One Friday night when I was 15 years old, my friend Rob Feldman brought over a book of poems by Alan Ginsberg called "Howl". Illustrating the book were images of a statue of Buddah wrapped in a Banyan tree rising from the jungle floor. I was entranced by these images which were from Angkor Wat, the largest temple complex in the world. Angkor Wat sits at the outskirts of Siem Reap, where our Flying Doctors of America Mission will land at the end of this week. 20 American doctors, nurses, dentist and support personnel will arrive, equipped to triage, examine, diagnose, and treat men, women and children in and around Siem Reap, Cambodia. All of our services and medicines will be supplied for free, courtesy of the volunteers and those who have supported us. We will also tour Angkor Wat as part of our mission, thus achieving a goal that I first conceived 40 years ago! After our mission is completed, Dixie and I will travel to Singapore and Malaysia. In Singapore we will visit with Charles Lee, a former intern at our practice who is now married, expecting a child, and practicing chiropractic in Singapore. In Malaysia we will tour the newest chiropractic college in the world located in the capital city of Kuala Lumpur. We arrive back in the USA just before Thanksgiving.

Can your Health Savings Account help pay for chiropractic healthcare products & services?

According to the IRS Publication 502 Medical and Dental Expenses a good number of chiropractic services and healthcare products are eligible for coverage under a Health Savings Account or to be listed as Unreimbursed Medical Expenses

for tax purposes. Please note that the items described that are available in our office must be prescribed by Dr. Schantz for a specific condition or disorder for which you are being treated.

Items and services that are for promotion of your well-being are not considered eligible medical expenses. Here is a partial list of items that you may have been prescribed or may be appropriate for your condition. Please ask Dr. Schantz or our staff if you have questions. Consult your tax advisor and/or your HSA administrator for specific allowances and limitations.

CUSTOM-FIT ORTHOTICS THERAPEUTIC MASSAGE T.E.N.S. UNITS

NUTRITIONAL SUPPLEMENTS & NATURAL MEDICINES EXERCISE DEVICES

CERVICAL PILLOWS LUMBAR CUSHIONS SUPPORTS/BRACES/SPLINTS

HEEL LIFTS TMJ DEVICES CHIROPRACTIC ADJUSTMENTS

X-RAYS DIAGNOSTIC PROCEDURES MASSAGE CHAIR

How does a 5 year old know if he needs a chiropractor?

Most 5 years olds don't walk into our office on their own. The most dramatic episode in my professional life was when one was carried in by his father.

I was working as an Associate in an established chiropractic office in Sandy Springs in the late 1980's.

On Saturdays I saw all the patients in the practice. I was getting ready to leave for the day when our receptionist told me that we had one more patient to see. There in the doorway was a man in his mid-30's clutching a young boy wheezing and gasping for breathe. I exclaimed to the father, "This boy belongs in the Emergency Room-not a chiropractic office!". The man replied, "We have tried that route before, but it doesn't work-please help my son!" I couldn't say no, so I had him place the boy on the chiropractic table. I palpated his spine and found several vertebra associated with the nerve supply to the lungs misaligned. I carefully placed my hands in the proper position and performed a swift thrust. The vertebra popped in to place. The boy immediately began breathing rhythmically and regularly with no sign of respiratory distress. He fell asleep in his father's arms, and together they left the clinic for their home.

The clinical experience of most chiropractic doctors will show that children tend to respond to chiropractic treatment for internal disorders. This is because their nervous system is more sensitive than adults, and subluxations of their spines will more commonly result in nerve disruption to internal organs, rather than trigger pain.

By the time a child has reached the age of 5 they have grown 500% or more since birth. They have learned to crawl, sit up, stand, climb, walk and run. Along the way they have had an opportunity to accumulate spills, falls and upsets that can result in subluxations of the spine.

The subluxations may cause nerve interference-even in the absence of pain.

44% of patients surveyed at our practice felt that it would be OK to bring a child to a chiropractor after the age of 5.

What do you think?

Chiropractic & Infants- Safe? Necessary?

Our August patient survey, "When Should a Child Have Their First Chiropractic Visit?", revealed that 36% of those surveyed believed that "Anytime after birth" was an appropriate time to bring a child for a chiropractic visit. Among the comments we heard were, "The younger you get started, the better chance you have of staying healthy", and "If an infant had some kind of trauma, and wasn't getting better under medical care, then of course I would recommend chiropractic".

The International Chiropractors Assocation (ICA)recommends the earliest possible evaluation, detection and correction of chiropractic lesions (subluxations) in children, especially infants, to maximize the potential for normal growth and development. The ICA points to research indicating that vaginal deliveries, especially when forceps are used, can lead to excessive force on the cervical spine, leading to trauma and subluxation in newborns.

