Author: Chiro1

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Diagnosing pain.

Did you know that there is a diagnosis code for virtually every part of your body plus the word “pain.”

Low back pain M54.5
Pain in the Thoracic Spine M54.6
Pain in the left foot M76.672
Chronic Bladder Pain R39.82

There are also diagnosis codes for significantly more detailed problems. This is often the reason for the “pain” diagnosis. I can diagnose right facet joint arthritis, or cervical degeneration that causes radiculopathy. There is value in both forms of diagnosis.

When you, the patient, comes in, you usually tell me about how you’re feeling. This discussion revolves, most commonly, around your pain. I will dig around and ask some questions and let you tell me your story. At this point, I can easily diagnose you with your specific pain diagnosis. You come in with neck pain, and I can diagnose neck pain in about 3 minutes of meeting you.

In the next step, I get to dig around and find out if there is an even more specific diagnosis that explains the “pain” diagnosis. This is the part where I rule out the really serious diagnoses, like a broken bone or a torn ligament. It is the part that takes a lot longer, occasionally more than one visit sort of longer. This is the part where we will usually throw out the fancy words. “Hip Impingement” or “Arthritis.” (And occasionally these fancy words come with an even fancier test.)

Now here is the really tricky part. Getting rid of pain can be really easy. (Tylenol, Gabapentin, Codeine) But getting rid of the fancier word part, the actual cause… now that is a lot harder. Just like diagnosing it requires a deeper understanding by your doctor to name it, it also requires a deeper understanding by you, for you to heal it.

Notice I said “You” to heal it. I can help you get rid of the pain and understand what needs to be done to heal, but the longer term changes, that is going to take more than just coming to see me a few times and taking tylenol for a couple weeks. There is a good chance you’ll need to support your body with movement, nutrition, rest and time.

This is a process. I hope to teach you everything you need to learn to heal, but it takes time. It takes time for us to peel away the layers that got you into pain in the first place and it takes time to explain each new healing step as we reach it. It will take time for you to make the changes you need to stay out of pain.

As Always,
Keep Moving.

Dr Cate

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It is not what you do, it is WHY you do it.

This weekend I filled in another page on my websites. I got right to the point and stated what I did, and how it could help. This morning I got to the office and had a short break between patients. I was feeling more energetic than the spa music that is usually playing in my office so I decided to turn on a Ted Talk while I did my weekly organization.

I started (and ended) today with Simon Sinek: How great leaders inspire action. At the end of the talk I thought back to how pathetic my writing was this weekend for the website. I realized I described what I do with great fluency but I barely touched upon the “Why.”

So here are some Why’s of my office:

Its always your choice

Because I believe that women with “Unexplained Infertility” can have the joy of becoming pregnant and having healthy babies.
Because I believe that drugs and medications can be very harmful and that western medicine fails to adequately explain these negatives.
Because I want women to feel empowered by their decisions.
Because I feel that the act of placing my hands on someone can be very healing.
Because I want you to feel strong and capable in your own body.
Because feeling stuck in a cycle of disease isn’t a good way to live.
Because I want my support women through their journey so they can in turn support their families and friends and the world will slowly become a more loving place.

Yes, I’m a chiropractor and a Mercier Therapist. Yes, I adjust the spine and the pelvis and increase blood flow to the ovaries. But the “why” is so much more than that and i just wanted to share.

As always,
Keep Moving.
Dr Cate

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Mercier Therapy

A few months ago I took a training for something called “Mercier Therapy.” I could spend all day explaining in long dramatic prose about what it is and who would benefit. It turns out that sitting down to write and explain myself is not really my forte.

So I’m going to give a very brief overview and then borrow some links from other websites to help describe it in more detail until I write a longer discussion. Mercier Therapy is helpful for Pelvic Pain, Infertility, Painful Periods and other female anatomy related concerns.

Mercier therapy aims to change both the function and the negative associations. By manipulating the tissues, blood flow, scar tissue and pelvic tension are all addressed. The treatment begins with warming the tissues, evaluating your organ position, and ultimately, enhancing blood flow and function. As a Mercier therapist, my goal is to bring both a healthy awareness and healing cells to your pelvis through visceral manipulation.

