Steve Jobs and You

When Steve Jobs left earth, perhaps the greatest technological visionary of our times,
maybe even in modern history passed.

His impact has been profound.

But why?

Simply, he created his own realities, and thus has shaped yours too!

Steve Jobs Impacted Your Daily Life in Profound Ways…

Steve Jobs relentlessly pursued Star Trek like visions, and then actually executed the development, construction and ultimately the myriad of applications using devices and tools Buck Rogers, Gene Rodenberry, Ray Bradbury and the like could only dream about.

He was a powerful CEO, building incredible teams that never lost their vision.

But what he did best, was actually DESIGN the future! By conscious choice.

And so it is with us.

Every day new choices.

Rest on our laurels or relentlessly design, then actually execute a better world for those we serve every day.

I for one am glad I got to see in my lifetime how powerful one person can be.

And that’s how our patients look at us too.



Patti Hayes is CEO of Perfect Practice Web, and has 30+ years experience in practice management.

Our team may be reached for a free 15 Min “Strategy Session” if you simply Leave Your Info HERE – or text 339-793-8591  *just be sure to leave your name, phone and time zone and we’ll get back to you 9-5 EST Monday-Thursday.

For further information join us anytime at all on Facebook and Instagram

To subscribe to our newsletters and private practice updates go to our website Perfect Practice Web

#privatepracticebuilding #perfectpracticeweb #livingpracticingbydesign

The Writing on the Private Practice Wall

”You keep talking about all the changes in Private Practice. What do you mean, and what’s happening?”

What I thought I would do today is summarize how changes during the last decade have impacted doctor’s behaviors and decisions we all must consider in private practice.

Don’t read any further if you want sugarcoated op-ed. This is not it.

The most striking thing we advocated many years before it was trendy was that unless you the OWNER clearly handle patient finances (no, it’s not like the ER), patients are gone, especially in the scared and frightening media driven economics for so many of those we serve.

In essence, we need to be crystal clear, and also priced for the realities of our own future!

Also ask yourself if you serving humanity to the best of your abilities, and at the same time offering options to those who want and will gladly pay for them? Not everyone wants or needs a Rolls Royce, but they still make and sell plenty of them.

Patients are no different, when unique or more personalized service is needed. And wanted. Help give them their health back, teach them how to maintain it, and it’s the greatest gift ever. Literally, they get their lives back!

These are the harsh realities of practice today. It’s not the latest “let’s see what I can max on an insurance case” still advocated by some. Unless of course you like audits and recovery efforts by insurance carriers.

The next big error is not staying in close, regular contact with past patients, and all your referral colleagues. Especially when the revenues dip. Some costs rise, and you could, like many foolish businesses cancel marketing expenditures.  You may erroneously ration to stop marketing to those who have seen you before and refer to you every month, because it might cost you 1000-2000$/month to do so. Just ask your next new patient where they found out about you, and you’ll quickly see what I mean.

We suggest fully developing and integrating EMR and data management systems into autopilot style marketing with regular patient reminders, recall letters and even birthday messages and letters if you choose.

And what about your current staffing and HR Systems? Have you made these as bullet proof and compliant as possible? Are you continuing to staff private practice or group like you are the UAW? I guarantee, no one’s going to be there to bail you out. Don’t get me wrong. Excellent staff that help drive the practice are worth every dollar. But are you sacrificing your own future by not handling poor training and possibly willful non-compliance?

Finally change is perpetual. Medicine as a business is no different.

As it should be in your practice too, the strong will thrive and prosper.

But it so often takes a fresh set of management, operational and marketing perspectives. Why not let this be you?

If you’re up to the challenge, I welcome the opportunity to help you build your perfect practice.



Patti Hayes is CEO of Perfect Practice Web, and has 30+ years experience in practice management.

Our team may be reached for a free 15 Min “Strategy Session” if you simply Leave Your Info HERE – or text 339-793-8591  *just be sure to leave your name, phone and time zone and we’ll get back to you 9-5 EST Monday-Thursday.

For further information join us anytime at all on Facebook and Instagram

To subscribe to our newsletters and private practice updates go to our website Perfect Practice Web

#privatepracticebuilding #perfectpracticeweb #livingpracticingbydesign

The Most Powerful Marketing Secret Ever?

The Most Powerful Marketing Secret Ever? Read on and see if you identify.

It’s no secret. I’m a play junkie. If I don’t go outside and play, regularly, I get cranky, stale. Daily work becomes harder, stiffer, less fluid. You probably are the same. But maybe it’s been far too long since you let yourself find out.

We’ll here’s a whole new reason to go play.

Patients love it!  No Kidding. Play, travel and just getting out and doing something you love makes you real, keeps you pleasantly conversant, and someone they really want to emulate.

The problem is for too many is we become far too rigid in daily and especially weekly routines. Over achievers like physicians too often put their inner child last. In fact, we are some of the most under-recreated people ever. Big mistake. Illness, divorce, depression are far too often the price.

Now, I am giving you a whole new reason to disconnect, and kick up your heels! Regularly.

It will help you build an enormous practice! Why? Because you can use your play to market yourself while feeling more rested, creative and inspired to be your very best.

Yes, that’s right! Especially now a days while it’s so easy to create media. Cams, phones, you name it.
This recently was reinforced in my practice when I sent out a reminder card to patients. I uploaded an image of me sitting on my motorcycle with a caption “Time to ride on in?”

Patients loved it, and it was one of the most effective recall pieces I have recently done. And I have lots of fun photos of my adventures and likes around the office for them to see too.

Here is a strategy any practice owner can use. Do this right, your practice grows, as does your wealth account.

Step 1-
Make sure your practice is set up around your life, NOT the other way around! What do you like to do outside of practice? Where do you want to live, travel to or experience? If it’s been a while since you’ve done this, take your time, and be honest with yourself. Be sure to write or dictate all of this.

Step 2-
Start recording snippets of your adventures in media-you can take decent photos, video, heck even record great conversational sound bites. Some of my best marketing pieces and images have come from weekend ski or motorcycle adventures, and of course my vacations. The more impromptu the picture or video the better.

Next, Make storage and organization of your files easy. That’s why I am very partial to the Mac products like iMovie, and iPhoto.

Step 3-
be sure to use this material creatively. Put photos in your office news, flyers and especially on the web. This is why Facebook and other social media can be so powerful. It helps make you a real person.

Step 4-
Get some help. Too often, there is no solid marketing strategy, steps to follow or calendar for team members to focus on.

You’ll do far better to have a staff person help you with the implementation, but you’ve got to have a strategic plan they can follow. This is one of the very first things we teach in our Platinum sessions.

Step 5-
carve out regular time to make sure you are living your dreams, and your practice is supporting it! This is crucial. It’s also why administrative and creative time must be on YOUR checklist, every week, and if you really want to accelerate your personal growth, every day!

This is living and practicing by design, not default (which gets stressful and ugly quickly).
Remember, we are here to support you with the personal coaching, systems and tools that help you create the practice (and thus life) of your dreams!


Patti Hayes is CEO of Perfect Practice Web, and has 30+ years experience in practice management.

Our team may be reached for a free 15 Min “Strategy Session” by texting 339-793-8610 – just be sure to leave your name and time zone and we’ll get back to you 9-5 EST Monday-Thursday.

