back pain, a treatment that doesn’t require drugs or surgery and could make them more comfortable is an important tool to have in the physician‘s toolbox.  Patients will know immediately if they get any relief.  If they do, great.  If not, stop using it.

A TENS unit is inexpensive (well under $100) and doesn’t require refills other than changing the electrodes and batteries once in a while.  It can be used right before driving or handling heavy machinery.  It doesn’t cause stomach upset or make you feel “loopy” like some of the commonly prescribed pain meds.  Does it fix your back? No.  Could it make you more comfortable? Maybe. Does it deserve to be crossed off the list?  Certainly not.

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What’d Ya Say? Divided By a Common Language.

applesoranges

The importance of using common language when communicating about back pain has been well documented in the medical literature. There are three main areas that lead to difficulties in communication about back pain:

  • patients seeking information from health care professionals can experience difficulties understanding them and the medical literature
  • misunderstandings among health professionals concerning terminology can arise
  • lack of standardized definitions for back pain terms can make comparison of research studies problematic

A study just published in the BMC Musculoskeletal Disorders aimed to explore the meanings and issues surrounding the use of existing medical terms for back pain from the perspective of health care professionals and lay people. Focus groups were used to explore participants’ understanding and samples included general practitioners, chiropractors, osteopaths, physiotherapists, and lay people.

Lay participants understood the majority of the terms explored in the group differently than the health professionals. Some terms were not understood, some misconstrued and some had inadvertent negative connotations or implications. (For example “wear and tear” instead of the harsher term “degeneration” gave implications of wearing away or rotting).   The commonness of misunderstandings, unintended meanings and negative emotional responses to terms used in this study have a number of implications.

Firstly, it must encourage providers to ensure their patients understand what has been explained to them including the contextual and emotional implications. Secondly, patients and providers should have an ongoing dialogue to promote understanding of terms and comminality of language.  Third, this study should be used as a lesson to chiropractors who cling to old, antiquated terminology that we know has differing meanings both intra- and interprofessionally. If other chiropractors cannot agree on a term’s meaning, and other professions cannot agree on that term’s meaning, you can sure as heck bet that your patients have no idea what you are taking about either.

I was recently told that we should take antiquated terms and reframe them so we can continue using them in a different context. To me, this study implies that is not a wise course of action.

 

Brett L. Kinsler, DC is a chiropractor in Rochester, NY who avoids using antiquated terms when he blogs at www.RochesterChiro.wordpress.com

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The Autism Panic!

panicThe sky is falling!  The sky is falling!

Wait, what?

Oh, sorry. 

The sky is rising! The sky is rising!

Wait, sorry.  What now?

Oh, okay. 

The autism rates are rising!  The autism rates are rising!

Alright kids, let’s go over this again.  Autism rates, really the autism spectrum disorder (ASD) rates, are on the increase.  You’ve heard the new 1 in 100 number quoted, right?  I’m not saying that’s inaccurate.  It’s just that there is no real increase represented.  How can that be? Clearly something (or someone) must be to blame for this terrible condition.  Who can we hang?  Quick, after them!

There were two recent studies concerning the prevalence of autism in the US that have attracted a lot of attention.  One study conducted by the CDC (not yet published) reports that the new prevalence of autism spectrum disorder (ASD) is now estimated at 1% or 100 in 10,000 children. This is an increase over the last few years. In 2002 the prevalence was estimated to be 66 per 10,000 (0.66%).

The second study published in the journal Pediatrics was a telephone survey of parents where they asked if they had any children who had ever been diagnosed with an ASD.  This non-clinician scored study estimated ASD point-prevalence at 110 per 10,000.  These are slightly higher numbers than the CDC data but that is to be expected, since diagnoses from the phone survey were not confirmed by a doctor.

There is no argument that the number of ASD diagnoses has been steadily increasing for the last 20 years. The real question is whether or not the increase is  a true increase in the disorder or an artifact of increased surveillance and an expanded diagnosis.  Without a doubt, the evidence strongly supports the conclusion that the increasing autism prevalence is due to increased efforts to make the diagnosis and a broadening of the definition of autism. The evidence is not sufficient to conclude that there is not also a real increase in ASD incidence, but nor is there data to support this conclusion.

Recently, more data have come out of the National Health Service (UK) that looked at a very interesting statistic.  They looked a the prevalence of ASD in adults.  See, if there is a true rise in autism, the adult population should have a lower number of cases than the current children.  Guess what?  1% across the board.  Kids and grown-ups.  Oops.  Sorry conspiracy theorists, move it along…nothing to see here. 

What can be concluded is that 1% is likely close to the true prevalence of ASD in the population.  And, the strong evidence points to the lack of an increase ASD rates.  Let’s continue to use good science to get to the bottom of ASD and not sheer panic and anti-vaccination finger pointing.

