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.
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?
I closed my clinic last month and moved to another continent. My office, therefore, is for rent. It’s located at 6887 Brockton Avenue, Riverside, CA 92506. I thoroughly enjoyed working in the area, and I think you would to. Do you have a business idea or are you looking to transform your web-based business into a brick-and-mortar concept? Contact Dr. Bijan Pourjamasb if you’re interested in looking at my former office. He can be reached at 949-727-1753 or 951-786-3636. Best of luck in your future endeavors!
It’s true, folks. The clinic is closing. Why? I’ve recently accepted a position as the chiropractor at a U.S. naval hospital overseas.
I don’t think I’ve ever experienced anything more bittersweet in my life. The offer came as a shock. Did I apply? Yes. Did I expect to get the job? No. Nonetheless, I couldn’t say no to this opportunity. I’m truly saddened that my time in private practice is abbreviated and is rapidly coming to an end. But I’m fiercely excited for the adventures ahead.
I’ll be seeing patients through November, so come by! In the meantime, can you guess where I’m going? Let’s start with the continent.
Stay tuned! Over the coming weeks, I’ll gradually reveal where I’m off to next.
Do y’all watch Survivor? I’m totally a fan. If you tuned in Wednesday, Boston Rob referenced chiropractic.
The premise of this season is that two returning champions, Boston Rob and Sandra Diaz-Twine mentor and then test a contestant. This week, Kellee was called to the Island of the Idols (so dramatic!) and tested her on her listening skills. This involved Boston Rob and Sandra bombarding her with personal information about themselves, interspersed with questions such as, “So what do you think about chiropractors? Are they legit?”
Kellee’s answer? “Ummm…”
I chuckled at this segment. But since Kellee hesitated to answer, I’ll take the liberty of providing one.
Yesterday, I had the refractive eye surgery, SMILE, performed so that I can see without the aid of glasses or contacts. Since I was a child, I wanted to have my severe nearsightedness corrected. As an adult, I found that I was not a candidate for LASIK or PRK. Recently, I even explored ICL, before the minimally invasive SMILE was suggested to me. I leapt at the opportunity.
Folks, the glory of the day after receiving refractive eye surgery can scarcely be described. Even immediately after the procedure, I sat up and could read the very large letters on the machine where just twenty minutes prior, I couldn’t perceive that there was a raised platform in the room and had to be guided to the operating table.
I’ll simply leave you with some pictures of my latest adventure.
Have you had refractive eye surgery? How was your experience? Let me know in the comments below, or at your next appointment. I’m so happy to report that I can see much better!
I have a confession. I moved to California three years ago and I don’t know any Spanish. I have also made no effort to learn any.
(Is that one confession, or two, or three?)
Until recently, of course. Observe my progress on Duolingo.
It’s a start, and long overdue. Spanish will be the fifth language I learn. Though I don’t expect that I’ll be able to conduct all clinical operations without a medical interpreter, maybe I’ll be able to hold a conversation before one arrives.
A couple of weeks ago, I had an ophthalmology appointment. I brought a friend, who was my chaperone. (Note: Feel free to bring a friend/chaperone along with you for your appointments with me.) My friend took the picture below.
That’s right. My left shoulder is significantly lower than the right. That’s because I used to play the violin.
It’s easy as a health professional to recognize postural imbalances in a patient. It’s one of the first things we learn in chiropractic school. It’s harder to recognize them in yourself. Self-awareness of posture is so rare, in fact, that my professors were surprised when I could articulate which of my shoulders were lower. However, despite knowing this, I’ve not been able to correct this because my left shoulder simply does not feel lower than the right. This is the aspect of self-awareness that is missing for many, the fact that we don’t feel lopsided at all! Many patients have reported that when they try to correct their posture, they feel lopsided when in fact their shoulders and hips are level. How can we remedy this conundrum and build awareness?
Progression muscle relaxation may offer assistance. This technique is designed to help build awareness of what activated versus relaxed muscles feel like. After you’re familiar with progressive muscle relaxation, try it while standing in front of a mirror and watch how dynamic posture really is. (Of course, because you’ll be standing, the muscles in the legs will not completely relax in this variation.) Let me know how it goes in the comments below, or at your next appointment.
One of my patients is an athlete with particularly high aspirations. They* sought me out to be part of their health care team. From their reports, it doesn’t appear that their sports medicine department is very robust. I’ve been trying to discern what, if any, resources the athletes had, in terms of health care professionals. I brought up sport psychology, which I had studied during for my M.S. degree. During my explanation of sport psychology, they nodded with clear understanding and elaborated in their own words. They mentioned that indeed, when comparing athletes, if everything else is equal, it’s likely the one with positive thinking that runs faster.
I was happy to hear their espousal. I’m nervous when mentioning psychology as a health care system, as it’s still fraught with stigma. To see a young person demonstrate that they had no such notions and that they understood the basic precept of positive psychology was very refreshing.
I told them that there are many ways to exercise the mind, as there are many ways to exercise the body. I encouraged taking a class or two on psychology, or to read books on the subject. Thus, I came across this article. I think these books are applicable to a wider audience, so I’m sharing the list here. Fun fact: I’ve read only one of these. Can you guess which one? Which have you read? Let me know in the comments, or at your next appointment.
*They/Them/Their pronouns are used in this post to protect health information. The pronouns are used in the singular sense and do not necessarily denote gender neutrality, or any portion of the gender spectrum.
Yesterday, I came across this article about the ideal day off. I read it, chuckled, and proceeded to be one of the many who commits to a full day’s work on a day off. I checked my email, caught up on work, and didn’t step a foot outdoors except to toss the trash.
So I’d love to hear, what did you do yesterday?
P.S. I was asked why I decided to post this seemingly a day behind schedule. Because it’s never too late to plan for your next day off! Which, for me, will be Fourth of July.
Have you seen this? This font was deliberately designed to be hard to read in order to improve memory retention. You can try it out on the website, it’s free to download, and if you’re a true fan, it’s available as an extension to convert all website text to Sans Forgetica.
I’m fascinated by this! Unfortunately, I can’t read it at all because I’m dyslexic. However, not all people with dyslexia process fonts similarly. Are you dyslexic? Can you read Sans Forgetica? If you’re not dyslexic, what’s your experience with using this font? Do you think it does what it claims? Let me know in the comments, or at your next appointment.
P.S. To the scientists at RMIT University, please make a Sans Forgetica for dyslexic folk! I volunteer as a research participant.