Mercier Therapy is both an alternative and a complementary treatment for infertility. It is safe and natural. The main component is multiple, typically between 6 and 12, hands-on sessions lasting between 30 and 60 minutes. These sessions focus on the uterus, ovaries and their supporting structures. After a reproductive consultation we will decide if Mercier Therapy is a good fit for you.
In addition to the hands on Mercier Therapy treatment, we will discuss the most common nutritional and lifestyle alterations that need to be made. This can vary from things as simple as gratitude journals and stretching to things as complex as supplements, dietary changes and possibly bio identical hormones. The truth is, reproduction is complex. It takes time and a commitment to see changes.

Take a look at Dr Jennifer Mercier’s Website for details about the intensive training. After you peruse that you can look at her specific office website here and then hop over the AskDrSkip.com and check both the infertility section and his pelvic pain section.

I’ll do my best to get more information out about the treatment soon! If you’re looking for Mercier Therapy in Chapel Hill, NC or anywhere in the triangle, call call us to set up a consultation to chat.

As Always,
Keep Moving

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Breathe.

Quickly becoming one of my favorite topics, I have been talking to more and more patients about belly breathing and filling their abdomen and pelvis with pressure. I’ve spent an amazing amount of time looking up the best videos and nothing has satisfied me. (I’ve even debated making my own videos… I’ll keep you posted on this idea!)

Every single person is unique and while we are built similar, we all have a different concept of breathing. Some people are aware of their breath. They have either done yoga, meditation or singing. Or on the opposite side, they have battled asthma or chronic bronchitis. Others are less aware and haven’t given a thought to breathing in years, if ever. So lets do a short exercise…

Take a moment right now and pay attention to your breath. First just feel the air move through your mouth or nose and then feel it fill your lungs. Feel the pressure on your abdomen, or perhaps in your chest and shoulders.

Take about 5 more breaths with focus. SImply feel the air going in and out and feel the beat of your heart as it moves that oxygen through your body. Don’t try to change it. Simply feel it.

Today I don’t plan to teach you how to change your breath. Although I’m sure many of you might need a little work. My goal today is simple awareness.

Try taking a moment each day to be aware of where your breath is moving. And when we meet, we can go into more detail.

As Always,
Keep Moving.

Dr Cate Niezgoda DC

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My feeling on New Years Resolutions

Friends, not a lot has changed in a year. I have to tell you that last years “Fulfilling your  healthy resolutions” completely failed me. (Or perhaps I failed it?) Regardless, I’ve come to know myself and my body a little better and it turns out that winter is a horrible time for me make changes!

Colleen, (my ‘usually right, how did she know that about me?’ acupuncturist) will probably say something along the lines of “Duh!” once she reads this. But according to various schools of thought, eastern medicine included winter as a time to “Be” and to become aware of oneself. Instead of looking to alter ourselves, we should look inside and find out what unique things make you the person that you are. (You can read more here.)

Some of the things I’ve learned about myself include –

1 – I can’t force myself to be a morning person, especially not in the dark of winter. (I should mention I’m also not a night person. I’m really more of a “Daytime” person…)

2 – I actually do drink plenty of water. I’ve added that extra cup in the morning, and then by the end of the day, when I actually add it up, I’m rarely below 60 ounces. So in that respect, I didn’t even need to change!

3 – I have to exercise when I feel comfortable, not when an article on pinterest says I should.

I don’t believe that I’m looking at the New Year with pessimism, nor do I feel that I don’t want to change. And maybe the New Year is the perfect time for YOU to make changes! For me, the calendar year is not the ideal time to make changes and perhaps it is the same for you?

As Always,
Keep Moving Forward.

Dr Cate

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Everything Is Connected

I’ve been studying (again) and most recently I’ve decided its time to read the Anatomy Trains book by Thomas Myers. (Hopefully cover to cover.) I’ve long been using the principles of Anatomy Trains and the premise that everything is connected through many pathways. I’m in the first chapter where they discuss some brilliant philosophers and researchers and this sentence really hit home;

“Much of the manipulative work of the last 100 years, like most of our thinking in the West for at lease half a millennium, has been based on a mechanistic and reductionist model – the microscopic lens.”