For further information join us anytime on Facebook and Instagram

To subscribe to our newsletters and private practice updates go to our website Perfect Practice Web

#privatepracticebuilding #perfectpracticeweb #livingpracticingbydesign

“Living and Practicing by Design-Saving the Hearts That Care for Our Lives”

Physical and Emotional Clutter in Private Practice

Physical & Emotional clutter has a significant impact on your Private Practice,  and of course your life and your health. The more you clean up and break away from, the more room you create for the right things! Keep it simple. You won’t regret it.


What is Arachnoiditis and How Can You Help?

As a specialty practice emphasizing the relief of chronic pain, you will encounter patients who suffer from arachnoiditis.

Unfortunately the number of these cases is growing by leaps and bounds.

The cause is thought to be at least in a large part due to the rising use of intraspinal injections.

As we both know, now a days and too often intraspinal injections are used as a first-line rather than the last line therapy for back pain, radiculitis etc.

The net result can be patients who are injured, or suffer severe adverse reactions.

These reactions can range from chronic back pain to unrelenting extremity and spine pain and even paralysis.

There is some concern that preservatives as well as the variety of drugs used in intraspinal injections can cause autoimmune reactions, which can lead to the development of more serious conditions including chemical hypersensitivity.

But the worst effect of course is, the chronic and debilitating and unrelenting pain that these patients suffer from.

As one of our trained clinicians, though you have tools right at your fingertips, which may be able to help even the most difficult patients.

Arachnoiditis patients present cases that will test all of your skills.

You need to of course be sure to start with a very thorough evaluation. Depending upon your expertise, develop a rational but powerful treatment plan using all the tools we have given you. Alternatively refer to one of your colleagues better equipped and trained to help these patients.

There is even a place for lifestyle and behavioral therapies in the treatment of the arachnoiditis patient. This is of course due to the significant life destruction they have experience.

Commonly, your office can serve as an oasis for these patients providing all types of information, which they are not getting anywhere else.

If you’re not familiar with arachnoiditis, we will be providing our clients additional continuing education material on this.

If you thought Neuropathy patients were challenging, you haven’t seen anything until you tackle some of these cases.

The good news is you can offer help to many of these patients.

But the first thing to do is start reaching out in your own practice and in your own community!

Communicate the value of what you are doing a daily basis.

Emphasize the need for a rational conservative approach to spine pain and possible arachnoiditis prevention, doing all of this despite traditional pain clinics emphasis on invasive and potentially dangerous injection therapy.

Above all, expand your expertise and learn to truly help the arachnoiditis patient.

We wish you the best along your journeys!

Want to learn more about how to build your private practice?

Then Join our team experts for a free strategy session HERE

Have a great day!

The PPW team

Skiffs and Sunset - Enjoy life
Do You Have a FAVORITE Sunday Personal and FUN Act…

Do You Have a FAVORITE Sunday Personal and FUN Activity?

Find What Helps You Feel The BEST?

Then Do MORE of it!

You’ll enjoy Life and Practice so much more…

Alternative Therapies for Your Chemotherapy Induced Neuropathy Patients

Alternative Therapies for Your Chemotherapy Induced Neuropathy Patients

One of the more challenging patient populations you can treat is the chemotherapy induced peripheral neuropathy patient.  They’ve already been through the cancer diagnosis and are either in the midst of chemotherapy or they’ve finished their treatment.

Just when they think they’re done with all the side effects of chemotherapy, they’re visited with[1]

–       Shooting pain

–       Burning and numbness

–       Tingling in the hands and feet

–       Inability to sleep because of the pain

Can you imagine the frustration?

Chances are really good that no one told them that chemotherapy induced peripheral neuropathy (CIPN) was a potential side effect of their treatment because, let’s face it, no one can really predict which patients will develop chemotherapy induced peripheral neuropathy.  Why bring it up if you don’t know for certain that it’s going to happen?

For many, their symptoms last well beyond their chemotherapy.

For your CIPN patients, the first option is, of course, drugs to deal with the pain.  But many chemotherapy induced peripheral neuropathy patients are choosing to be more proactive and do everything they can to alleviate their current symptoms and lessen the possibility of permanent nerve damage.  They don’t just want to take a pill to make them feel better. They want to give their bodies the best treatments available.

What Else Can They Do?

More and more CIPN patients are opting for what used to be called “alternative medicine” treatments.  While many think of anything outside of conventional medicine as “alternative”, that’s really not accurate.  Alternative treatments are defined as anything not approved by the Food and Drug Administration.  The treatments we’re talking about here are more complementary or integrative therapies.  In other words, they’re therapies used in addition to and to complement traditional medicine, not taking the place of it.

Because of the growing popularity (and effectiveness) of these complementary and integrative therapies, the medical community has actually named them – Complementary and Alternative Medicine.

Some complementary and alternative therapies providing good results for chemotherapy induced chemotherapy patients are:

–       Cancer treatment specific diets

–       Herbal supplements

–       Non-herbal supplements (like Vitamins B6 and B12, alpha lipoic acid)

–       Acupuncture

–       Massage therapy and Reflexology

–       Exercise

–       Homeopathic and ayurvedic medicine

Any of these therapies, in the hands of skilled practitioner, is a great complement to your chemotherapy and other cancer treatment and can provide substantial relief from chemotherapy induced peripheral neuropathy pain.  Offering these services to your chemotherapy induced peripheral neuropathy patients is an excellent way to treat the whole patient and not just the symptoms.

Involve Their Oncologist

Before you start any Complementary and Alternative Medicine treatments with your chemotherapy induced peripheral neuropathy patients, talk to their oncologists.[2] Make sure that what you’re planning to do will not have an adverse effect on their chemotherapy regimen (some antioxidants do).  Always keep the oncologist in the loop on what you’re doing to complement or following a chemotherapy regimen.

Why These Complementary and Alternative Medicine Treatments Work

Many of the Complementary and Alternative Medicine regimens we mentioned above will help deal with and even alleviate some chemotherapy induced peripheral neuropathy symptoms.

The body is a finely tuned instrument and all the systems work together.  Massage therapy, acupuncture and Reflexology can help with muscle pain and stimulate the systems within the body to fight the cancer.

Certain supplements can help give the body the nutrients and vitamins it needs to repair itself and eliminate the possibility of permanent nerve damage caused by chemotherapy induced peripheral neuropathy.

Treating the Whole Patient By Working With The Whole Team

Everyone On The Patient Team Must Work Together...

None of the medical specialties treating chemotherapy induced peripheral neuropathy patients operates in a vacuum.  You all need to know what the others are doing.

Luckily, most oncologists these days are familiar with the Complementary and Alternative Therapies chemotherapy patients are turning to for relief from the chemotherapy induced peripheral neuropathy symptoms.  Make sure that you involve your patients’ other treaters in your care by communicating with them.  By integrating your Complementary and Alternative Medicine treatments into the overall treatment program, you have a much better chance of giving your patients the optimum results they deserve.

When you are ready, let them know you’re there to help them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to http://perfectpractice to download a FREE E-Book Copy of my 5 star Amazon  “Living and Practicing by Design” at



Nutrition Planning for Chemotherapy Neuropathy Patients

For better or worse, a rapidly growing patient population is the chemotherapy and post chemotherapy patient.

Patient education and patient compliance are key to success.

While dealing with the emotional issues involved in a cancer diagnosis, they can also be dealing with side effects of chemotherapy like

  • Loss of appetite
  • Nausea and other digestive issues
  • Post chemotherapy peripheral neuropathy
  • Dry mouth

In addition to counseling them on taking their medications properly and physical therapy or massage therapy for muscle, joint and nerve pain, offering nutrition counseling and diet planning is a great way to ensure that your post chemotherapy neuropathy patients are doing everything they possibly can to heal.