 

Dr. Brett L. Kinsler is a chiropractor in Rochester, NY who blogs at www.RochesterChiro.wordpress.com

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Quantum Light Weaving

 

quantumhealing

“Tell me, Doctor, what do you think of Quantum Light Weaving?” my patient recently asked me.

“What do I think of what now?”

“Quantum Light Weaving.”

“You’re putting me on, right?”  My patients know I will usually express my opinion on most things that are wacky and some of them try to get me to take their bait.

“No, it’s a real treatment.  I saw it when I was in California.”

“You’re setting me up for a blog post, right?”

“I have no idea what you’re talking about.  Have you heard of it?”

Well, to be honest, I hadn’t heard of it.  I was almost certain it was something made up and silly.  Light weaving?  Really, now?  I have a friend who was a pretty serious weaver for a while.  I was nearly certain she used wool and fabrics.  Very, very rarely would she weave pure energy or electrons.  Nope, something didn’t smell quite right.  I promised to investigate and get back to this sweet young patient with an opinion.

I performed my usual deep level of research which can be partly reproduced for you by clicking this link.  I learned some amazing facts — and by “amazing” I mean “silly” and by “facts” I also mean “silly.” Quantum Lightweaving is, according to the experts (“salespeople”) “an evolving and ever-expanding body of work that is bringing forth new aspects of spiritual work that embodies The Christos energy from the heart of Creation itself. The vibration is brought forth to this earth and Galaxy through The Council of 14 and your personal healing and support team of masters and angels.”

Okidokie then.  We’re got ancient Christian and presumably Last Supper stuff mixed with galaxy energy and personal support teams of masters and angels.  Hell, I can’t even put together a team that includes a decent plumber, how am I going to get an angel on such short notice?

Have no fear!  Your personal guide is Kenji who teaches you “how to be a miracle man, miracle woman, miracle kid and miracle pet.”  Miracle pet, huh?  Whoa.  Deep, dude.  And for only $25 to $50 there is an assortment of attunements you can download right to your computer.  You can even use your mystical Paypal account!  Let the miracles begin!

Well it all makes sense when you learn that “when we align through the meditative state, or “hook-up,” miracles beyond time and space and distance can occur in the twinkling of an eye.”  Wait…hook-up?  Do they really use “hook-up” to describe a state of being?  How is your hook-upedness today?  I am attempting to achieve the 9th level of hookopcity. Can I hook up my angels to my masters?  Do I need a special adapter? Will that create a miracle pet?  Will my miracle pet still puke on the carpet?

“Lightweaving affects all 144,000 dimensions of your being, or the 12 major levels of your embodiment.”  Awesome.  Lately, I have only sensed like 120,000 dimensions but I thought it was just the weather.  I feel enlightened.  I feel empowered.  I have seen the quantum light show and now know the true answer.  Quantum Lightweaving is…just…another magical way to separate people from their money.

Up the Nose With a Rubber Hose

balloon_nose

Sinusitis is an inflammation of the sinuses that occurs with a viral, bacterial, or fungal infection.  There can be pain and nasal congestion.  Acute sinusitis often follows a cold, but chronic sinusitis can last for extended periods and make people miserable.  More than 30 million Americans suffer from chronic sinusitis, meaning symptoms last longer than two months or regularly recur. Patients repeatedly try antibiotics, decongestants or steroid-containing nasal sprays, but about a quarter are thought to get inadequate relief.  Sometimes, surgery is the best option for chronic sufferers.  Standard surgery involves cutting away bone in the sinus cavity to open the passage way and allow drainage.

This week, a patient asked me about a procedure where they stick a balloon up a patient’s nose and inflate it in order to ‘move the skull bones’ and help with sinus problems.  I thanked him for the idea for a blog article and began to do my research on what I was sure would turn out to be some wacko in a clinic in California (why is it always California?) sticking things up people’s noses and declaring them “Sinus Free!”

Instead, I got educated on a new alternative to the standard sinus surgery.  Balloon Sinuplasty is compared to angioplasty — you know the procedure where a catheter is fed through an artery and plaques are squeezed to the sides with an inflatable balloon.  With the sinuplasty, the catheter is inserted into the sinus cavity and inflated to open the passageway and promote fluid drainage and pressure reduction.  Inflating the balloon aims to stretch the sinus opening back to its original size or little bigger, thus letting air (and antibiotics) into the sinus.

The research looks promising for this technology and it is most certainly not a novel means of cranial adjusting as I initially suspected.  Whew.  Patients who have the balloon catheter procedure appear to have significant improvement in symptoms two years after surgery.

The best part is that the research generally scores patient symptoms using my favorite clinical instrument:  the SNOT – 20 which I discussed in a previous post.

 

Dr. Kinsler is a chiropractor in Rochester, NY.

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