It goes on for paragraphs and discusses some amazing concepts. But I just kept coming back to that idea and how our lives, and our medical care, often feel as though they have become broken down to the most specific level of concern. I’m sure you’ve heard me say it before and if you’ve been in my office, you’ve definitely heard it before, but “Everything is Connected.”

I see this concept a lot with exercises and therapy protocols. If the shoulder hurts, as therapists we address only the shoulder. If you’re getting a cold, we pump you with vitamin C and zinc. If you’re feeling anxiety, we tell you that it is a lack of exercise.

Here’s the thing. It’s all connected. If your shoulder hurts, yes, we need to treat the shoulder, but what other areas do we need to look at? The neck and the opposite hip, for starters? Are you having any anger issues or holding onto any emotional strains.

If you’re getting a cold then yes, lets help your immune system, but we should probably address why your immune system is low in the first place. How’s your stress and your sleep? Have you eaten healthy this week? What is your caffeine and sugar intake?

Anxiety?  Well then we need to set up a true treatment plan with exercise, dietary changes, and likely counseling and stress management.

In school we spent a massive amount of time studying Origin, Insertion, Innervation and Action for virtually every connected muscle in the body. We discussed the fascial connections and the way that some muscles work together, and some are opposites. But what I don’t remember learning hardly at all is what happens when you put it all together. What happens when the you’re feeling anxious and your shoulder hurts? What do we address first? Or do we address it all at once?

As usual, there is no immediate answer to this mindful chatter. Just simply that in all of our continuing knowledge and our ability to see smaller and smaller parts, I’m starting to think that perhaps we need to look larger and farther. We need to grasp the idea that everything is connected, and for all the time we try to spend going deeper and more specific, we should spend equal time looking at the opposite, and larger picture.

As Always,
Keep Moving.

Dr Cate

 

 

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Volunteering at a Chapel Hill 5k

What do you do to for the purpose simply of doing?

When I turned 13 I started “VolunteeNing” with the Buffalo General Hospital. I primarily chose this location because I knew I wanted to do something in the medical profession. (I also chose it because it was where my Mom worked and I could get a ride easily!) Regardless, the act of donating my time became a part of my life.

Since then, I’ve tried to do something that has given me the opportunity to be of service to those who need assistance. I’ve been wracking my mind trying to come up with a way to create some form of nonprofit or donated time through my profession. Until I’ve figured out a way to to do that, I’ve decided to join the Chapel Hill Service League which is an amazing organization that works in community outreach, fundraising and their biggest event, Christmas House. This favorite annual event ensures a brighter holiday for more than 800 local children each December by giving financially challenged parents or guardians the opportunity to select new toys, books and coats for their children during a one-day, free shopping event. Last year I simply participated by being present and assisting the shoppers. The event was truly amazing and eye opening.Kate McGee Running Group

As a result of enjoying the event so much, I decided to help with the Fundraising.  The event is the 12th Annual Southern Village 5k and Family Fun Run. (Follow the link to read more, or to register)  Since I started organizing this event, I’ve learned about women doing a lot more in the community than I am, one of my favorites is this amazing story about Kate McGee! 

I’m learning a lot about fundraising from this event and how difficult yet rewarding it can be.  Anyways, I just wanted to let you know what I was up to outside of the office! PS – If you’re interested in sponsoring one of Kate McGee’s Runners OR you’re interested in supporting our race, let me know!

I’d love to hear about the groups and causes that you support so that I can in turn help support you!

As always,
Keep Moving!

Dr Cate

 

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“We do that on everyone” – The Insurance Debate

The great insurance debate.

So I had a small medical concern that I wanted to get checked out. I went to see my favorite Nurse Practitioner (Rachel VanBree at The Women’s Birth and Wellness Center) and we had a chat. We started with the usual discussion of my symptoms and she didn’t rush me. I went in knowing what I wanted to bring up, the timeline of things, the things I had ruled out and the things I knew I wanted to rule out. We set up a plan. She wanted me to get a test done, she told me the best time to get it done, what the next steps would be if we didn’t see anything on this test and what we would do then.