Study after study is confirming that proper nutrition is a vital piece in the treatment puzzle for a successful recovery from chemotherapy and other cancer treatments, as well as recovering from the cancer itself.

Just like any other treatment program, patient education and patient compliance are key to success.  Here are some things to think about when designing a chemotherapy or post chemotherapy recovery nutrition program:

Cancer Nutrition Tips[1]

The chemotherapy or post chemotherapy patient’s body needs extra support for the immune system.  Chemotherapy wrecks their immune system and that makes them more likely to catch virtually any bug they come into contact with.  And that makes it even harder for them to heal.

Their best option for immune support is a diet full of whole foods that are easy on their sensitive digestive system.  They need foods that are high in anti-oxidants and protein.  Make sure your diet plan for them includes foods rich in vitamins C, D and E and nutrients like soy isoflavones, amino acids, folic acid, l-glutamine, calcium and carotenoids.

When designing their daily nutrition intake, build in a requirement for drinking plenty of water.  Actually give them a schedule if you have to.  Remaining hydrated is vital for tissue repair.

Rebuilding The Body During and After Chemotherapy

When designing a nutrition plan, take each individual patient’s requirements and tastes into consideration.  Make sure you include foods rich in the following vitamins and minerals but try, wherever possible, to include foods the individual actually likes in their meal plan.

The following list is a really good guide for meal planning:[2]

Vitamin C

  • Red cabbage
  • Kiwi fruit
  • Oranges
  • Red and Green Bell Peppers
  • Potatoes
  • Strawberries and tangerines

Vitamin D

  • Salmon and tuna

Vitamin E

  • Nuts, including almonds and peanuts
  • Avocados
  • Broccoli
  • Mangoes
  • Sunflower seeds


  • Apricots
  • Carrots
  • Greens, especially collard greens and spinach
  • Sweet potatoes
  • Acorn squash

Soy Isoflavones

  • Soybeans
  • Tofu
  • Soy milk – might be easier to digest than regular milk because it’s lactose-free

Folic Acid

  • Asparagus
  • Dried beans
  • Beets
  • Brussels sprouts
  • Garbanzo beans
  • Lentils
  • Turkey

Turning The Food They Need Into The Food They Want

It’s easy to tell your chemotherapy and post-chemotherapy patients what they need to eat.  The tough part, especially if they’re nauseated or just have no appetite, is getting them to eat it.  Make your meal plans more appetizing by liberally using herbs and spices to enhance the flavor of the foods they need. Try recipes that use:

  • Cinnamon
  • Cardamom
  • Basil
  • Coriander
  • Cumin
  • Ginger (natural anti-inflammatory properties)
  • Garlic (natural anti-biotic properties)
  • Mint (great for fighting nausea as well)
  • Fennel
  • Turmeric
  • Parsley

If your’ clinic doesn’t offer diet planning and nutrition counseling to your chemotherapy and post chemotherapy patients, you and your patients are missing out on a vital part of the recovery puzzle.

Use this article as a guide for diet planning.  The combination of your professional expertise and proper nutrition support and counseling is a winning combination for doctor and patient.

When you are ready, let them know you’re there to help them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to to download a FREE E-Book Copy of my 5 star Amazon rated book “Living and Practicing by Design”.

A Case Study on Patient Compliance and Diabetic Neuropathy

Diabetes is one of the fastest growing diseases in the country.

Nothing builds a powerful specialty practice like incredible results!

With the increase in the number of patients developing diabetes comes an increase in the number of patients developing complications.

One of those complications is diabetic neuropathy.

The good news is that with proper treatment and a compliant patient, diabetic neuropathy can be managed and quality of life vastly improved.

Meet “Evelyn”

Evelyn is a 62 year old woman who presented to our office with progressive and severe diabetic neuropathy.  She suffered from peripheral neuropathy symptoms in her hands and feet, intense cramping in her legs and tingling in both feet.  The range of motion in her back was severely limited from the middle of her back to her hips. She was no longer able to sleep and could not exercise due to the painful neuropathy symptoms in her legs and feet.  Even the easiest exercise, such as walking, was no longer a possibility.  At the time she came to us, she had been suffering with these symptoms for 10 years.  Even after 10 years of medical and podiatric care, she was getting worse instead of better.


After a thorough history & physical and evaluation, we took her into the NeuropathyDR® treatment program.  Her customized treatment program consisted in part of our three pronged approach – manual therapies, in clinic Rebuilder® therapy using both the basin with the feet and the gloves with the hands, daily blood sugar monitoring and charting (four times per day) and metabolic and dietary counseling and treatment. 

With the combined NeuropathyDR® metabolic therapies, Rebuilder® treatment and effective nutritional planning, we were able to drop her blood sugars by 120 points, without changing or increasing her medication.

The drop in her blood sugars led to a decrease in her medication needs. 

In addition to diet planning and counseling, we put her on a combination of nutrients.


As a result of the metabolic and nutritional work we did with Evelyn, her blood sugar was down by 120 points, without any medication changes or additions.  Ultimately, her primary care physician was able to reduce her prescription meds. After 5 weeks of treatment, her numbness and tingling levels on a 0 to 10 scale, with 10 being the highest, went from 10 before treatment down to 5 after treatment. She reported overall improvement of 25 – 30%. The tingling in her feet and hands was significantly reduced.  Her leg cramps were markedly better as was her back pain.

With the improvement in her leg and foot pain, she was able to start significant walking again.

 Every day that she can exercise puts her one more day closer to a normal life.

The success of her treatment is a testament to the patient as well as the treatment protocol. She followed our orders diligently and was extremely compliant with our treatment program.

She purchased from our clinic a special ND/Rebuilder® home care kit, treating herself at home concurrently with the office care, took her prescribed ND supplements, did the prescribed blood sugar monitoring as well as her exercise and metabolic rehab.

While there are no miracle diabetic neuropathy cures, this case illustrates the results that can be achieved with a solid treatment strategy and patient compliance.

 Without a strong partnership between patient and clinician, these results would not have been possible.

As effective specialty practice clinicians, patient success depends upon your ability to convey the message that from the outset of treatment that without your patients full compliance with your treatment regimen, they will not see the results they’re looking for.

And nothing builds a powerful specialty practice like incredible results!

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to to download a FREE E-Book Copy of my 5 star Amazon rate book “Living and Practicing by Design”.

Nutritional Supplements for Your Diabetic Neuropathy Patients

Your diabetic neuropathy patients know they need to keep their blood sugar under control…

Your role is to make sure your patients understand exactly what supplements can do for them.

They know they should exercise…

They know they have to watch their diet, especially when it comes to controlling their sugar intake…

When it comes to medication, insulin is probably first and foremost in their minds.

And it should be.  Taking their insulin properly can mean the difference between life and death to a diabetic neuropathy patient.

What they may not realize is that in addition to taking their insulin, watching their diet and a good exercise program, there are nutritional supplements and vitamins that can help control their blood sugar and lessen the effects of diabetic neuropathy.

Granted, these nutritional supplements will not take the place of proper diet, controlling blood sugar and a sound exercise plan, but they can definitely improve the effectiveness of all of these pieces of the diabetic neuropathy puzzle. 

Your role in all this is to make sure they understand what they should take, how much, how often and exactly what those supplements can do for them.

What to Look For in Nutritional Supplements[1]

Diabetic neuropathy patients have different requirements from their nutritional supplements than other patients.  A pill they take once a day is not enough because it’s only going to be really effective for the two hours after they take it.  They need more than that for the symptoms of diabetic neuropathy. 

