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Re: how would you handle this one?
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Re: how would you handle this one? - February 21, 2006 4:50:00 PM
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ginger
Posts: 660
Joined: February 26, 2005
From: Melbourne Victoria
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Hokum, verb , to hock, as in 'now that you and brad are no longer engaged marylou , what will you do with the diamond earings he gave you?'
or
hokum , adj., hocking, to fling awkwardly, as in
'don't just stand there jason, hokem up to me and we'll stack them boxes in the loft.'
or
hocum , verb. a not undesirable though presumably unlikely event in the working day of a street hooker.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
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Re: how would you handle this one? - February 21, 2006 6:18:00 PM
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ginger
Posts: 660
Joined: February 26, 2005
From: Melbourne Victoria
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news flash
The Lada motor car company of Russia announce the newest member of their small four wheel drive line up,
The Lada Hocum.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
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Re: how would you handle this one? - February 23, 2006 8:19:00 AM
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chiroortho
Posts: 655
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When I speak in hokum I try to make it interesting hokum. LOL.
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Greg Priest, DC, DABCO
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Re: how would you handle this one? - February 23, 2006 8:55:00 AM
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truthseeker
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Ginger, shame on you. ;-)
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Re: how would you handle this one? - February 23, 2006 11:15:00 AM
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ginger
Posts: 660
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From: Melbourne Victoria
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Hocum,
language spoken by the Hokumites, a little known Syrian tribe from the northern desert."dwell ye not amongst the Hocumites Ishmael, lest thy tongue dry up and ye speakest ill of thy brother"
Hocum
first movement of the dance the hocum pocum. Lesser known but entirely satisfying derivative of the hokey pokey
Hoccum
odd gargling sound made with an inflamed epiglottis. Usually heard back stage at pearl jam concerts.
Hocum , as in the Hocum manoevre, used by serial philanderers when giving plausible yet not well researched excuses for coming home at 4am. eg, " I was at the dentists , passed out from the gas after I left and spent the night slumped in the car, darling"
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
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Re: how would you handle this one? - February 23, 2006 7:54:00 PM
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chiroortho
Posts: 655
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heheh. This could go on for a while.
"Hocum,
language spoken by the Hokumites, a little known Syrian tribe from the northern desert."dwell ye not amongst the Hocumites Ishmael, lest thy tongue dry up and ye speakest ill of thy brother"
Now THAT's funny. :)
BTW, did you folks know that chiropractic is named as it is because it was first practiced in Cairo by the concubines of Tutunkhamen? Lest you mock me, I kid you not. Poor King Tut died from a vertebral artery dissection after a poorly administered upper cervical manipulation. (Just kidding about the VAD my DC friends, just kidding). But the rest of it is true, I read it in Prevention magazine, my favorite medical journal. Look it up.
_____________________________
Greg Priest, DC, DABCO
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Re: how would you handle this one? - February 24, 2006 5:19:00 AM
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OaksPT
Posts: 124
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From: Va
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Greg,
Actually hocum has a latin derivative, and is identified as an interogative conjuction; as in when teaching english in any of the Asian countries;
"Hocum you use rice noodles, when the dish calls for tofu?"
Or in the south we have the annual Hocum Festival, which the feature event is to see how far a glob of phlegm can be spat. ( accuracy not important, my experience is to not stand behind the contestants on a windy day)
And Greg, I read in better homes and gardens that the term chiropractic developed after the founder, being a grocer, at his store had a bottle of Karo syrup fall off the top shelf while he was bent over getting stock, it landed(as we know now) at the C7-T1 junction, essentially creating a P/A thrust, which in turn, he immediately felt relief from his arm pain which had flared-up earlier in the week. That deaf guy didn't come in until the following week.
Can you tell I'm avoiding real work?