A few weeks later I had my reminder call and my pretest instructions from the office. I also had the discussion with my awesome NP rolling through my mind. I had looked up the approximate cost of the test because I knew my insurance wouldn’t cover a penny of it until my deductible was met. I went to the front desk, checked in, and inquired if they knew close to the exact cost of the test. She rattled off the cost that it would be if it were cash, but that could be very different if it were billed through the insurance. But after she stated the price, 2 things happened. First, my mouth dropped because it was 3 times as much as it suggested online and second, I knew something was incorrect.

I asked her if the cost she quoted were the tests that were recommended on the referral form. The first test was what I was expecting, the second I was not. The front desk said that the referral said, “If it looks needed” in reference to the second test, which made sense to me. I also realized the front desk there couldn’t make any changes, so I figured I’d mention it to the tech.

I was taken to the next waiting room, where they promptly came to get me and I was whisked into the test room. I immediately asked about the second test to which the tech said, “We do that on everyone.” I asked if we could base the decision off the first test and she said again, “We do it on everyone unless you refuse to have it done…”

So I refused, the tech said, “No problem!” and we went about doing the first test…

So why do I feel compelled to share this story with you? So many reasons!!

First – If you hadn’t had the in depth conversation with your primary, you might not be 100% certain of the reasons for your test. I felt prepared to make the decision about MY healthcare and I felt  comfortable saying no.

Second – It might be completely covered by insurance and you wouldn’t blink an eye.

Third – If the second test is better at seeing what we were looking for, why wouldn’t they skip the first test, and go right to the second test!?

Fourth – Because it brings me back to this constant internal struggle that I have with my own patient centered business plan. To take insurance, or to not take insurance. As most of you know, I’m currently a “cash only” practice. Which means we do not file insurance for anyone (Except medicare patients.) About once per week I think, maybe I should take insurance and I always come back to the same reasons: I think a lot of patients would benefit from being able to use their insurance and it might be a good idea from a business perspective.

But in this patient transaction I saw exactly what scares me about insurance from a business perspective. “We do it on everyone.” as well as how easy it would be to simply go with the flow and allow others to make the health care decisions for you.

So for now – we shall continue to be a cash only practice until my patients urge me to do otherwise…

In the meantime, do you have any similar stories? We’d love to hear them!

As Always – Keep moving,

Dr Cate

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Your Treatment Goals

I get excited when new patients are coming into my office. I mean – legitimately excited. So excited that I often text my next door neighbor,Colleen at The Balance Point Acupuncture when I see a new patient on my schedule!

Why do I get so excited? Because I have the chance to meet someone new and I have a new puzzle!! But lets be honest, odds are, you aren’t as excited to be in my office as I am to have you. Why not? Because you’re in pain. Maybe you’re scared. Maybe you’ve been in chiropractic offices before and you didn’t get the results you expected.  Or maybe you’re afraid its going to cost more than it said on my website.

I’ve come to learn that those fears and concerns I’ve just described are actually one of the biggest pieces to the puzzle.  Without evaluating them, there is a good chance that neither of us are going to leave the appointments as satisfied as we would have liked. The biggest thing that I’m learning I need to ask my patients are, Why have you come to my office and what are your hopes for today’s visit? Do you have treatment goals?

Some people simply want their diagnosis and what I would suggest. These clients are often going to go home, think it through and decide whether or not they want to take my advice. Some patients are ready for me to fix them, starting right now! And some patients want to know if they can fix themselves, with limited help from me or anyone else.

Each of these attitudes is completely acceptable. I’m happy to tell you my diagnosis and my treatment plan for you. The tricky part is the being certain we are on the same page together. I need you to tell me how you’re feeling each and every time. I need you to let me know if we aren’t getting where you want to be. I need to know and I need you to know what you’re looking for from my office.

So what exactly are your treatment goals? What is the reason you’re seeking my care? Let me know and I’ll be happy to help you with whatever you decide!

As Always,
Keep Moving.

Dr Cate

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Posture Stretch

chapel hillDoing something for the first time is often difficult… my first youtube video was very difficult (See below… I’m certainly not the next big star!)! Adding this posture stretch into your daily routine will start out as difficult as well.

Regardless – the information is sound and the stretch is so very important!!! Begin doing this posture stretch every 30 minutes and you’ll begin to feel and see changes in your posture in no time.

 

As Always,

Keep Moving!

Dr Cate