To get the full effect for treating diabetic neuropathy, they need to maintain a steady therapeutic level of these vitamins and nutrients throughout the day to help keep blood sugar under control.

Your diabetic neuropathy patients should choose supplements they take at last three times a day to keep the levels steady in the blood stream. 

And look for nutritional supplements that come from an FDA approved manufacturer to ensure that what they take is pharmaceutical grade.

Which Vitamin Supplements They Should Take

There is so much information on the market now about nutritional supplements[2] and vitamins.  Your diabetic neuropathy patients need know what they’re buying before they go out and just load up on supplements.  Your job as a NeuropathyDR® clinician is to educate them and make sure they’re taking the right vitamins for their specific diabetic neuropathy symptoms.

Here’s a quick cheat sheet of the Top 12 vitamins and nutrients to provide to your diabetic neuropathy patients to help them identify some of the essential supplements that can help their diabetic neuropathy and exactly what they do:

Thiamin (Vitamin B1) – helps maintain healthy oxygen levels in the blood stream which means that they have less chance of nerve damage due to poor oxygen levels reaching the nerves.  The Recommended Daily Allowance (RDA) of thiamine for the average person is 1.0 to 2.4 mg per day but diabetic neuropathy patients should take in the range of 60 mg per day in equally divided doses. 

Riboflavin (Vitamin B2) – works in combination with Vitamin B6 to help the body use glucose properly. The RDA is 1.2 to 1.6 mg per day but therapeutic levels should be around 60 mg per day.

Vitamin B6 – along with folic acid and B12, it helps prevent nerve damage and heart attacks.  It can also help prevent diabetic blindness and/or vision loss. Therapeutic levels should be at least 60 mg per day but be very careful with your dosage.  Some toxicity has been reported with extremely high levels of B6. 

Vitamin B12 – works with folic acid to help prevent stroke and loss of limbs due to diabetic neuropathy.  It also helps relieve neuropathy pain. 

Biotin – when taken in combination with chromium, biotin (a B vitamin) helps insulin work more effectively, keeps the pancreas working well, and lowers blood sugar levels.

Chromium – when taken with biotin, helps insulin work better, keeps the pancreas working well and lowers blood sugar levels.

Copper –helps protect the cells in the pancreas that make insulin healthy, helps prevent diabetes related damage to blood vessels and nerves and lowers blood sugar levels.

Folic Acid – works with B12 to help prevent strokes and loss of limbs due to diabetic neuropathy.

Magnesium – helps relieve diabetic neuropathy pain and helps insulin work more effectively.

Manganese – helps prevent damage to blood vessels and nerves.

Selenium – sometimes called an insulin imitator, selenium helps take blood sugar into the cells.  Selenium protects against blood vessel and nerve damage from elevated blood sugar levels, two of the contributing factors in diabetic neuropathy.  

Zinc – helps blood sugar get into the cells and insulin work more efficiently.

These supplements, when used properly and under your care and supervision as their NeuropathyDR® clinician, can help improve diabetic neuropathy symptoms and lessen the chances of permanent nerve damage and eventual amputation.

Emphasize to your diabetic neuropathy patients that these supplements will not take the place of eating properly and exercising.   They work in combination with a healthier lifestyle, not in place of it.  By properly taking these supplements, watching their diet, exercising and complying with all of your treatment requirements as their NeuropathyDR® clinician, they greatly improve their chances of living a life free of the pain of diabetic neuropathy.

Let us help you reach this challenging patient population.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to to download a FREE E-Book Copy of my 5 star Amazon  rated book “Living and Practicing by Design”.

Chiropractic Care For Your Diabetic Neuropathy Patients

As a medical professional specializing neuropathy, you probably have a significant number of diabetics as patients.

Chiropractic care for diabetic neuropathy patients usually concentrates on correcting misalignments in the spine.

Diabetes ranks number 5 in the deadly diseases in the United States.

Those numbers are growing at an alarming rate.

One of the more difficult issues in treating diabetic patients is helping them deal with diabetic neuropathy and all it brings with it.

In order to get your diabetic neuropathy patients to make the connection between their diabetes and their diabetic neuropathy, you have to educate them on their diabetic neuropathy and its symptoms and health implications.

You also have to educate them on all their treatment options.

As a NeuropathyDR® clinician, you know how effective chiropractic treatment can be for your diabetic neuropathy patient.  Part of your job as their treating physician is to educate them on the option of chiropractic treatment.

First, make sure they understand why their diabetes has caused diabetic neuropathy.

Why Does Diabetes Cause Neuropathy?

If your patient’s blood glucose levels aren’t controlled and have been high for significant period of time, the blood vessels that carry oxygen to your nerves can be damaged[1].  Elevated blood glucose can also damage the sheath that covers and protects the nerves. That leaves them vulnerable to damage. 

Diabetic neuropathy is just the medical term for the nerve damage caused by elevated blood glucose levels.  That’s the simplest way to explain diabetic neuropathy to your patients.  It will help them to better understand why they’ve developed these new symptoms.

What Happens To The Body Once Those Nerves Are Damaged?

Diabetic neuropathy happens when the nervous system is damaged.  Symptoms change according to which part of the nervous system is damaged.   

If the peripheral nervous system is damaged your patient can experience

  • Numbness in the arms, hands, legs and feet
  • Inability to feel heat, cold or even pain in the arms, hands, legs and feet
  • Burning or tingling or even the “pins and needles” feeling they get when their legs or arms “go to sleep”
  • Changes in the shape of their feet caused by weakened muscles
  • Carpal tunnel syndrome

If their neuropathy affects their autonomic nervous system, they can experience

  • Digestive problems like nausea, vomiting, constipation or diarrhea[2]
  • Erectile dysfunction
  • Irregular heart beat
  • Loss of bladder control
  • Inability to regulate their blood pressure

Why Chiropractic Care Can Help Diabetic Neuropathy Patients

Chiropractic care for diabetic neuropathy patients usually concentrates on correcting misalignments in the spine.  Those misalignments can wreak havoc on the nervous system and internal organs – including the pancreas, a direct link to diabetes.

As a NeuropathyDR® clinician, you have an exclusive treatment protocol with proven results for diabetic neuropathy patients.  An integral part of that treatment protocol is chiropractic adjustment to correct problems with spinal alignment.

As a result of chiropractic adjustment for diabetic neuropathy, the next step in the treatment for diabetic neuropathy is taking steps to reduce their symptoms and help the nerves repair themselves.  This can be done through a combination of topical pain medications, manual manipulation of the bones and joints to properly align the nervous system and nerve stimulation. 

Proper alignment of the bones and muscles and nerve stimulation are all important aspects of successful treatment of diabetic neuropathy. 

Offer your diabetic neuropathy patients an ongoing monitoring and follow up program.  Keep in touch and watch for blisters, sores, torn skin, or inflammation as a sign of new nerve damage. Make sure they’re doing a visual inspection and not just relying on soreness or pain.  Diabetic neuropathy impairs the ability to feel pain in the extremities and they may not notice the problem until it’s too late for successful treatment.  It never hurts to have a fresh pair of eyes (yours) keeping watch over them.

When you’re trained and ready to treat them, let us help you reach them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to download a FREE E-Book Copy of my 5 star Amazon rated book “Living and Practicing by Design” at

Should Your Peripheral Neuropathy Patients Get a Flu Shot?

It’s that time of year again…

Your patients need to make an informed choice about whether or not to get a flu shot.

