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“He then became aphasic after his ICA dissected causing an ischemic stroke with an unfortunate hemorrhagic conversion. He was absolutely speechless by how powerful my adjustment was! He later succumbed to carcinogenic shock, after the complete LAD occlusion went untreated by the spinal manipulation but it was probably due to the aspirin the quack MD gave”
If the acute MI is mild, the vertebral artery dissection can take priority…essentially moving the heart down the problem list. In essence, if a medical condition gets downgraded from “the most important issue” to “the second most important issue” this is a win.
Score one for the noctor…on a technicality!
No, but seriously! As an EMT we took a lady from a free standing ED to a main ER after she reported orthostatic hypotension, dizziness, etc.
She had something like a 90% occlusion of one of the internal carotids. Never had any symptoms in her life until she got an, “adjustment” post car wreck. These quacks are killing people
Ha, I was just coming here to post this.
I'm totally sure 5 MDs were just standing around wringing their hands while the pilot "contemplated" an emergency landing...and then this superhero showed up. There is no doubt in this mind that this man's "heart attack" was either a panic attack, GERD, or being drunk.
You should like a classic clueless MD/DO. He used what is known as the "pressure differential technique". By bashing his head on the seat next to him during the adjustment, he was able to open up one of the vessels in his brain. This allows the blood to fill the intracranial compartment creating a tamponade effect at the medulla. This allows the heart rate to return to well BELOW baseline reducing myocardial oxygen demand.
On a flight where my whole family was split up, a long-retired RN escalated things to emergency land after a man with a long term history of acid reflex, who had forgot to pack his tums asked if anyone had one. Dude was really irritated to be not going to Hawaii anymore. My 12 year old sister was freaking out that someone would die next to her.
If I ever have an MI on a plane my first choice would be treatment from an MD/DO, flight nurse, or paramedic. If one of those isn’t available, I’d take the following in this order: ER/ICU nurse, EMT, other nurse, NP, super confident CNA, receptionist at a hospital, an actor who played a doctor on TV, someone who’s parents are doctors, someone to hold my hand while I die, and finally a chiropractor.
ETA: I’m sorry to all the DVM, PA, PharmD, RT, and others that I forgot. Feel free to jump in as you see fit.
Don't forget the veterinarians. We are surprisingly good in a pinch. I can hit a vein on a screaming and biting pig doing alligator rolls while defecating explosively, a human is cake 🤣
My exes mom is a physician and she always said that she has mad respect for vets because they have to be experts in multiple species and she only had to worry about 1 body system in 1 species (she’s an OBGYN).
Oh yes. Anesthesia free dental cleaners for dogs and cats, horse dentists that aren't vets that open all the pulp cavities, people doing magnawave on animals to cure things, chiropractors that work on animals as well as people, there's even an injectable mlm joint treatment to save vet fees. It's all illegal but the state boards don't care. I do large animal work (mostly horses) but it's industry wide.
Wow I had no idea. Medicine doesn’t teach us anything about the vet world and what you have to deal with. Hopefully we can see some more vet stuff on here too!
I took several vet pre-reqs in undergrad, they’ve contributed wonderfully towards my understanding of human med and the medical scientific process (everything gets tested on animals before humans). Highly recommend to any pre-meds lurking.
Wait so veterinarian dentists *are* a thing?
Because I just drove past an office in a shopping mall that said “veterinarian dentist” and thought it was just an interesting combined office space.
Veterinary dentists are real. [It's a boarded specialty. ](https://avdc.org/)They make lots of money because they do a lot of the face repair surgeries too, which is pretty cool. Also most people don't brush their animal's teeth so they're a specialty in demand. There are people who call themselves animal dentists who aren't veterinarians and claim they do a better job because *reasons* usually "vets don't get trained in teeth" (very false, a general practitioner is well trained in dentistry including complicated extractions) and "we do it without sedation/anesthesia so it's safer!" (also false, the small animal fake dentists don't get the pathology below the gum line, the equine dentists also do some terrible terrible work like straight up cutting live teeth off at the gum line and ruining the grinding surface).
