Freezing Cold Electrodes? Not Anymore!

I live and practice chiropractic in Rochester, NY right smack in the middle of the upstate New York snow belt. And I know it’s hard for you to believe but it does get a tad bit chilly around here…even in the winter time. Seriously.  Now, on occasion in our office, we use some electric modalities with patients (electric muscle stimulation, interferential, etc.) and one thing always bothered me. Generally, when we choose to use one of these modalities, it is because of overly tight muscles or splinting (settle down there Ben Franklin, we can talk about the research in another post). And regardless of whether we used the sticky electrodes or the 3 x 5″ carbon electrodes that were sprayed with water (my economical preference), patients always jumped just a bit from the cold electrodes. This seemed counter-productive — especially when we are talking about people who are in pain and spasm and shouldn’t be exposed to a shock that makes them jump at all.

Several times per day, I would hear myself say, “Sorry, these are going to be a bit cold.”
To which the patient would respond, “Arrrrrgh! Holy crap, is that cold!”

Not the greatest strategy for patient comfort, retention and bedside manner.

So five years ago, I decided to take it as a personal challenge to solve the problem of the freezing cold carbon electrodes. First, I tried heating the water in the spray bottles we used. I got a desktop coffee cup heater and rested the spray bottle on that. I also tried ultrasound gel warmers and a few other strategies. No help. The water stayed warm but once the water hit the air, it was almost as cold as without heating it. And keep in mind, 72 degree room temperature water is awfully chilly to a 98.6 degree body.

After several experiments I determined that the only way to consistently deliver comfortably toasty electrodes to the patient would be to actually heat the electrodes. Then, once the water hit them, they would still feel warm. But how? We have a microwave in the office but this seemed like a terrible idea for the degradation of the carbon. I was also afraid it would become uncomfortably hot and perhaps even cause burns. Another idea was to dunk them in a hydrocollator but I didn’t have one in every treatment room and had no intention of buying a bunch of hot water tanks at $250 a pop. Not to mention the space they take up and the horrible prospect of a kid turning his arm into soup. It also made the electrodes really wet and patients didn’t dig that too much.

The perfect solution would be something that I could rest the electrodes on and keep them at a safe, steady temperature.  It would need to be small, be able to stay on all day without over heating and be safe around little patients’ little fingers.

In the unlikeliest of places, I actually found it! A small, thin, flat heating element that stayed at 100 degrees Fahrenheit. No more, no less. The device is meant to be kept on all day long with no danger of overheating. You can turn them off at night and they warm up quickly in the mornings. They are safe to touch. They don’t wear out the electrodes and they cost under 15 bucks!

I bought four of them and they have been in constant service for 5 years.  None have failed. None have caused patient burns. And best of all, there have been no chilly electrodes.  I can use them with the carbon or the sticky ‘trodes.  I sandwich the paper-thin heater between two pairs of electrodes and usually toss a package of stickies on top.  Now patients say, “Ohh, that’s nice and toasty. Like a spa.”

I can live with that.  Bring it on, Winter! I’m ready for ya, Tough Guy!

I searched around since the store I initially got these heaters no longer carries them but I just located them online for a great price! The exact model and brand I have been using can be found here in case you are interested in getting some for yourself.  Yes, it takes you to a pet store website.  No, that is not a mistake.

Too bad you have to get them online, though. I really enjoyed the horrific look I got from the checkout girl when I first purchased mine when her eyes widened and she asked, “Exactly how many cobra snakes do you own?!?”

You will miss that conversation and the wide-eyed checkout girl but you won’t miss your patients cringing from your formerly cold electrodes.

Let me know how it works out for you.

Link to get the “Electrode Heaters” I use.

Chiropractic’s Relationship With Research

 

Chiropractor Shawn Thistle discusses chiropractic's relationship with research on the On The Other Hand Podcast.

Chiropractor Shawn Thistle discusses chiropractic's relationship with research on the On The Other Hand Podcast.

Chiropractors have an interesting relationship with research. Some part of the profession uses it to properly guide the manner in which we make clinical decisions.  Some chiropractors only use research when it agrees with what we are already doing to reinforce our decisions. Some use it as marketing tool — no matter how weak the evidence may be.  And some chiropractors ignore research entirely.