Pre-flu season…

And everywhere your peripheral neuropathy patients look they see signs advertising “Flu Shots – Walk Ins Welcome” or “Get Your Flu Shot Today.”

For the average, healthy person getting a flu shot is a no-brainer.

After all, the flu accounts for 200,000 hospitalizations every year and up to 36,000 deaths.  If they can take a shot and avoid that, why wouldn’t they?

But if your patients have peripheral neuropathy caused by

  • Diabetes
  • Cancer (and you’re undergoing chemotherapy)
  • Shingles
  • HIV/AIDS or some other immune system disorder
  • Exposure to toxins
  • Gluten sensitivity (also known as celiac disease)
  • Kidney or liver disease
  • Hereditary neuropathy

They may have concerns about getting a flu shot – especially your peripheral neuropathy patients with underlying immune issues.  HIV patients tend to be especially skeptical about receiving the vaccine. 

If your patients’ peripheral neuropathy is caused by any of these underlying illnesses, they need to make an informed choice about whether or not to get a flu shot.   

They make that informed choice by consulting you as their NeuropathyDR clinician.

This is what they need to know. 

The Flu Vaccine Will Not Actually Make Them Sick

Contrary to urban myth, the flu vaccine will not make your peripheral neuropathy patients sick.  It works by stimulating the immune system to produce antibodies that actually fight the virus. It does not give them the flu.    

Make sure they understand that there is no evidence that the flu shot will make their neuropathy symptoms worse if their neuropathy is caused by any of the underlying illnesses we listed above.  In fact, the Centers for Disease Control strongly recommends that peripheral neuropathy patients with any of these illnesses receive a flu shot every year because they’re more prone to developing serious complications if they get the flu.

Special Concerns for Your Guillain-Barre Syndrome or CIDP Patients

If your patient’s peripheral neuropathy is caused by Guillain-Barre Syndrome or chronic inflammatory demyelinating polyneuropathy (CIDP), they need to exercise some caution before receiving the flu vaccine. 

Because the vaccine keeps them from getting the flu by tricking their immune system into producing antibodies to fight it off,  if they have neuropathy caused by Guillain-Barre Syndrome or CIDP,  this immune stimulation may actually cause a relapse in patients with a history of either of these illnesses.  

If they have had Guillain-Barre Syndrome and the resultant peripheral neuropathy in the past, it might be a good idea to wait at least one year after their symptoms are gone before receiving a flu shot. 

If your patient has CIDP and their symptoms are still present, they might want to avoid the flu vaccine.  Talk to your CIDP patient and consider the chances of complications from the vaccine as opposed to the health risks of actually getting the flu.  Issues to take into consideration are:

  • Advanced age
  • Other chronic medical conditions
  • Possible relapse triggered by getting the flu virus  

Who Should You Advise to Get a Flu Shot?

The Centers for Disease Control recommends that people receive the flu shot every year if they fall into any of these groups:

  • They’re six months to 19 years old
  • They’re 50 years of age or older
  • They have a chronic medical condition (lung, heart, liver or kidney disease, blood disorders, diabetes)
  • They live in a nursing home or other long term care facility
  • They live with or care for someone at high risk for complications from the flu (healthcare workers, people in their household (i.e., children too young to be vaccinated or people with chronic medical conditions)  

Make sure that you ask about all of these issues when you do your physical and history.

In the end, the decision to get the flu shot or take a pass on it is up to the patient.  As their Talk NeuropathyDR clinician, your job is to help them make an informed decision by weighing all the possible issues they may face as a peripheral neuropathy sufferer.

Pre-vaccination counseling is another service you can offer your peripheral neuropathy patients.  Let us help you reach them.  

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to download a FREE E-Book Copy of my 5 star Amazon rate book “Living and Practicing by Design” at

Why a Specialty Practice in Todays World?

Make no mistake about it, businesses are being challenged to their core right now.

But, the reality is in a down economy you can OWN your market! Why? Because of how many businesses (practices) pull back, fail to market or maintain contact with people who likely could be customers for life!

I see this as a private practice consultant every day. Those who do all the right things in private health care right now are thriving, pulling together larger market shares all the time as weaker practices fold.

And one factor in our success clearly is the advantages of  developing a true Specialty Practice.

Specialists become experts by advanced training. Specialists get paid more. They especially get more referrals from generalists. Patients know this, then really sense it in the presence of their clinician.

As I watch in our 50 some-odd NeuropathyDR Clinics, those who continue to study, learn new techniques to help those whose lives have been devastated by serious disease and illnesses never want for new patients!

Real Specialty practices in particular have incredible “leverage”.  Staff always are learning newer and better ways of helping patients. Specialty practices have “staying power” when staff is trained properly, each system is perfected,  then marketed to their communities consistently.

And if by chance something is not working, its almost always just one of the above.

So, if you are on track to have an incredible finish to your year, I commend you.

If not, take a hard look at how your practice is positioned in front of your community from every angle. Give patients reasons to ONLY want to see you.

But above all, do this before your nearest competitor does.

It’s not going to be “easier” next year.

NeuropathyDR.The Treatment system Patients and Professionals ask for by name. (TM)











To learn more, click HERE




Diagnosing Peripheral Neuropathy

If a significant percentage of your patient load is made up of patients with

Show your patients how to do a visual inspection of their feet and hands for any problems.

  • Diabetes
  • Cancer (and you’re undergoing chemotherapy)
  • Shingles

You know how to deal with their primary symptoms.  Granted, every patient is different, but to some degree you know what they’re going to experience and their primary care physician has probably (hopefully) given them some idea of what to expect.

But unless that primary care provider is exceptionally thorough, peripheral neuropathy and its symptoms probably didn’t make the top 10 list of what they can expect from their illness.

Suddenly they’re experiencing

  • Swelling in the feet, legs or hands
  • Muscle cramps in the legs
  • Changes in the skin and nails
  • Numbness in the feet and hands
  • Inability of feel heat or cold
  • Sleepless nights due to pain
  • Muscle weakness
  • Painful burning and itching in the hands or feet
  • Feeling like they’re wearing gloves or socks when they’re not

And they didn’t expect any of these symptoms. 

So they do some research and they come to the conclusion that they might have nerve damage and, if you’ve positioned yourself properly as a NeuropathyDR® clinician, they find you.

And now they’re sitting in your waiting room. 

Diagnosing Peripheral Neuropathy in the Hands and Feet[1]

This can be a really difficult diagnosis to make.  The symptoms can vary widely between patients.  And when you’re dealing with patients with such serious illnesses at the root of their problems, it can be hard to pinpoint exactly what the problem is. 

The best course for you to take is to start with a really thorough history and physical followed by an extensive neurological examination.  If your patient is presenting with a known illness, that will make it much easier for you to make the peripheral neuropathy diagnosis because you don’t have to search for the underlying illness. You just have to figure out if the symptoms they’re seeing you for are caused by nerve damage.    

Treatment Options for Peripheral Neuropathy in the Hands and Feet[2]

Once you make the peripheral neuropathy diagnosis, work with your patient’s other doctors to make sure that the underlying medical condition is under control.  Once you understand the treatment regimen they’re undertaking, you can begin to address possible nerve damage and healing the nerves.

Make sure your patient is

  • Getting plenty of rest
  • Pacing themselves
  • Exercising regularly – walking and swimming are good exercises for neuropathy patients
  • Taking care of their feet and hands
  • Not smoking
  • Eating a healthy, well balanced diet

Your patient needs to understand how important it is to pay attention to their feet and hands and to contact you immediately if they notice any blisters, sores, torn skin, or inflammation.  