Scott
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Scott Oaks PT,DPT
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Re: how would you handle this one? - February 27, 2006 2:41:00 AM
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Alex Brenner PT MPT OCS
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From: Kentucky
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Jason and others,
I still don't see the benefit of co-treating with chiropractic. Let's say that the patient did have low back pain and they were sent to physical therapy first. The therapist performs their examination which includes a thorough history, overall health screening including questions involving yellow and red flags or any other differential diagnoses that could cause low back pain. The therapist continues with a good thorough physical exam being sure to clear the hip and any other areas that could refer pain to the spine. If clinically indicated the therapist can then intervene with spinal manipulation including both the lumbar and/or thoracic spines. Depending on the findings the therapist also provides same day modalities to address pain and can give the patient some exercises/stretches to address any other impairment seen and/or to help centralize any peripheral pain. If orthotics are indicated they can be produced or given. If there is a need to order radiographs, some PTs can do this; otherwise many have direct channels to the referring physicians to obtain these.
Maybe I am missing something, but what else would the chiro offer that the PT would not or could not address?
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Alex Brenner, PT, MPT, OCS
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Re: how would you handle this one? - February 27, 2006 3:34:00 AM
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TMondale
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From: Newton-Wellelsley Hospital
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Good show Alex,
It has never made any sense; and never will.
Tim
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Re: how would you handle this one? - February 27, 2006 4:37:00 AM
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UTDC
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Alex and Tim,
I think you are missing the obvious. The majority of PT's are not comfortable with spinal manipulation. In some cases it even falls outside of their scope.
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Re: how would you handle this one? - February 27, 2006 5:00:00 AM
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TMondale
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From: Newton-Wellelsley Hospital
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UT,
It falls outside our scope in very few areas in the country, and most PT's are comfortable with spinal and peripheral joint manipulation. And for those who aren't, there are plenty of those of us who do to refer to.
Tim
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Re: how would you handle this one? - February 27, 2006 6:04:00 AM
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UTDC
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"most PT's are comfortable with spinal and peripheral joint manipulation"
I suppose this is a difference in our experiences. Personally, I have worked alongside many PT's, in states where it is legal for them to perform manipulation. Only a small % of them were confident in their manipulation skills (a dipmanip included). In my experience on this board, it seems that this trend holds true as well (exceptions being yourself, Alex, Jason S., Ginger, Chris and a few others).
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Re: how would you handle this one? - February 27, 2006 6:06:00 AM
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UTDC
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"It has never made any sense; and never will"
Thats a lot of "nevers" Tim. So how about those states where it is not possible for PT's to perform manipulations?
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Re: how would you handle this one? - February 27, 2006 6:55:00 AM
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TMondale
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From: Newton-Wellelsley Hospital
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No question, those states (Arkansas, and Washington) are in trouble. They unfortunately dealt with the devil and continue to get burned. I guess maybe they would refer that out in those cases to osteopathy or something. UT in terms of your experience with PT's I can't tell you why that would be, but even our students are coming out of school being able to manipulate; no big deal.
Tim
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Re: how would you handle this one? - February 27, 2006 7:28:00 AM
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FLAOrthoPT
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From: West Palm Beach
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I concur with Alex, it does not make sense if all PTs were specially trained in spinal work. Not all of us are, I regularly use manipulations when idicated, but do not trust most of the guys around me to manipulate, they have no advance training in the how to assess i it is appropriate and when and when not to do it. I guess all I am saying is that the average chiro is a better manipulator than the average PT, and that is where they are basing their stance on. What alex, myself, and others are saying is, I personally would never co-treat with a chiro, there is nothing they could do that I do not have the knowledge of doing, so why do the redundancy. I think this argument back and
forth is based on hypothetical and realistic scenarios. Hypothetically a lot of PTs would do well having a chiro to co-treat with for manipulations if necessasy because they themselves are not knowledgeable enough in the spine. Realistically, there are many PTs not just 10 or 12, but maybe 25% of us who are adept at the parameters for manipulation. I think the chiro contingency for the most part fail to see this as a possible scenario and herein lies this debate.
Love,
Ben
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Re: how would you handle this one? - February 27, 2006 2:43:00 PM
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UTDC
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FLA,
That is what I was trying to communicate.
Thanks.
