Thank you for all that you do!
By Sharon A. Vallone, DC, FICCP
In these surreal times, whether you are in your office or sheltering in place, We on the JCCP staff would like to send you our heartfelt regards for your courage and persistence in taking care of yourselves, your families and your patients. We are all doing the best that we can. We are all in this together.
Are any of you dealing with new roles in your life in addition to practicing chiropractic? Some of us are homeschooling children, caring for elders, working online (telehealth!), supporting patients emotionally and sharing information on how to stay safe and stay well. Some of you are writing, some teaching and many of us learning new skills we never gave much thought to ever having to learn. Zoom, for some of us, was to move fast, as we do when chasing a child around the adjusting table. Now “ZOOM” is a door into futuristic communication and opportunities to reach others around the world.
It’s been a challenging and sad time for many of our comrades, seeing loved ones succumb to health challenges and not be able to gather as a family to bid them farewell. Some of us have also suffered serious health challenges ourselves during this time complicated by the nature of the burden on the healthcare system. For these friends we stand in solidarity. And to all of those who have served on the front line, in your chiropractic offices, in hospitals, on ambulance squads and fire companies, in nursing homes and those providing home and hospice care and for those who have continued to work in service situations in place or delivering goods to those who couldn’t leave their homes, we owe you our gratitude.
For those in leadership roles, we look to you to bear your responsibility seriously and safeguard us while still remembering that the safeguarding of our constitutional rights as is much an important part of that responsibility. That also goes for our chiropractic leadership who have gone to great lengths to secure our scopes of practice and maintain our ability to keep our office open to serve our patients as an essential healthcare service. We owe them our gratitude as well.
As far as justifying our role as essential, this too has been a topic tossed about on the waves of the internal chiropractic communication network. Are we evidence based? Are we essential to the health and wellbeing of our patients? I think those chiropractors who have been willing and able to serve selflessly will attest to the gratitude of their patients who as a result of their chiropractic care, remain healthy and able bodied to carry on in their position whether it be on the front line or in the home. You’ve heard gratitude expressed by many who found relief in your offices and didn’t need to turn to the overburdened emergency room. There are many in our field who are spending time calling out for more evidence based research to support our providing care and there are those who are trying to provide it by collating a systematically reviewing the research that has been published. But we who care for our patients every day, have the clinical experience to know that what we do makes a difference for our patients and those that can, continue to work in their offices and have been willing to continue to make that difference even through these challenging times.
Our leadership has provided a beacon of light with daily communication from ICA president, Dr. Stephen Welsh, and other officers of the International Chiropractors Association like past present Dr. John Maltby. Dr. Maltby recently spoke to the ICA members about this pandemic and his joy in meeting the needs of his patients. He recalled a conference he attended in Lima, Peru when a physician was speaking on evidence based care. She drew three interlaced circles. The circles were identified as research, clinical expertise and patient needs. Dr. Maltby noticed all the circles were the same size and pointed out how no circle was larger therefore more important than the rest. Research helps us as a chiropractor to hone our skills and provide specific care to our patients but clinical expertise whether there is EBR to support it “yet” is an undeniable part of our practice whether we’ve been in practice 40 years or 4 years. And last but not least, are our patients needs. Patient centered care has always been as important as either of the other two. All three circles are of equal size, all of equal importance.
We serve a unique population. Our children are not untouched in this pandemic. The isolation from friends at school, baseball season being canceled, graduations and dance recitals all on hold have resulted in challenges difficult for our children to bear. Being aware of the psychological effects of this stress helps us understand behavioral changes, depression and a rising rate of pediatric suicide and possibly help intervene early by providing support and referrals to families even if that support is virtual support. Putting the emphasis on the positive, more time together as a family, helping stressed parents with ideas to both entertain and de-stress the family while they juggle working at home and helping their children with their schoolwork. Building a little extra time into our visits to allow them to decompress as many have been in isolation and may think they are the only ones going through this! We are there to remind them we are in this together. Many of you may be performing the same juggling act!
As chiropractors, we need to keep improving our skills. There are chiropractic educators who are generously offering us the opportunity to take their webinars at no cost to help improve our skills during times when we might be feeling we need to know more to be able to support our patients. We also need to keep up with the research in our own field of chiropractic, particularly pediatric chiropractic. We also need to keep up with topics that pertain to our patient population like the rise in child abuse during the lock down period or educate yourself on the incidence of presenting complications for the pediatric patient like Pediatric Multi-System Inflammatory Syndrome Potentially Associated with COVID-19, which shares symptoms with toxic shock and Kawasaki disease including fever, rashes, swollen glands and, in severe cases, heart inflammation and be prepared to recognize these symptoms and treat your patient and refer and appropriate for collaborative support. We may never see this in our office but knowledge is an excellent clinical tool and in my 34 years of practice, it’s my colleagues that have recognized things in their office and in the field (I’m thinking a one particular doctor who’s clinical eye on mission trips caught so many unbelievably rare conditions as she traveled through jungles to visit children’s schools in remote villages) that have gone unnoticed or unrecognized and have played a key role in the child’s recovery.
Areas we should be spending time reading and learning more about are the current guidelines and risks for pregnant patients, labor and delivery, separation of parent and child if one tests positively for the virus, breastfeeding guidelines and pediatric complications. It’s important to follow and carefully review the protocols being posted by other national and international health organizations so that we know what our patients are facing and we can support them with information to advocate for themselves if they do not agree with the current policies and ask for alternatives.
For example, the nursing dyad and COVID- 19. By doing our due diligence and accessing educational articles on MEDSCAPE, like Postpartum Care and Breastfeeding or monitoring the The Academy of Breastfeeding Medicine website will keep you abreast of current concerns and the most up to date guidelines that your patients can familiarize themselves with before they enter the hospital setting to give birth and perhaps help prevent the separation of the mother and child or interruption in breastfeeding due to misunderstood COVID-19 concerns. Information that would be helpful for our patients as they approach delivery might be the article written by Dr. Alison Stuebe published in Breastfeeding Medicine accessed at https://www.liebertpub.com/doi/pdfplus/10.1089/bfm.2020.29153.ams.
So in conclusion, thank you for all you do! For all you know and acknowledging all we have yet to learn. We appreciate you and encourage you to be gentle with yourself and others as we walk this uncharted course together. If there was ever a time for the well-developed skill of the chiropractor to “think outside of the box”, it’s now! Carry on!
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