Show your patients how to do a visual inspection of their feet and hands for any problems.  They need to know not to rely on feeling pain to know that they have sore or blister on their feet.  Their peripheral neuropathy will keep them from feeling pain in their feet and hands.  They may not notice the problem until it’s too late for successful treatment. 

This is a patient population that really needs your help and the NeuropathyDR® treatment protocol is perfect for helping them avoid permanent nerve damage.

Let us help you reach these patients and treat them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to to download a FREE E-Book Copy of my 5 star Amazon rated book “Living and Practicing by Design.”

Designing an Exercise Program for Your Autonomic Neuropathy Patients

As a medical professional treating neuropathy patients, you know how vital it is that your patients remain as physically active as possible. 

Talk with your patients about their expectations and make sure they understand their limitations.

Autonomic neuropathy[1] makes that a little more difficult because this specific type of neuropathy can seriously impact the very systems that are directly affected by exercise.

As a NeuropathyDR® clinician, an exercise program is a vital part of your treatment regimen.  With your autonomic neuropathy patients, you have to be especially careful in both designing and monitoring their exercise program to ensure that they receive the full benefit of the exercise and don’t do more harm than good.

Exercise On A Case By Case Basis

Any exercise program for an autonomic neuropathy[2] patient should be designed for their specific symptoms and circumstances. Talk with your patients about their expectations and make sure they understand their limitations and what their anticipated outcome can be. 

To be most effective, the exercise program you design should include recommendations on:

  • Intensity
  • Type
  • Duration
  • Frequency
  • Controlling when they move to the next level


Most healthy people keep an eye on their heart rate when exercising.  For autonomic neuropathy patients, the heart rate is not a good indicator of the intensity of exercise because their heart rate is already depressed. 


Make sure your autonomic neuropathy patient is interested in the exercise you prescribe.  If you prescribe exercises that they have no interest in or can’t do, the program is doomed to failure.  Some of the best exercises are stationary cycling, semi-recumbent cycling and water exercises. Even sitting in chair and doing light weight exercises is better than doing no exercise at all.


Your autonomic neuropathy patients may have a seriously decreased tolerance for exercise simply because their heart and lungs aren’t functioning properly.  Your exercise program should take this into account and not be too ambitious in the beginning.  Make sure you have a firm grasp of their tolerance for exertion.


If you want your autonomic neuropathy patients to have a successful exercise program, make sure you are both realistic in your expectations.  In order to make it a habit, daily exercise is the most effective.  If at all possible, advise your patients to do some kind of exercise every day.  If they can do it, great but don’t allow them to become discouraged if they can’t.  Just adapt to what they can do.

Moving to the Next Level


This can be one of the more challenging concepts in designing an exercise program for your autonomic neuropathy patients.  You don’t want them to be bored but you don’t want them to overexert themselves. Instead of attempting something more difficult, think about just increasing how often they exercise at first.  Then build to a more intense level of exercise. 

Early intervention with a physician well versed in treating all types of neuropathy, like a NeuropathyDR® clinician, is still the best course of action for an Autonomic Neuropathy patient.  While you can’t reverse your patient’s condition if they have already developed autonomic neuropathy, you can help them achieve a better quality of life and lessen the chance of severe and possibly fatal complications.

Let us help you reach these patients and treat them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to to download a FREE E-Book Copy of my 5 star Amazon  rated book “Living and Practicing by Design”.

Planning to Efficiently Treat Your Peripheral Neuropathy Patients

We become doctors to help people. 

Offer your peripheral neuropathy patients an ongoing monitoring and follow up program.

Unfortunately, the reality of a modern medical practice can sometimes make us rethink our original motives in becoming medical professionals…

So many patients…

Mountains of paperwork…

Not enough time to really get to know our patients as individuals…

Healing can sometimes take a backseat to the “quick fix.” 

Especially in patients with peripheral neuropathy. 

They’re not only dealing with the other symptoms of their underlying illness, now they have[1]

  • Diarrhea, nausea and vomiting
  • Difficulty swallowing
  • Deep pain in the legs and feet
  • Loss of sensation and ability to feel warmth or cold
  • Muscle cramps
  • Numbness, tingling or burning in the arms, hands, legs or feet
  • Weakness
  • Dizziness, especially when they try to stand up
  • Drooping facial muscles
  • Loss of bladder control

They just want to feel better…now…

One of the best ways to get a strong start with treating peripheral neuropathy patients is to make efficient and effective use of every appointment. 

And that means helping the patient help you treat them.

Preparing For That First Appointment

When your new patient calls in for an appointment, have a solid new patient questionnaire ready for them to complete.  Don’t wait until they come in for that first appointment.  Have your scheduling staff email or snail mail it to them a week before their first appointment and follow up with them to ensure they’ve filled it out before they come to your office.

Get as much information as possible.  Other than the very basic questions like age, weight, etc., here are some sample questions you might want to include[2]:

  • What is your occupation?
  • Do you have any underlying medical conditions (i.e., diabetes, shingles, cancer, alcoholism or substance abuse, HIV/AIDS, Guillian-Barre Syndrome)?
  • When did you first notice your symptoms?
  • How often do you experience your symptoms? Do you have problems at specific times of the day or after any specific activity?
  • On a scale of 1 to 10, (1 being mild and 10 being severe), how would you rate your symptoms?
  • Have you noticed anything that makes your symptoms better or worse?
  • How often do you exercise?
  • What does your diet consist of?
  • Have you undergone any significant lifestyle changes recently?

Getting as much information about a day in the life of your new patient before you see them will help you use your appointment time efficiently and really get started with diagnostic testing and treatment.

Once you and your patient have done your homework, you have test results in hand and you know exactly what you’re dealing with, you can formulate a treatment plan specifically for this particular patient.  A plan that will not only alleviate their symptoms but start repairing the nerve damage that’s caused their peripheral neuropathy.

In addition to regular medical treatment, you can offer your patients:

Diet Planning and Nutrition Counseling

The first goal for treatment in peripheral neuropathy is to get the patient’s underlying medical conditions under control and keep them under control to slow the progression of any nerve damage.   That means ensuring that they properly take any prescribed medications and that they’re eating a healthy diet.

A diet that includes:

  • Fresh vegetables
  • Fresh fruit
  • Lean meats
  • High fiber
  • Whole grains
  • No sweets

An integral part of the NeuropathyDR® protocol is sitting down with the patient and planning their meals to include the proper portions of each of these categories on a daily basis.

Pain Reduction and Nerve Repair

Once you know their underlying medical conditions are under control, the next part of the treatment protocol for your peripheral neuropathy patient is taking steps to reduce symptoms and help the nerves repair themselves.  This can be done through a combination of topical pain medications, manual manipulation of the bones and joints to properly align the nervous system and nerve stimulation. 

Diet, proper alignment of the bones and muscles and nerve stimulation are all important aspects of successful treatment of peripheral neuropathy. 

Ongoing Monitoring

A lifetime of bad habits can’t be undone overnight.  You’ll want to provide an ongoing treatment and monitoring program with your peripheral neuropathy patients. 

Once they see how much better they feel after the NeuropathyDR® treatment protocol, it’s incredibly easy for them to slip right back into their old habits.  If you don’t stay in touch and follow up with them regularly, they can undo everything you’ve worked with them to achieve.  And, even worse, they could be facing even more severe nerve damage than they had before. 