Some patients expressed concern about the safety of adjusting infants, since their bones had not hardened enough.

Let's look at a 2008 study from Great Britian, "Adverse Effects of Spinal Manipulative Therapy in Children Younger Than 3 Years", published in the Journal of Manipulative and Physiologic Therapeutics. The objective of the study was to identify any adverse effects to chiropractic care occurring in the pediatric patient and to evaluate the risk of complications arising in the pediatric patient resulting from chiropractic care. A 3-year review of pediatric case files from the Anglo-European College of Chiropractic teaching clinic were evaluated. The results showed that out of 697 children receiving 5,242 chiropractic treatments, 85% of parents reported an improvement. 7 parents reported an adverse effect. There were no serious complications resulting from chiropractic treatment (reactions lasting >24 hours or severe enough to require hospital care.

Infants don't complain about back pain.

If your use of chiropractic care is limited to reducing back pain, then you probably would never conceive of a situation where an infant could benefit from chiropractic treatment. If you take a closer look at what chiropractic treatment does- improve the function of the nervous system- then you may be able to see how chiropractic may be appropriate for infants.

Case Study from Our Practice- 11 month old baby with painful bowel movements becoming less and less frequent, from every other day to every 4 days. Increase in medication from using up a whole bottle of maltsupex once a month to every two weeks, even while increasing fruit and vegetable intake. Incredibly hard stools and rectal bleeding.

One treatment improved the baby to having soft movement every day. She needed another treatment the following week, and now she's having 2-3 movements regularly, every morning with no medication at all. No more tears and screaming.

This baby had subluxations in the lower spine and sacral region resulting in decreased nerve stimulation to the bowel. There was inadequate musculature contraction to initiate normal bowel movements resulting in chronic constipation. Infants typically respond quickly to chiropractic treatment (1-2 visits), because their nervous and musculoskeletal system is less mature.

Other Conditions of Infants that May Respond to Chiropractic Treatment

Ear Infections

Respiratory Distress

Breast Feeding Problems

Digestion and Elimination Problems

Developmental Delays- Lifting head, balancing, crawling, standing, walking

Colic

When Should a Child Have Their First Chiropractic Visit?

We asked our patients last week, "When should a child have their first chiropractic visit?". We told them to give us their opinion, not what they thought we wanted them to say. We gave them four choices.

#1 Any time after birth.

#2 Any time after age 5.

#3 Any time after age 13.

#4 Any time after age 18.

Over the next few weeks we will take a look at our patients' answers, and explore the rationale for chiropractic care at different ages. We will share stories about children that we have treated here in our office, and let you decide if and when it make sense for a child to see a chiropractor.

NEXT WEEK- CHIROPRACTIC AND INFANTS: Is it safe or necessary to perform chiropractic on newborns or infants?

Medicare Fee Increase

Congress has approved a 2.2% fee increase for Medicare chiropractic services and other physicians services that will take effect in our office beginning September 1, 2010. This means that Medicare patients will pay between $.66-$1.31 more for chiropractic adjustments. The difference is due to the number of regions of the spine that must be treated on each visit. If just one or two regions are adjusted, then the lower fee applies. If five or more regions are adjusted, then the higher fee applies. You may think, an adjustment is an adjustment, is an adjustment.

Medicare and most other healthcare plans count each region of the spine as a distinct, reimbursable area of treatment including the cervical (neck& head), thoracic (mid back & ribs), lumbar (low back), pelvis (hips). Other segments of the body may be adjusted, but are not reimbursable by Medicare, such as the hand, elbow, wrist, knee, ankle and feet. It is not known if Congress will stick with the 2.2% increase, or enact at 20.2% decrease for chiropractic and other physician services after November 1st, 2010. Sources claim that a decrease of that proportion will cause many primary care providers to refuse to accept Medicare patients. The fallout from that could overwhelm hospital emergency rooms, as they would now become the only alternative for seniors needing primary medical care.

Fundraiser a Success!

The enormous generosity of our patients showed through this week with an outpouring of donations. We far exceeded our goals for Flying Doctors Day, ending up with over 50 patient visits and over $3,000 in donations. More than 30 patients contributed $50 or more, with the top donation of $500! Lots of patients will be sporting a Flying Doctors of America T-Shirt this summer. I am due to depart on November 10th and return on Thanksgiving. It may seem like a far way off, but it will probably be here before we know it. Thanks again for every one's help and support to make it possible for me to give chiropractic care to the impoverished people in Cambodia.