Risks

I’m sure y’all have heard about the association of stroke and chiropractic manipulation of the neck. Chances are, it’s written in the informed consent that you sign before receiving treatment from a chiropractor. It was in the informed consent form that I had at my private practice, and it’s a discussion that I have with my patients in my current position.

The NIH states that “incidence of [vertebrobasilar stroke] was too small to report.” For those who like numbers, however, “1 per 5.85 million cervical manipulations” has been calculated by Haldeman et al. I also have notes from my alma mater that state that the risk is about 1 in every 3 million cervical manipulations, though I can’t seem to find this number cited elsewhere. (Can you? Let me know in the comments below.) The risk of stroke from chiropractic manipulation, however, is hotly disputed, with giants like Forbes slinging mud at the NIH, and the NIH striking back. These days, I put things into perspective for my patients by providing another number.

The risk of blood clots related to the Johnson and Johnson COVID-19 vaccine seems to be about 1 in 1 million.

You guys, 1 in 1 million is significantly more risk than “too small to report,” 1 per 5.85 million, or 1 in 3 million. Do understand, and every patient of mine has understood after I’ve explained it in this way, that treatments and prophylactics can return to the marketplace despite risk. That was true of the Johnson and Johnson COVID-19 vaccine, and chiropractic has continued though there have been adverse events. Ultimately, it is not about risk, but rather the risk to benefit ratio that matters. Health care professionals have an obligation to inform you of the risks so that you can make a decision on whether you wish to undergo a procedure. I have had patients refuse treatment because they think that 1 in 3 million is too much risk to bear. I respect that fully. On the flip side, I have had to explain to other patients that chiropractic manipulation is highly inadvisable for them, because the risk to them, based on their health profile, is simply not worth the potential benefit. As sentient beings, we have choice.

I will conclude with a question I frequently ask to my patients. What are your questions?

Zooming

This is a screenshot of me during a zoom seminar, held by the chiropractic professional organization of which I am a member.

Boy oh boy, do I look unenthused.

Have you taken Zoom seminars? How do you stay engaged? Let me know your tips and tricks in the comments below or here because I clearly need help.

Black Lives Matter

I’ve been reading a fashion blog since 2009. (Confession: I suppose I read multiple fashion blogs, but this one stands out.) It started off as a blog, a journal of sorts written by one woman. It has evolved into much more than a blog, into a business, a company, a store, and a brand, and now projects more than one woman’s voice.

It has not been lost to readers that all women who write articles for this blog are white. While I am a silent consumer of content (I’ve never commented on a video or article), others are more vocal and have pointed out the lack of diversity presented by this company. Did it bother me? Yes, but not enough to be bold enough to comment. Did I continue to read the articles? Yes, though I began to turning to other sources as well (see confession above).

Recently, before the shooting of Ahmaud Arbery and the killing of George Floyd, the founder addressed the lack of diversity within her company and stated that the platform will begin publishing articles on non-fashion topics such as the environment (and how the fashion industry impacts the environment), mental health, and diversity. There was much pushback from readers, many of whom expressed their concern that a group of white women are ill-equipped to write about experiences of racism. There was also opinion that a fashion blog doesn’t need to address these topics, and therefore shouldn’t.

These articles never materialized, due to the COVID-19 pandemic. With the recent atrocities, however, the company could hold its silence no longer and stated it would begin delving into tough topics by publishing editorials about institutional racism.

I’d like to address two concepts I’ve presented. The first is silence. For me, racism had always been a private topic, something I would discuss in a safe place with family or close friends.

Nevermore.

We cannot live in a world where African-Americans are killed in broad daylight in front of multiple witnesses. This is wholly unacceptable.

The second concept is propriety. Just as readers asked the fashion blog founder, is it appropriate for your blog to speak on these topics? Perhaps you should continue to speak on headbands? Some of you may ask, what does a chiropractor have to say about Black Lives Matter?

To answer that question, what I have to say about Black Lives Matter is that Black Lives Matter.

We are beyond opining on who should speak and can speak on racism. We all need to speak about racism.

I challenge you to post on your blog, within your niche, about racism. Break the barriers of silence. Destroy the walls of appropriateness. Share your articles in the comments.

Understand, folks, that racism will end. Evil, and all its faces, will never prevail.

To ask or not to ask

It’s no secret that there are many business, small or large, that are struggling right now. Chiropractic clinics are no exception. It is all in stark contrast to my position. That’s why, earlier this week, I posted to my chiropractic class’s group on Facebook.