I had to opportunity to speak with Dr. Shawn Thistle from Research Review Service.  His company acts to distill down some of the more important research for field practitioners and translate it into a format that is easier to understand and use.  Something like an electronic journal watch personalized for chiropractors. Since he straddles the line between active practice and research liaison, he sits in a unique vantage point.

Dr. Thistle and I spoke on an episode of the On The Other Hand Podcast which can be found on iTunes or here. He also offered listeners to the podcast a discount code if they are interested in his review service subscription.  Enter “OTOH” (which stands for the title of the podcast) during checkout and you can save 25% on subscription fees.  I have no part of this arrangement  –I’m  just passing it along as a friendly thank you to my blog readers and podcast listeners. Enjoy.

Podcast interview conducted by Dr. Brett L. Kinsler.

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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Medpedia News and Analysis

badge_text_tallI like Wikipedia as a shortcut to quick information but I am afraid to use the information there for any serious projects.  After all, the people producing and editing the content there are just average Joes.  Sure, if you put together enough average Joes and solicit their opinions, you are more likely to come to an accurate conclusion…sometimes.  Not exactly a bet I’d want to place.

Wouldn’t it be cool to have a wikifor medical information where only verified medical professionals can directly edit the material?  There is so much medical misinformation on the internet it would be nice to have a source that is more apt to be responsibly written.

Medpedia looks like it might fit that description.  Still in beta phasebut set to fully launch soon, the Medpedia Project is backed by Harvard Medical School, Stanford School of Medicine, Berkeley School of Public Health, University of Michigan Medical School and other leading global health organizations. The goal is to create a new model of how the world will assemble, maintain, critique and access medical knowledge. Over time, they expect to have a collection of up-to-date unbiased medical information, contributed and maintained by health experts around the world, and freely available to anyone who is interested.

This week, I was contacted by a Medpedia staffer. They requested permission to put my blog posts onto the News & Analysis section on their site.  I am pleased and proud to be among the bloggersinvited to participate and welcome the new Medpedia readers and their comments.

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Get CE Credit for Reading This Blog?

laptop

You’re one of the hundreds of fine and intelligent people who have been reading my blog.  Thanks!!  I truly appreciate you reading my ramblings and especially relish your comments and private emails.  But, if you are a chiropractor, PT, OT or certified hand therapist I know what you’re thinking.

It’s probably one of two thoughts.

The first is, wow, that RochesterChiro writes some funny and poignant stuff but I can’t waste so much time reading his blog without getting continuing education credits for it.  What’s in it for me?

The second thing you’re thinking is, I wonder if the doctor who writes this blog has a voice that sounds just like the I use one in my head when I read his funny, poignant stuff.

Well, dear reader, I have solved both of your problems at the same time!!

You may know that I write online continuing education courses for the best Online CE provider in the world!  OnlineCE.com also known as Chirocredit.com offers online continuing education courses for Chiropractors, Occupational Therapists, Physical Therapists, Certified Hand Therapists, Massage Therapists, Athletic Trainers and Aromatherapists.

I have a bunch of very good courses in the Pediatrics, Emergency Procedures and Physical Diagnosis sections (you can search instructor name Kinsler if you want) which you can take for credit.  But I have just posted a new course in a new format that I am really excited about.  In it, the chirogoddess Dr. Elliott and I discuss the newest research concerning Autism and Vaccinations (See course Peds 113) in a one hour course complete with slides and an audio presentation.  It is the first one we have done in this format and we would appreciate any feedback you have.  It sort of felt like doing a podcast — an idea I have been toying with as well.  You should check it out.

Besides, where else are you going to get an hour of university sponsored, state approved CE credits for like twenty bucks?  You can even wear those torn sweatpants and bunny slippers and not leave your house! And, you know the instructor so it’s not exactly a crap shoot.  One hour, five easy quiz questions and you can print your certificate!  How cool is that?

You’re already reading my stuff, you might as well get credit for it.  With the latest landmark decisions in vaccine court, you should have the information to make informed recommendations to your patients.  This course will definitely help with that.  Enjoy and let me know what you think!

 

Dr. Brett L. Kinsler writes the RochesterChiro blog and post graduate continuing education for OnlineCE.com

Ergonomic Keyboard Bobs and Weaves

smartfish pro motion keyboard

Engadget is reporting on a sighting at the International Consumer Electronics Show in Las Vegas– an invention by Englewood, NJ chiropractor Jack Atzmon. Dr. Atzmon developed a regular-sized keyboard that contains a small motor and enough computer power to tilt slightly every so often — on three different axes — thus moving the user’s typing position.