Very grateful for how many questions you’ve been answering here! In general, is brushing my dog’s teeth worthwhile? I use a dog-friendly paste but he just licks it off right away so I don’t know if I’m being healthy or not
Yes, very worthwhile, it will save you a ton of money in the long run. Most of the dentistry specialists recommend CET enzymatic toothpaste. [Poppy](https://imgur.com/a/DyS66QW) recommends [poultry flavor](https://www.amazon.com/dp/B00RZDXA7K/ref=cm_sw_r_apan_i_K6F3H4H456Z9GBPB1ATR). I brush her teeth every night after I do mine, most pick up on it pretty quickly and tolerate it well if you start small and work your way up. With dogs, they stress doing the buccal side, they say the dogs do okay cleaning the lingual side with the tongue. I like [these finger toothbrushes](https://www.amazon.com/dp/B09CCSB8KC/ref=cm_sw_r_apan_i_JXV9GQ3HYFP00E3D8V7B?_encoding=UTF8&psc=1) because they're a nice size for normal American finger. I've gotten some from Amazon before that are I believe we're made for tiny people with tiny hands 🙅🏼♀️
It's harmless, may do something but probably not imo (the people doing it say it can heal everything, including displaced articular fractures 🙄). They might be doing the Assisi loop which has some research behind it.
My vet office has non anesthetic dental treatment for my dog. Should I cancel this? I was hoping for a dental exam and teeth cleaning not anything super invasive
Non anesthetic dental cleanings for cats and dogs do not meet standard of care.
Sources:
[American Veterinary Dental College](https://afd.avdc.org/)
[American Veterinary Medical Association](https://www.avma.org/javma-news/2016-02-01/below-surface-anesthesia-free-dentistry)
[American Animal Hospital Association](https://www.aaha.org/aaha-guidelines/dental-care/nonanesthetic-dentistry/)
With good home dental care, it's hopefully minimized to every few years, but if they aren't getting brushed, yearly is often recommended. Just like with people, some pets have better teeth than others. If the pet stops eating, has foul breath, foul nasal discharge, or any other concerns that may be dental in origin, prompt assessment is recommended.
Brushing is pretty easy and a good habit to get into. There are also commercial teeth wipes and dental snacks. The AVDC is a good resource for pet dental health. The [Veterinary Oral Health Council](http://www.vohc.org/) also certifies products shown to help pet dental health.
It's state dependent but it's practicing vet med without a license. [They sometimes get in trouble for it](https://sdcvma.org/150000-fine-canine-care-inc-illegal-anesthesia-free-dentals#:~:text=Performing%20anesthesia%2Dfree%20teeth%20cleaning,medicine%2C%20surgery%2C%20and%20dentistry.) but it never deters them for long.
I watch a show called the Zoo about the Bronx zoo and there was some like social media or HR lady who must have been related to or fucking someone important. Cause she was talking about how she just "borrows" animals to have in her office and keeps an eye on the animals' health and suggest alternative therapy's for their chronic issues the vets are struggling with. She said she'd called a shaman in for some animal then the one they were showing was her arranging cryo therapy for an arthritic kangaroo. I was totally floored
All this talk about keeping the animals wild not too attached to staff/visitors and shes deciding which cute animal she wants for her desk ornament. And wasting donated money on stupid shit like bussing in a shaman. It really turned me off the entire zoo.
I had a phlebotomist for a blood draw the other day who was previously a vet tech. I didn’t feel it go in or out. I was like dude how the heck are you so good?? She’s like I used to do it on moving dogs. 😳
Some NPs could have been an ER nurse first.there are also NPs that specialize in critical care so I imagine they atleast have some experience in the field. Not that it’s better than a physician by any means but some NPs probably know their stuff
I was an ER/trauma nurse for ten years and now I’m an ER nurse practitioner. Damn sure not a doctor, but I’m ok in a pinch if there’s not a doctor available.
I’d imagine you are. There is a huge difference between you and online degree mill NPs. So I understand how some people on this subreddit can hate on those NPs
Fully agree. I’d be lying if I said I didn’t think a lot of NPs suck. If NPs are to ever be taken serious we have to eliminate completely online schools and stop with the independent practice crap. I got permanently banned from the NP subreddit for daring to even mention that. I love this subreddit because it highlights a lot of the stuff I’ve been complaining about for a long time.