Offer your peripheral neuropathy patients an ongoing monitoring and follow up program.  A newsletter with articles about peripheral neuropathy, healthy lifestyle choices and tips for things to watch out for and report to their physician (you as their NeuropathyDR® specialist) will help you make a lasting difference in the lives of patients suffering from peripheral neuropathy. 

When you’re trained and ready to treat them, let us help you reach them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to download a FREE E-Book Copy of my 5 star Amazon  “Living and Practicing by Design” at

Are Your Peripheral Neuropathy Patients Taking Care Of Their Feet?

As a medical professional treating patients with peripheral neuropathy, you want to have a positive effect on your patients.

More than half the patients admitted that they walked around the house and even outside with no shoes.

You treat them…

You worry about them…

You advise them…

But are they really listening to what you tell them?

If your patients have peripheral neuropathy in their feet, chances are really good they’re not listening to you.  They hear you but they’re not taking what you tell them home.

A recent study that followed 41 patients with type 2 diabetes and peripheral neuropathy found that

  • 90% of the patients had been educated about proper footwear
  • 83% washed and dried their feet properly every day
  • 51% actually perform foot self-exams recommended by their doctors

But more than half the patients admitted that they walked around the house and even outside with no shoes.  And more than two thirds of them were not wearing appropriate footwear.  They were wearing shoes with pointed toes, high heels or flip flops, and even worse.

If you want to really get through to your peripheral neuropathy patients, you need to impress on them how serious they’re condition is and exactly what can happen to them if they don’t follow your instructions.

Step One  – The Thorough Foot Examination[1]

If you have patients with peripheral neuropathy in their feet, even if they don’t present with foot issues, you need to be proactive as their physician and ensure that you see them at least once a year for a complete foot examination. 

When you’re examining their feet, make sure you: 

  • Examine each foot between the toes and from toe to heel.  Make extensive notes in the chart of any problems by drawing or labeling the finding on the foot diagram.  If your patient has skin that is thin, fragile, shiny and hairless, they could have problems with their circulation and that means possible nerve damage. 
  • Ask the patient if they’ve noticed any change in how their feet sweat.  If their feet don’t sweat as they normally would they can develop dry, cracked skin and those cracks can become infected.
  • If your patient is wearing nail polish, take it off.  Check for ingrown toenails, deformed nails or any type of nail fungus. 
  • Make notes on the diagram and in the chart of any areas on the feet that are noticeably dry, red or warm to the touch.

Step Two  – Patient Education

In order to prevent serious problems, your peripheral neuropathy patients need to know how to care for their feet and what to watch for so they can come in to see you before they reach a point  of no return. 

Here’s a good checklist to provide to your patients to remind them of exactly what they need to do to help themselves[2]:

  • Check their feet every day.  Look at their bare feet to make sure they don’t have any sores, blisters, or swelling.  If they can’t see the bottoms of their feet, they should use a mirror or ask someone else to check them.
  • Wash their feet every day and dry them completely to eliminate the possibility of fungus growth.  Make sure they pat their feet dry – don’t rub them.   
  • Use a good lotion on their feet to keep skin smooth and prevent dry, cracked skin.  Don’t use lotion between the toes – it will keep the skin there too moist and that breeds bacteria.
  • Trim their toenails but not too short.  Cut them straight across and file the edges with a nail file to prevent ingrown toenails and cut them right after they bathe while the nail is still soft.
  • Always wear shoes and socks – even inside the house.  If they have neuropathy, it’s just too easy to step on something and injure their feet without even feeling it.
  • Wear comfortable shoes, preferable shoes designed for people with peripheral neuropathy in their feet.  Check their shoes before they put them on and make sure the lining is intact and smooth and that nothing is in their shoes.  Talk to them about Medicare assistance with purchasing special shoes. 
  • Never put their feet in hot water.  Always check the temperature of their bath water with the elbow before stepping into it. 
  • Never use hot water bottles or heating pads on their feet.  Neuropathy makes it harder to sense extreme temperatures and they can burn their feet without even knowing it.
  • When sitting down, they should prop their feet up to keep the blood circulating.  Move the toes and ankles to keep the blood pumping.
  • Never cross their legs when sitting.

Don’t just tell them what they need to do and take it for granted that they understand what you’re telling them.  Ask them to demonstrate the steps to proper foot care so you know they know what you’re saying and that they are physically capable of doing what you’re telling them to do.  Offer clinics on proper foot care for your patients with peripheral neuropathy in their feet. 

And offer your peripheral neuropathy patients an ongoing monitoring and follow up program.  Keep in touch and watch for any of the symptoms of peripheral neuropathy in the feet. 

Peripheral neuropathy in the feet impairs the ability to feel pain and they may not notice the problem until it’s too late for successful treatment.  It never hurts to have a fresh pair of eyes (yours) keeping watch over them.

When you’re trained and ready to treat them, let us help you reach them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to to download a FREE E-Book Copy of my 5 star Amazon  “Living and Practicing by Design”.

Is Your Patient’s Statin Medication Making Them Sick?

Let’s say you have a new patient who presents with

Prolonged exposure to statins can cause serious damage to the peripheral nerves.

  • Burning pain
  • Sensitivity to touch
  • Tingling
  • Numbness
  • Prickling sensation
  • Weakness
  • Difficulty walking
  • Shooting pain in their muscles

For too long a time, they couldn’t figure out what was wrong with them.  They thought they were just tired or getting older or maybe coming down with something. 

Then they did some research and they think their symptoms may be some sort of neuropathy…

They’re not diabetic, they haven’t been through chemotherapy, they’ve never had shingles…

In fact, the only medical issue they have is high cholesterol and they’re taking statins.  And that can mean they may very well have is one of the fastest growing types of neuropathy…

Statin neuropathy.

And you can both be thankful they landed in your office.  As a NeuropathyDR® clinician, you probably have an excellent chance of recognizing, diagnosing and treating statin neuropathy.

What Is Statin Neuropathy?

Statin neuropathy[1] is nerve damage caused by exposure to cholesterol lowering medication.  By lowering cholesterol, statins also affect the cholesterol rich membranes that surround the nerves.  Prolonged exposure to statins can cause serious damage to the peripheral nerves. While that may not sound like a big deal, it can ultimately affect your patient’s

  • ability to breathe
  • ability of their heart to function properly
  • ability to control many of their bodily functions

The Difficulty of Diagnosing Statin Neuropathy

Patients with statin neuropathy often present with very subtle pain or mild weakness.  Because their initial symptoms are fairly mild, it’s harder to pinpoint a diagnosis.  When symptoms are more pronounced and painful, there may be a lag time between the exposure to the toxin and the onset of significant symptoms.  The symptoms come on so gradually that it’s harder for the patient to give the clinician a clear picture of exactly when they started.

The difficulty in diagnosing statin neuropathy is one of the reasons that it is so important for them to consult a healthcare provider who specializes in treating neuropathy, like a NeuropathyDR® clinician.  Because this is your field of expertise, you are more likely to pick up on subtleties that will allow a faster diagnosis.  Faster diagnosis means faster treatment and that means less chance for permanent nerve damage.

What is the Treatment for Statin Neuropathy?

As a NeuropathyDR® clinician, your initial goal will be to confirm the diagnosis and then help your patient control their underlying medical condition and get off their statin medication[2].   

The next step is to devise a treatment plan.

One of the benefits to the statin neuropathy patient of being treated by a NeuropathyDR® clinician is your hands on approach and specialized training in treating their statin neuropathy.  You can advise them on the necessary safety precautions to avoid falls and potential injury caused by nerve deficits as well as providing nerve stimulation and manual manipulation of their skeletal system to get their body back into alignment and alleviate their nerve pain.

