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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

Carotenoids

  • 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 http://perfectpracticeweb.com to download a FREE E-Book Copy of my 5 star Amazon rated 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 http://perfectpracticeweb.com 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 http://perfectpracticeweb.com.

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 http://perfectpracticeweb.com/.

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
  • HIV/AIDS

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 http://perfectpracticeweb.com to download a FREE E-Book Copy of my 5 star Amazon rated book “Living and Practicing by Design.”

Still Ignoring The Social Media Revolution?

Twitter…

Facebook…

Blogging…

Online articles…

Search Engine Optimization…

"How can I possibly do all this and run a practice.."

These terms are becoming as much a part of the modern chiropractic, medical or physical therapy practice as Preferred Providers and deductibles.

We all know that people are looking for everything online but chiropractors and physical therapists have been some of the last to join the Social Media Revolution.

But join they have and they’re using the internet like every other savvy business owner.

What Does This Mean To Your Chiropractic or Physical Therapy Practice?

Two studies conducted in 2008 showed that 41% of all the research medical professionals are doing is now done online (and that number was expected to double in 2009) and that the large pharmaceutical companies were gearing much of their marketing efforts to the online community as the best way to communicate with and educate their target audience – healthcare providers, including chiropractors and physical therapists.

Just take a look at some of the more popular social networking sites for medical professionals – Ozmosis, SocialMD and DoctorNetworking – each of these sites has literally thousands of members.

If you’re going to develop a presence online and reach your potential patient base, now is the time to do it if you haven’t already.

5 Trends In The Use Of Web & Social Media by Chiropractors and Physical Therapists

1.            Increase in Social Networking.

There are a growing number of sites that give healthcare providers the opportunity to connect with other professionals in their specialty to share knowledge, network, and support each other. Most of these sites are protected and allow users to communicate and share opinions and results in a safe online environment.  Check out our own NeuropathyDR site as an example.

2. Scholarly Medical Journals Have a Presence Online

Newspapers are not the only print media suffering the effects of online information.  Many scholarly medical journals have opted for an online-only format to save printing costs and to reach a broader base of readers.  Even beyond the convenience of their information being a mouse click away, many of these sites are increasingly interactive with Q&A sessions and even online classes and seminars for CME credit, perfect for the busy chiropractor or physical therapist trying to build a practice.

3. Blogs and Online Articles.

Many chiropractors and physical therapists are now blogging and publishing online articles to reach potential patients and educate the public about their particular specialty.  Where it used to take             months to be published in a medical journal, now you can set up your own blog, sit down and type a post (or have someone else do it for you), and you’re done.  This allows you to share a unique perspective about your specialty, local events, even the healthcare system.             All from the vantage point of a practicing chiropractic or physical therapy professional.  Your patients and future patients see you as a human with particular expertise and a voice they recognize.

4.            Twitter and Facebook.

Do you have a Twitter account? A Facebook page? If you don’t have at least one of these             social media tools working for you, you’re missing a huge marketing opportunity that’s             virtually free.  The only real cost is time.  If you don’t have the time to post to your own             Facebook page or send regular “tweets”, we’ll  do it for you!  In fact, I can help you get all of this done, and even get an ezine in the hands of YOUR patients for just pennies a day, automatically. “Frequent, relevant content” as my friend Nitin Chhoda DPT says, will keep you in constant contact with your patient base.

That puts you first in their minds when they, or someone they know, needs your specialty.

But if you are doing it all yourself, an important thing to remember about either of these tools – don’t use “doctor speak”             when posting your messages.  Imagine you’re talking to your next door neighbor at a             barbecue and keep that tone in your social media message.  You’ll get your point across             and impress rather than intimidate your patients.

When diving into the social media scene, the first thing to consider is exactly what you’re attempting to accomplish.  Don’t go in without a plan.  You’ll do nothing but send mixed and scattered messages.

Post strategically, wherever you post, and you’ll be amazed at how quickly you profit from this new social interaction.  Join the Social Media Revolution and make this year the best your chiropractic or physical therapy practice has ever seen.