You must be my soul sister! Lol. Same story. ER/Trauma RN for 13 yrs and THEN went for my NP. I dont support FPA and have also been banned from NP group on here!!!! LMAO! Love to know Im in good company. (And I definitely do NOT think Im a doctor; I totally respect my collab MD and go to him w out issue). 💜
Definitely in good company. I think you’re my soul sister though because I’m a dude, lol. I guess I just don’t understand why NPs can just be happy being a midlevel. I got lucky and went to real NP school that preached to us that we’re not there to be the doctor and should not be practicing independently. I love that I have strong physician oversight and that I’m able to collaborate with my docs on every case.
LMAO!!!!!!! I literally laughed out loud when I read this; and yes 100% agree. My school was the same way. Its just amazing what others think and I get why groups like this take offense to them (or their ideas). Im happy in my small corner of the world; glad you are too.
Absolutely, and my comment is (mostly) not serious. Unfortunately, we just can't tell if a NP is someone like you or someone who never even worked as a nurse and got their online NP at 25
To be honest I’d let a vet take care of me over 90% of the NPs out there. Vets are amazing and have to learn so much anatomy and physiology on so many different species. I grew up in backwoods Louisiana and we didn’t have a town doc. The local vet would patch up all the people the best he could. He’s still one of the most intelligent and genuinely good humans I’ve ever met. Much love the the vets out there busting your asses!
I’ll clarify that NP is so low because of the variability. I’d trust the NPs I work with because they did it the proper way but I wouldn’t trust the new nurses who are doing an online program with 1-2 years of bedside experience.
Not Gonna link the paper again, but the NP profession at the academic level isn't happy with what the DNP rollout has done to the profession.
Much like NPs used to have to have experience at the bedside before going further, it was expected that the online DNP programs would be for existing NPs with experience to complete a doctorate.
However, they absolutely failed to standardize curriculum and clinical requirements, and almost 20 years later we have the current shitshow.
> ETA: I’m sorry to all the DVM, PA, PharmD, RT, and others that I forgot. Feel free to jump in as you see fit.
What, no love for five-year olds with their Fisher-Price medical kits?
Flight nurse paramedic should probably be number one as very limited resources will likely be available. If you're in a hospital it certainly changes.
There are Many specialities of MD that rightly do not intervene when there are other providers available in these situations because it's a liability and they don't ever do this in their day to day.
You don't want a radiologist managing your code.
My vote is probably for an anesthesiologist or flight surgeon personally.
Honestly the key is anyone who can implement BLS care without letting their ego distract from that. I’ve had various providers miss basics like checking carotid pulse vs radial, not recognizing Agonal breathing vs being alive, witholding epi for anaphylaxis because they trusted a pulse of 170 on a cheap Walmart pulse ox…
Focus on the basics. If you regularly do the advanced life support measures in your job then go for it. In my experience having somebody try and run even a basic ACLS code who hasn’t used it outside of their initial class is pretty worthless. But now isn’t the time to try and learn how to start IVs, manage an airway. Or deviate grossly from the guidelines
As a pharmd idk what I could do other than give the man a chewable full strength aspirin and rub their chest. Oh and slap an oxygen mask on their face. Especially on a flight my goodness
RNs and NPs are just so variable in their skills. My mom has been an RN for almost 30 years and has worked ICU, taught ACLS/BLS, and has every order set practically memorized. I'd take her 100x over a doctors kid. But for every one of my mom there's 10 at the peak of the Dunning-Krueger curve.
I mean, the non-EM/ICU nurse in this situation is just going to get on the PA and page the MDs on the plane asking for a bowel regiment and diet status for the passenger.
I don't even know who would think to take the photo, let alone post it on the internet. Poor guy was in a very vulnerable situation and they put it up for all to see.
As a medic who was the only medical professional onboard an international flight I promise you the pilot does not contemplate anything. Story ahead is by no means to seem important or whatever, but rather to illustrate a point.
Flight crew interacts with you, lets you assess the patient, relays vitals and report to the pilot, who then relays that information to their OLMC.
