Read the article
Approaches to chest pain and COPD each have their own articles. Both discuss the underlying disease and the musculoskeletal components of the treatment with both osteopathic principles and manual treatments. COPD for example often involves coughing which leads to muscle pain and spasm. Chest pain can be from a primary musculoskeletal issue and the authors discuss evaluation and treatment.
A review of the new American Diabetes Association guidelines appears this month. It brings a quick review of what we should be doing with a few changes. Setting goals for the individual is part of the new guidelines. Older patients, with shorter life expectancy may be at more risk of falling from hypoglycemia than from long-term risks of less than perfect Hba1c goals. One of the interesting points is that the eye exam can be done every 2 years if normal on 2 or more annual exams. This just makes sense, especially in well controlled, barely diabetic folks. This does not mean the insurance companies are on the same page. It has been said that it takes 9 months to birth a board question but how long does it take quality indicator monitors to get with the new guidelines?
CONGRATULATIONS
The journal of Osteopathic Family Physician
applauds the following 2015 award recipients!
2015 OFP Attending Paper of the Year:
Osteopathic Considerations in the Management of Migraine in Pregnancy.
Sara Soshnick, DO; Christina Mezzone, DO; Sheldon Yao, DO; Reem Abu-Sbaih, DO
2015 OFP Resident Paper of the Year:
Dietary Supplements: Navigating the Pharmacologic Influence's of Nature's Medicine.
Andrew J. Kubinski, DO, MS
Psoriasis diagnosis and treatment is reviewed. The article is well organized and easy to read. A patient of mine used a different treatment on each psoriatic plaque of his body to minimize exposure to steroids. Treatment can certainly be individualized to what works with the fewest side effects.
You may want to review pain management guidelines from the CDC March 2016; here primary care doctors take a big hit for controlled substance prescribing. There is no pain clinic prescribing controlled substances in my community how about yours? I would be happy to refer. It is challenge enough to treat the diabetes, hypertension and depression. Someone else can do better helping my patient with pain management? Where are you? Again, we try to do the best we can and for sure we can all try to do better.
We have had an uptick in submissions to the visual diagnosis column so after this issue we plan to run two per issue for a while.
Kids will be out of school soon and summer vacations underway. Hope this one is your best vacation ever.