“To the esteemed class of 2016,” I wrote. “How are you doing? How can I support you?”

For a full day, I received silence. No reactions, no comments. I confess I was surprised and disappointed. I’d chosen my words carefully, even researching how to best ask someone if they needed help. Then, a like, and a comment.

“Doing great!” my classmate wrote. “How’s it going with you?”

I was struck by how casual, flippant, and, if I’m being honest, somewhat unbelievable this statement was. I wondered if my research on how to choose the best words to convey my concern for my profession, and for my classmates, was for naught. Had I offended someone? Was I condescending? Is that why my words are being flung back at me?

I responded and clarified, “Likewise. I may be in a unique position to be able to aid our profession, but am unsure how. Hence, I’m asking if there are specific ways I can support colleagues.”

Again, there’s silence. But then another classmate comments, “Oh it’s going! Just waiting it out. Any chance you can get your hands on some PPE?”

At school, we’re taught to prideful. We have to be, for a profession constantly on the defensive. We’re proud of our philosophy, we’re proud of our concept of health care, we’re proud of our private practices. And the proud don’t need help, don’t ask for help, and indeed, reject help because we’re the ones who do the helping, not the other way around.

Here’s the thing, folks. If you don’t ask for help, you will absolutely, assuredly receive none. If you do ask for help, you may be turned away, but you may receive exactly what you need. I asked my classmate to private message me the type and quantity of PPE and stated that I’ll see what I can do.

I understand that it can be nerve-racking to ask for help. We think it places us in a vulnerable position, a position of weakness. Instead, it is a strategic pause, allowing you to gather your resources and thoughts and readying you to launch a new offensive.

In closing, to my colleagues, how can I support you?

To hear or not to hear

Y’all, I’ve been busy, and I’m sorry that I’ve neglected this medium. I have a story to share that has nothing to do with COVID-19. (Regarding that, I hope that you are all staying healthy.)

The history of chiropractic is inspiring, dramatic, ironic, and tragic. My favorite part is the beginning, wherein D.D. Palmer delivered the first chiropractic adjustment for Harvey Lillard. It’s an amazing story, so amazing, in fact, that it’s looked upon with more doubt than wonder these days.

Harvey Lillard was a janitor who worked in close proximity to D.D. Palmer. Mr. Lillard remarked to D.D. Palmer that he had lost his hearing at the age of 17, after hearing a “pop” in his back. D.D. Palmer examined Mr. Lillard. After finding a bony protrusion between the patient’s shoulders, he asked Mr. Lillard if he could push the bone back into its proper position. Mr. Lillard consented, and D.D. Palmer delivered the first chiropractic adjustment. A few days later, Harvey Lillard reported that his hearing had returned.

What’s amazing about this story is not just that the first chiropractic adjustment restored hearing for a deaf man. What’s more amazing is that the first chiropractic adjustment to the thoracic spine (between the shoulders) restored hearing for a deaf man.

Unfortunately, we have not been able to reliably reproduce this result. Imagine my wonderment then, when a patient remarked giddily after I adjusted him, “It’s weird. I feel that I can hear better.” These days, I treat only active duty service members, many of whom have bilateral hearing loss. His speaking this truth was unbelievably validating. Generally, I have to prompt patients by asking if they feel better, worse, or the same as they felt when they were in the waiting room, and they typically respond that they feel better, worse, or the same. This particular utterance, then, was staunchly atypical. It was as if I was hearing his innate intelligence speak, without filter or editing.

I went about the rest of my day with a bounce in my step. And I’m happy to report that the bounce hasn’t subsided.

It begins

Last year, I started learning Spanish. I knew its broad usage in California would be highly applicable to my practice. Later, I found out that I was selected for position overseas, where Spanish is not at all widely used. Nevertheless, I stubbornly finished the Duolingo Spanish course.

Please don’t expect too much of me. I can barely speak it, but I’m glad I’m now moderately proficient at reading.

Because learning never ends, I started another course this week.

How many languages do you know? What are they? Let me know in the comments!

I’m in Japan!

Did you guess correctly?

Here’s a hilariously bad picture of me at the airport.

Travel tip: I like using hardside luggage. However, there’s a significant risk of it breaking in transit. Because this has happened to me, I use luggage ties so that in case of breakage, my essentials don’t scatter. Another benefit to luggage ties is that it uniquely and colorfully distinguishes your luggage.

What do you do to prevent travel mishaps? Let me know in the comments!