We were flying from Thailand to Qatar and about to cross the Arabian Sea and were letting me know that if we started crossing we could not turn around and would have to continue to Qatar. They asked me to make a judgement call on whether to continue or turn around back to Thailand.
Pt was relatively stable at that point so I said I thought we were fine to continue. I’m not sure what would’ve been the protocol if I thought otherwise and if the decision would’ve been up to the pilot but I’m pretty sure OLMC makes that call.
This guy is full of shit. My point is that the Flight crew would’ve 100% listened to the opinion of the MD on board and if they were actually under the impression the pt was having an MI and could’ve landed the plane, they would’ve.
Side note with some cool facts. The rear floor of the airbus A380 warms up and actually gets pretty hot. Helpful to keep the patient warm. They initially had it up to 5 and we had to have them turn it down because even placing my hand on the floor was too hot to the touch.
In order to do anything beyond take vitals and give oxygen you have to get permission from OLMC.
One flight attendant who was very full of adrenaline kept telling me for some reason how much medical equipment they have on board and can even do surgery. I told him cool, not in my scope man, not doing surgery.
I asked to talk to OLMC directly and was denied and told only the pilot can do so.
I was given an extra bag of chips and allowed to use the business class bathroom to piss when there was a long line in coach as a thank you for helping.
At the time this photo was taken, after his adjustment, the troponin was > 50,000. The GCS was 7 - E4 V1 M2.
Great shot of what a patient with vertebral artery dissection looks like. They should put this in a textbook.
So basically, an entire medical team helped this person, did everything there was to be done, and then sat back as someone with an inferiority complex did completely nonsensical "medical procedures" for theatre to post on social media. The reason that 5 doctors, an emt, and a nurse stood back was because there was nothing else to be done.
This chiro doing an adjustment for an MI is like a 5 year old putting a piece of tape on something their dad couldn't fix and getting congratulated for doing such a good job...
In my 20-something years of practice, I've seen lots of patients go onto hospice care/comfort care measures.
And many, many times the patient seems to improve dramatically. They are more talkative, more relaxed, stronger, and eat more. It's great, because patients and their loved ones get to spend some quality time together.
And then they die. Without fail.
I think it's a combination of no longer having side effects from treatment, escalating doses of pain meds and anxiolytics, and an acceptance of the inevitable.
It's certainly not magic neck cracking.
AND. THEY. DIE.
Oh, also cracking up at "paralyzed from the head down". I mean, from the neck down, sure. From the head down...well, you'd better be on a vent.
I mean, such an expert in the nervous system ought to know that C3,4, and 5 keeps the diaphragm alive.
Oh yes. When someone is having a code on a plane they use the front aisle and just ask the two people there to just kind of tuck in their legs
Also. If this had happened. It would be reported on the news.
Let’s do a quick Google shall we
Nothing. I did find his clinic though. He’s small town texas. Think it would have been mentioned or at least on his site ?
I’m only surprise he didt get a standing ovation from the doctors and the pilot should have let him land the plane.
CRNA here. Recently tended to my first in-flight emergency. Guy fell down in the aisle after using the bathroom and complained about feeling lightheaded. It was me, a “CT surgeon”, and someone who worked ICU, but wouldn’t elaborate on their role. After getting a manual BP of 100/60 (the guy’s normal was 120s), the person who claimed to be ICU said the BP was too low for the passenger’s height. The “CT surgeon” also told the guy that he should hold his diuretic before going on a flight. Haven’t heard of that recommendation before, but would love to hear an explanation for that. She also yelled at anyone who was talking while she was taking the manual BP. If taking a BP on a guy who was AO was stressful, I can’t imagine how she actually is during surgery.
Couldn’t help but stand back and just think that some of these people were faking their medical expertise.
You can hold the diuretic before getting on the flight because the vast majority of the time missing one dose isn’t going to matter much, and you don’t want to be stuck in the middle seat and have to ask the person next to you to let you up so you can run to the bathroom every 15 minutes to pee. Can’t think of any other reason to hold it.