His production company, Smartfish, has not conducted any clinical trials to support the theory, but it collaborated with the Hospital for Special Surgery in Manhattan on the keyboard design.

A design such as this has the potential to decrease the incidence of carpal tunnel syndrome. Ergonomic keyboards are nothing new, but Atzmon’s appears to be a novel approach.

Atzmon had the idea for his keyboard during a trip to a Best Buy about two years ago. He realized that by having the keyboard itself move slightly every so often, it would shift the angle of a typist’s wrists and keep the carpal tunnel region from staying in the same position all the time.

Smartfish’s Pro:Motion keyboard, with a suggested retail price of $130, moves every 4,000 to 6,000 keystrokes, according to the company.

It remembers the last user’s typing pattern and will reposition itself about eight times a day. It also knows when you pause, and moves only then, so it doesn’t interrupt work flow.

Atzmon says his 20 years of chiropractic training and experience, including treating people with repetitive stress injuries related to typing, helped spark the inventor side of his brain. “Chiropractors are not taught to treat pain; we’re taught to fix it.”

About the same time, he injured his own arm while swimming with his kids, limiting his ability to perform chiropractic adjustments and giving him both the time and the motivation to turn his idea into a real product.

Jewish Autistic Astronauts Fake Moon Landing

Not really…but I thought you might like to see the Anti-Vaccination quote of the day:

“Many doctors now argue that reporters should treat the antivaccine lobby with the same indifference they do Holocaust deniers, AIDS deniers and those claiming to have proof that NASA faked the Moon landings. ”

Read this article on the lack of a link between autism and vaccination in the New York Times, see the link below:

http://www.nytimes.com/2009/01/13/health/13auti.html?partner=permalink&exprod=permalink

Patient Advocacy for Chiropractic

Dr. Duncan over at his “Chiropractic Discussions”  blog discusses a new online tool for chiropractic patients… http://chirotalk.wordpress.com/2009/01/12/patients-for-chiropractic/trackback/

Chiropractic Think Tank Launches Website

whg

The West Hartford Group, Inc., (WHG) is a chiropractic think tank dedicated to the advancement of the chiropractic profession in an ethical, responsible, evidence-based way.  The WHG is a pro-active and positive force moving in the direction of cultural, social and professional authority to improve the profession’s standing within the health care system and society.

Some of the members of WHG include such chiropractic notables as Michael Schneider, Richard Vincent, Stephen Perle, Donald R. Murphy, John J. Triano, David Seaman and Lawrence Wyatt.

 The West Hartford Group’s website was launched today.  Soon, position papers and other information will be added to help promote the non-surgical, patient-centered, spinal specialist model embraced by the think tank.  The website is located at:  www.WestHartfordGroup.com

Wasamatterudeskitis? Get a Workstation Evaluation Free Online

ergonomics

Recently, I successfully completed a tricky two-handed control-alt-delete maneuver while holding my 4 month-old baby.  Although I nearly dislocated a shoulder (mine) and there was some crying involved (the baby) it occurred to me at that moment that many people are not as well qualified to perform ergonomic evaluations of their workspaces as I am.  Well, that oversight cannot be tolerated.

Ergonomics is the science of designing a job, equipment, or workplace to fit the worker.  Proper ergonomic design prevents repetitive strain injuries, which can develop over time and can lead to long-term disability.  Some companies provide ergonomic specialists to evaluate an employee’s workstation and make recommendations as to ideal positioning and equipment.  For people who do not have this service, I strongly recommend a website called Ergonomics Simplified

These folks offer a free online evaluation of your workspace.  They ask for an email address for identification but there is no verification so if you are as allergic to spam as I am, you can use a spam proof one (like mailinator) or some other fake. 

The free ergonomic evaluation asks some information about you, your job and your space and then walks you through an interactive step-by-step process making suggestions or offering tweaks you can do along the way.  The information appears to be clinically sound and goes beyond the ordinary.  This skeptical chiropractor is impressed….and I don’t impress too easily.ergonomics_workstation

For the maximum benefit, go to Ergonomics Simplified from your workspace computer so you can actually make some of the changes that are recommended.

Let me know what you think.

Dr. Brett L. Kinsler is a chiropractor in Rochester, NY with a pretty good ergonomic setup for some of his desks but not so good for some others.  His office website is RochesterChiro.com

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