Take Command of Your Outcomes

Last week, I wrote extensively on really taking command of the direction your practice, and your life as a powerful economic stimulus. In reality, it’s all you have in private practice. There are some really simple ways to do this, but before we talk about that, here’s an “Economic Summit” reality check-up.

If I told you right now there are doctors like you doing 7 figures cash/year, would you believe me?

If not, why?

Likely, it’s a very limited worldview on what you can really accomplish with all the correct systems and tools. And far too often, this is so defeating if it takes place early in ones career.

If I also told you Concierge MDs are collecting 10-15k per patient per year cash, and these same patients gladly pay, and in fact request that type of healthcare, and also pay health insurance premiums, what does that say about how you value, and price your services?

We’ll have way more on this very topic, with some really incredible guest instructors for members next year. Some absolutely brilliant ways to look at life and practice in this brave new world. Yes, even in a tanked economy.

Well, here is another huge economic management tip.

 

Here it is. Regular benchmarking of your results against your goals helps put you at the head of the class.

There is a real easy way to get this done. This tip alone might put another 10K in the income column this month.

The first thing to do is take your list of basic daily, weekly and monthly targets. Higher performing CEOs/CFOs do this daily. Use your white legal pad, but better yet for this one is an Excel spreadsheet (because you can graph it easily and tweak it in all sorts of ways).

My basic daily targets are body weight, miles run or cycled, hours skied, services and income, dollars saved. Yours might be totally different, as it should be. You really can do some incredible things with these numbers, but resist that temptation in the beginning.

Put your goals or targets (BOLD) on one axis, and simply enter your results on another. Save room for notes, photos, and maybe even video clips.

Next, post this somewhere you can see it all the time during the day. Admittedly in the office, maybe it’s in your portfolio, which you pull out during the day, or simply, hidden on your desktop or handheld. Just be sure to look at it at least once daily.

Here’s why this is so powerful. Because it’s a glimpse of right now.

Many people who have trouble setting goals find new life with this method. It keeps you in the moment as well. For us type A’s, it can actually be a better way of dealing with “Futurizing”, which some might say is an unhealthy psychological trait.

But to make sure your not deluding yourself, if you use daily targets, they must be the correct fraction of the weekly/monthly/yearly whole.

Just by doing this daily exercise, some great things start to happen…

Writing from Nantucket Harbor From Childrens Beach this AM…

Doctors and Physical Therapists Meet In Boston on August 21st!

In just 20 days, you’ll have an opportunity to rub shoulders with some
of the most powerful people in Private Practice today.
Nitin Chhoda DPT, David Phillips PhD, Michael Beck DC.

Chiropractors, Physical Therapists and Medical Physicians Working Together

Lets face it. Things are changing rapidly for all of us in Private Practice now.

What my very special guests will show you is quite likely going to
change the way you may have looked at practice…forever.

The special $1,500 in early bird FREE BONUSES for registering for the
2010 SuperConference – Private Practice 2.0 – Strategic Blueprint Development,
are going fast.

Your complete seminar/workshop program and your registration form are here

http://privatepracticedomination.com

Don’t miss your opportunity to learn how to:

*       Acquire more of your ideal clients
*       Sell your unique services online
*       Promote career saving specialty care
*       Learn financial freedom secrets
*       Flood your practice with new patients
*       Boost referrals

This instructive, informative 2010 SuperConference guarantees to teach you the profitable revenue-generating techniques that are working today for practices just like yours.

And for registering early you’ll get $1,500 in FREE BONUSES.

All the info is here

http://privatepracticedomination.com

Now, You can Achieve breakthroughs in this turbulent economy with currently-productive knowledge found only at the 2010 SuperConference.

Yours to count on,

John

P.S.- Reserve your seat now so you can take advantage of the $1,500 in FREE BONUSES available to those that register early

http://privatepracticedomination.com

I Really appreciate the opportunity to assist you in achieving your goals!

John Hayes, Jr. DC MS DABCO

CEO Perfect Practice Web, LLC
NeuropathyDR(TM)
Instant Patient Newsletter Call (781) 754-0599
Email: info@perfectpracticeweb.com
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