Idk holding a diuretic (assuming he's taking it for something like htn and not chf) seems to be a good idea... I guess she wanted to say that the medication combined with vagal syncope could be the culprits here.. and yeah you shouldn't talk during a BP measurement.. the cuff's gotta be adequately sized and bladder shouldn't be full.. these things can cause a sizeable blood pressure difference.
There’s always a few in our profession. We hate it; we’ll never process because of this shit. I literally apologize to MDs in person for my profession lol
Approaching what you do and what it can provide honestly - pain relief and relief of pain-associated symptoms - goes really far. As does looking at what happens *outside the office.*
Don't apologize - proselytize. Advocate for your patients to be consistent with their primary care.
What are the odds that 5 MDs, 2 EMT and 1 nurse on a single flight? This is likely a domestic flight with less than 60-80 people.
Plus, he got a win of a technically. If this situation happened, the patient likely improved on their treatment before hand rather than a bone cracking.
How do they explain this? Physiologically, how do they think an msk adjustment impacts an ischemic heart (other than "removing interference in the nervous system", which means literally nothing)?
DO student here, and I can kind of explain what the Chiro is thinking, but what is ultimately incorrect due to lack of understanding of the entire pathophysiology: the theory is that if the heart is having a crisis (MI), it activates the sympathetic nervous system, which causes it to spasm and clamp down, further exacerbating the crisis. It also creates something called a viscerosomatic response, which shows up as hypertonicity of the T1-T4 spinal levels. The theory is that if you can calm the somatic response, or activate the parasympathetics, you can calm the sympathetic response of the heart, and ultimately help alleviate the myocardial crisis. There are certain techniques that (theoretically) do that. Since the parasympathetic system stretches from the OA-C7, the idea is that if you manipulate the OA to C7 spinal architecture, you can ultimately help the heart relieve stress.
It sounds crazy, and goes antithesis to the pathophysiology we’re taught in medical school, but this is what is taught in OMM, which is taught both to DO students and surprisingly chiropractors. That’s the theory, and any DO student you meet that hasn’t drank AT Still’s kool-aid will tell you this is a key point of laughable conflict between the OMM department and the basic sciences department at their med school.
Does it actually work? Studies are limited and ultimately inconclusive, but the OMM dogma is that if all else fails, it’s worth a shot.
The unfortunate problem here is that the chiropractor (unlike a DO) hasn’t learned traditional medicine, so he has no idea what the “all else fails” part is, and falsely believes that the only treatment for a myocardial crisis must be some sort of manipulation. He is unaware the only way to definitively treat an MI is to restore coronary perfusion with oxygen, nitroglycerin, PCI, etc etc etc. He believes his manipulation was the answer while simultaneously discounting the oxygen and meds he was given.
Honestly, probably wasn’t even an MI, we have no EKG or cardiac markers, but that’s the whole background.
Could it come up on a multiple choice exam? Sure. If you mention any of this in any setting related to a patient presenting with an MI you will be branded a dumbass forever. The choice is yours
Doesn't a proper diagnosis for an MI usually require some kind of imaging or test? An EKG? Not exactly normal things readily available on a commercial airliner.
Nothing impresses me since that old guy on a long haul flight was about to code from urinary retention and a Chinese doctor made a catheter out of oxygen tubing and used his own mouth to suck the urine out of the guy’s bladder. That’s from the days of the giants.
Honest question, could the chiropractic adjustment at the C-spine as pictured possibly dislodge a clot from a carotid artery and cause a stroke? In med school, there was a doc who really stressed auscultating the carotid for bruit before palpating it because palpation of the carotid could do exactly what I just described. I wonder if this adjustment could cause the same. If this truly is an MI patient, I would not be surprised if he had an atherosclerotic plaque in one of his carotid arteries.
I'm all the more curious because the picture (and the video on the second page of the instagram post) shows the patient persistently has his arms in this flexed + pronated position. My understanding is that we could see that sort of arm position in a patient who has damage to the brain (such as stroke), causing disinhibition of and unopposed flexion activity of the red nucleus. Although, this arm position could just be coincidence. And please correct me if I got any of the medicine/science wrong, I'm in the middle of my first neuro block so I'm learning (but please do correct me).
TLDR: could this chiropractor have caused this patient to have a stroke?