When you’re trained and ready to treat statin neuropathy patients, let us help you reach them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, and to download a FREE E-Book Copy of my 5 star Amazon “Living and Practicing by Design”, log on to

A Priceless Gift for Your Peripheral Neuropathy Patients – Quality of Life

As a medical professional treating patients with peripheral neuropathy, you know how to deal with their medical issues…

Have your staff provide your peripheral neuropathy patients with some reference materials to help them get the most from their time with you.

Physical therapy…

Nerve stimulation for regeneration and repair…

Prescriptions for pain…

But what might not be as well versed in is helping them maintain or regain their quality of life[1].

Helping your peripheral neuropathy patients recoup some of the intangible things they’ve lost to their illness can be incredibly rewarding, both for you and your patient.

And it can help you build a practice that goes beyond the medical issues and gives your peripheral neuropathy patients a priceless gift…

Giving their lives back.

Helping Your Patients Help Themselves

As part of your new patient intake procedure, have your staff provide your peripheral neuropathy patients with some reference materials and suggestions to help them get the most from their time with you and to help you know what their issues are from the outset[2]:

  • Give your patients some articles and reference materials to read and educate themselves about their condition.  If they know more about their condition, they’ll be more realistic about what they should and shouldn’t expect from treatment. 
  • Ask your patient to write down a list of questions they have about their peripheral neuropathy.  Suggest that they bring someone with them to their first appointment who can write down the answers to their questions for them so they’re not distracted and can really listen to what you tell them.
  • Have your peripheral neuropathy patient provide you with a list of all their medications (both prescription and over the counter – including vitamins, minerals and herbal supplements) so you’ll know how what they’re taking may be affecting their condition and causing some of their issues.
  • Take note if they are having particular issues that might warrant occupational therapy in addition to physical therapy.  Be proactive in making a referral for occupational therapy if you think it’s warranted. 

Listening for Signs of Depression and Other Conditions

No two peripheral neuropathy patients are alike.  Just as their daily lives and routines are different, the effect of peripheral neuropathy on their quality of life is going to be different.  Some patients will require closely monitored pain management therapy.  Others will need to be watched more closely for the signs of depression and withdrawal. 

While you may not be a mental health professional, part of treating the whole patient requires that you pay close attention to their mental state.  Their mental attitude and how they’re adapting to their peripheral neuropathy and the changes it brings to their lives is crucial in a successful course of treatment. 

  • Encourage your peripheral neuropathy patients to share how their feeling, not just physically but emotionally.  Keep a list of support groups available to refer your patients to that can help them deal with their pain and the impact it has on their lives.
  • Encourage your peripheral neuropathy patients to get out and socialize with other people as much as possible.  Joining a support group for neuropathy patients or even for chronic pain sufferers will give them people to talk to who will have a real understanding of what they’re dealing with.
  • Work with your peripheral neuropathy patients on learning to set priorities with their daily routine.  Making a list of tasks to be accomplished and being realistic about them will cut down on frustration and help them fight their depression.

Helping Your Peripheral Neuropathy Patients Adapt

Quality of life is a measure of how a patient adapts to their physical condition.  The pain in their hands and feet can make it difficult to grasp even the smallest object or to keep their balance when they try to walk. 

Imagine how that must disrupt their lives…

In addition to helping them with their medical and emotional issues, there are tips you can share with them that will help them adapt to the practical considerations of dealing with peripheral neuropathy:

  • Using thick, rubber handled utensils in their kitchen will make it more comfortable for them when they prepare meals.
  • Using long-handled “reachers” (like the ones they use in retail stores to get items off top shelves) to reach for objects on shelves or even to pick things up off the floor.
  • Using button hooks to button or unbutton clothing.
  • Using devices that assist with putting on and pulling up socks.
  • Wearing shoes that have closures that make it easy to put them on and take them off.
  • Using devices designed to help pull up zippers.
  • Making sure they never leave anything lying around on the floor that they could trip over.

How You Can Help Your Patients With Nutritional Neuropathy

If you’re treating patients with neuropathy symptoms as a result of[1]

When you’re trained and ready to work with your patients, let them know you’re there.

  • Anemia
  • Gastritis
  • Crohn’s disease
  • Celiac disease
  • Ulcerative colitis

They may well be suffering from nutritional neuropathy in addition to the symptoms for their underlying illness. 

Why Digestive Issues Cause Nutritional Neuropathy[2]

Patients with any of these digestive disorders suffer from a very special set of problems and nutritional neuropathy just makes their physical issues worse.

They have to be careful about everything they eat because they never know exactly what will set off their symptoms.  They have to plan their lives around food and exactly how their underlying illness will disrupt their lives. 

Their illness affects how their body absorbs the vitamins and nutrients from the food they eat.  One of the leading causes of nutritional neuropathy is vitamin deficiency, especially Vitamin B12.  If your patient is limiting their animal protein because of their digestive issues, they could be suffering from a vitamin deficiency in the vitamins they would normally get from those foods. 

Any condition that affects the body’s ability to absorb the nutrients and vitamins from food can lead to nutritional neuropathy. 

Designing the Right Treatment Program for Your Nutritional Neuropathy Patients

To effectively treat your nutritional neuropathy patients, the first thing you need to do is a thorough history and physical.  Your treatment program will need to not only take into account their nutritional neuropathy symptoms; you need to design a diet plan that will work well with their underlying illness.  Digestive issues present a separate set of challenges for you as a clinician.

Your diet plan will not only need to include the vitamins and minerals, but you also need to take into account any digestive problems that will prevent their body from absorbing the good nutrition your diet plan provides.

Make sure your diet plan includes:  

  • Whole grains and legumes to provide B vitamins to promote nerve health.  Whole grains promote the production of serotonin in the brain and will increase feelings of well-being.
  • Fish and eggs for additional vitamins B12 and B1.
  • Green, leafy vegetables (spinach, kale, and other greens) for calcium and magnesium.  Both of these nutrients are vital to healthy nerve endings and health nerve impulse transmission and, as an added bonus, they give the immune system a boost.
  • Yellow and orange fruits and vegetables (such as squash, carrots, yellow and orange bell peppers, apricots, oranges, etc.) for vitamins A and C to help repair skin and boost the immune system.

Advise them to avoid:

  • Coffee and other caffeinated drinks. 
  • Fried foods and all other fatty foods.  Fatty foods suppress the immune system and that’s the last thing they need when fighting nutritional neuropathy and their digestive system disease.
  • Limit high protein foods like animal protein.  High-protein foods elevate the amount of dopamine and norepinephrine which are both tied to high levels of anxiety and stress which will only make them more irritable.
  • Alcoholic beverages.  Alcohol consumption limits the ability of the liver to remove toxins from the body and can make a bad situation worse. 
  • Processed sugar.  They don’t have to eliminate sweets completely, just control them.  Keeping blood sugar levels constant will help control irritability.
  • Control salt intake.  Opt for a salt substitute with potassium instead of sodium and stay away from preserved foods like bacon, ham, pickles, etc.  Reducing salt intake will help ease inflammation and that alone will work wonders in the healing process.

Sit down and discuss your nutritional neuropathy patient’s diet as part of the initial consultation process.  The information gained will help you devise a nutrition plan tailor made for your patient and help to build a rapport between you.

When you’re trained and ready to work with them, let them know you’re there.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to http://perfectpractice to download a FREE E-Book Copy of my 5 star Amazon  “Living and Practicing by Design” at