Tim,
"osteopathy or something"
Yeah, ok
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Re: how would you handle this one? - February 27, 2006 5:50:00 PM
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ginger
Posts: 660
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From: Melbourne Victoria
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I wonder wether the use of manipulation used in this discussion refers to the passive movements of spinal joints generally , or used as in Australia , to refer to the pulling apart of those joints, as per a chiropractic "adjustment".
If a chiropractor was to perform usefull movement therapies , such as facet joint mobilisation, within a two day period of similar therapies being done by a Physio, then there certainly would be a conflict of interests, one unlikely to benefit the patient. A rebound effect where local pain is felt after 24 hours for about a further 24 hours , is a commonly seen effect of spinal joint mobilisation. This is not an indicator to overall success , but a factor to be considered when adjunctive therapies are proposed.
If instead the chiro/physio efforts were such that only manipulation ( "adjustments") were performed by a chiro ( or the osteopath for instance ), and spinal treatments of value were performed by the physio, then there is a very slim to negligable prospect of a conflict of interest that would be negative for the patient.
Spinal joint manipulations ( adjustments) are of such little value I wouldn't personally have concern with combined treatments.
The other nonsense that the old style chiro may offer ( wedges, spring loaded gadgets, vitalistic mumbo jumbo ) are of only slightly less value.
Should the chiropractic therapists eventually wake up to mobilisations as a method , they will definitely be a force to be reckoned with , one set for a strong future, rather than the garbage bin of therapeutic history as is now likely.
_____________________________
Ubi est mea anaticula cumminosa?
The Grand Pediculator
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Re: how would you handle this one? - February 27, 2006 7:27:00 PM
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Alex Brenner PT MPT OCS
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From: Kentucky
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Jeff,
I have very little experience with civilian PT and nearly all military PTs that I have worked will perform manipulation regularly. I think you are correct in that most civilian PTs do not perform manipulation.
I was speaking with a PT colleague and he mentioned that he does not like to co-treat because if the patient returns to his clinic with a flare up then he would not know if it was from his intervention or the co-treating Chiro's intervention and therefore would not know how to adjust treatment. I thought this made sense. I would think the Chiro might have the same dilemma.
By no means am I bashing Chiropractic; I just personally see the potential for more problems than good for the patient. If the patient wants to see both then communication would be key. Unfortunately I personally have had some bad experiences when trying to do this.
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Alex Brenner, PT, MPT, OCS
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Re: how would you handle this one? - February 28, 2006 2:39:00 AM
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drbuddy
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From: Pennsylvania
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"Spinal joint manipulations ( adjustments) are of such little value I wouldn't personally have concern with combined treatments."
Someone needs to read up on the literature.
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Re: how would you handle this one? - February 28, 2006 4:19:00 AM
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chiroortho
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My approach is simple. If the PT is adept at manipulation, I see no reason for there to be co-treatment because it wastes the patient's time and doubles the cost. If the DC is adept at rehab, likewise. As some PTs aren't adept at manipulation, and some DCs aren't skilled in rehab, co-treatment would make sense to me in those cases. Unless someone can show me data/research (just the facts, ma'am) showing that a manipulation by a skilled PT is inferior to a manipulation by a DC, I'll stand my ground on this - same is true for DC vs PT rehab.
In my practice, I see patients that, for example, have been in an accident and hurt their knee and their neck. The PCP sends the patient to the PT for knee rehab, the patient calls me for an appointment to treat their neck. I tell the patient that they need to continue with the PT for rehab and I treat the neck and leave the knee alone.
I have a great relationship with the few PTs that we work with here, non-adversarial, very cordial, and we act like adults.
This has been my practice for years and I have never once run into a problem, at least that I can recall. I do vaguely recall a patient or two telling me that the PT tried to 'crack my neck' and hurt the patient, but I don't know whether or not I would have done any better. I imagine that some of my patients have complained to their PTs that 'Priest used that shock thing on my back and it didn't help but your treatment is better.'
It's just not an issue with me.
I've got 4 kids, so I've got enough to think about other than turf wars and trashing my PT colleagues.
_____________________________
Greg Priest, DC, DABCO
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