Painful Decisions

The recent news of the birth of octuplets has raised a variety of issues about medical ethics. One article raises a central point in making healthcare decisions. As hard as patients try to make good decisions, sometimes the circumstances are against them.

In this specific example, about how to proceed with the pregnancy: "Rosenthal, on the other hand, questions the woman's capacity to make a good decision under the circumstances. Some neonatologists believe that when pregnant women are told about dangers of prematurity or have great expectations about giving birth, their judgment can be impaired, she said."

The article continues in the more general way: "Although the health care system in America gives patients autonomy in making decisions about their own bodies, when emotionally distraught, some people decide poorly, she said."

We see people every day who are in pain, frustrated, scared, or otherwise emotional about their health problems. These feelings are completely acceptable and normal and no one should deny you your experience. You are a whole person with thoughts, feelings, and a physical problem. All those feelings can build a vicious cycle, though, in which your pain feeds your emotions and your emotions feed your pain. Some people even need a specialist to help them work through those feelings.

That's why your doctor should aim to guide you through the whole situation. Appropriate reassurance, information, education, and options should be discussed. Once you have a better understanding of the situation, a lot of fear tends to just melt away.  You should ask questions and bring up your concerns. If you make a choice that isn't helpful or may even be dangerous to you, your doctor should explain what could happen and how the risks outweigh the benefits. All this goes to finding treatment options that will help your health problem and fit with your values and needs.

Sometimes, you're just not ready to make big decisions. First, remember that although you may feel alone and the weight of the world is on you, you are not the first person to be in this situation (and get through it successfully) and your doctor is there to help.  You and your doctor can break the problem down into smaller chunks that you can get a better handle on. Working this way, the big decision may end up making itself.

Remember, you are the most important person in you healthcare team. The rest of your team really, really wants to help you make good decisions and see you at your best.

If all the guidance and help still doesn't make you confident about your decisions, ask your doctor: "If I were your mom, what would you do for me?" Personally, this thought goes into how I try to help each and every patient.

Why chiropractic orthopedics and rehabilitation?

Why is a chiropractor doing orthopedics? Shouldn’t I just go to an orthopedic surgeon? And, why chiropractic rehabilitation? Aren’t physical therapists the rehab people? Why doesn’t he just crack backs like chiropractors are supposed to?

More good questions. Kind of like, “So What?”

Sure, orthopedic surgeons do orthopedics. But what if you don’t need surgery? Your surgeon will probably just send you to physical therapy. And, sure, physical therapists do rehab, usually dictated by a standardized protocol for all patients with that problem. But you’re not like everybody else. Finally, chiropractors do “crack backs” but what if yours isn’t a back problem that “cracking” can help, or not a back problem at all?

The point is you need a good, thorough orthopedic evaluation of the painful area. But it shouldn’t stop there. That evaluation should expand to other body parts and consider prior injuries, daily activities, ergonomics and a host of other things that could slow your recovery. The goal is a complete diagnosis from which your health care provider can tailor a treatment plan to meet your specific needs.

That is chiropractic orthopedics and rehabilitation.

So what?

So, what is a chiropractor doing with a blog? There are a gazillion other blogs out there? So, what can I get out of this one?

So what?

Well, that’s actually a really good question to ask when it comes to health and medicine. There are announcements made every day about new discoveries, new recommendations, and new gadgets. But, so what? “So, what can it do for me?” And how does it fit into the rest of healthcare? Is it really exciting, groundbreaking new information – or is it spin? Did the journalist making the report really understand the scientific paper? What should I do about it, if anything? So what!?

So, that gets to the big idea behind this blog. My goal is to share information and interpretations about new research and information when it comes to orthopedics and rehabilitation. I’ll share how I approach a patient’s problem and how my thinking changes when new data is available. When I go to a seminar or conference, I’ll take you behind the scenes as to what is happening out there. When a news or journal article is published, I’ll help you put it into context. Feel free to bring your questions and comments, too! Let’s work this thing together. Heck, if we’re not careful, we both might just learn something here.

Of course, there may be the occasional odd bit of trivia or other diversion. Hey, it’s a blog!