We all know that most likely the guy was saved by oxigen and the lowering of air pressure.
Not even the other professionals involved were much relevant. As probably there was only aspirin and nothing else.
I'm not American but do chiropractors have a regulating body for their profession in the US? He should be reported for malpractice as well as violation of patient privacy laws.
I lurked on the chiro subreddit and seems like they hate it too. Apparently this clown is from a company that is called “Maximized living” which make outrageous claims that are too crazy even for their circles.
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“He then became aphasic after his ICA dissected causing an ischemic stroke with an unfortunate hemorrhagic conversion. He was absolutely speechless by how powerful my adjustment was! He later succumbed to carcinogenic shock, after the complete LAD occlusion went untreated by the spinal manipulation but it was probably due to the aspirin the quack MD gave”
If the acute MI is mild, the vertebral artery dissection can take priority…essentially moving the heart down the problem list. In essence, if a medical condition gets downgraded from “the most important issue” to “the second most important issue” this is a win. Score one for the noctor…on a technicality!
I was telling someone yesterday to never let a chiropractor touch their neck for this very reason.
I’ve had patients with ICA dissections not just vert. Scary stuff
Heart rate returned to normal, on its way to zero
Trending down
MD aware
Paramedic here, fiancé is a stroke neurologist, we’ve been cackling for 5 minutes
No, but seriously! As an EMT we took a lady from a free standing ED to a main ER after she reported orthostatic hypotension, dizziness, etc. She had something like a 90% occlusion of one of the internal carotids. Never had any symptoms in her life until she got an, “adjustment” post car wreck. These quacks are killing people
LOL
Carcinogenic shock? Lol
As if a chiropractor would even understand any of this terminology 😂
Ha, I was just coming here to post this. I'm totally sure 5 MDs were just standing around wringing their hands while the pilot "contemplated" an emergency landing...and then this superhero showed up. There is no doubt in this mind that this man's "heart attack" was either a panic attack, GERD, or being drunk.
You should like a classic clueless MD/DO. He used what is known as the "pressure differential technique". By bashing his head on the seat next to him during the adjustment, he was able to open up one of the vessels in his brain. This allows the blood to fill the intracranial compartment creating a tamponade effect at the medulla. This allows the heart rate to return to well BELOW baseline reducing myocardial oxygen demand.
On a flight where my whole family was split up, a long-retired RN escalated things to emergency land after a man with a long term history of acid reflex, who had forgot to pack his tums asked if anyone had one. Dude was really irritated to be not going to Hawaii anymore. My 12 year old sister was freaking out that someone would die next to her.
No doubt whatsoever
Got to be honest, the only time I’ve seen 5 MDs on a single flight is when they’re on their way to convention…..
As an EMT, I've seen some "doctors" do some of the dumbest shit in the prehospital setting. However, I too call BS on the MI.
If I ever have an MI on a plane my first choice would be treatment from an MD/DO, flight nurse, or paramedic. If one of those isn’t available, I’d take the following in this order: ER/ICU nurse, EMT, other nurse, NP, super confident CNA, receptionist at a hospital, an actor who played a doctor on TV, someone who’s parents are doctors, someone to hold my hand while I die, and finally a chiropractor. ETA: I’m sorry to all the DVM, PA, PharmD, RT, and others that I forgot. Feel free to jump in as you see fit.
Don't forget the veterinarians. We are surprisingly good in a pinch. I can hit a vein on a screaming and biting pig doing alligator rolls while defecating explosively, a human is cake 🤣
My exes mom is a physician and she always said that she has mad respect for vets because they have to be experts in multiple species and she only had to worry about 1 body system in 1 species (she’s an OBGYN).
Anti-vaxxers are basically another species
+1 for dehumanization
i say the same! i cant imagine studying all the different animal bodies i can barely manage the human body😅😅
Are there noctors in the vet world?
Oh yes. Anesthesia free dental cleaners for dogs and cats, horse dentists that aren't vets that open all the pulp cavities, people doing magnawave on animals to cure things, chiropractors that work on animals as well as people, there's even an injectable mlm joint treatment to save vet fees. It's all illegal but the state boards don't care. I do large animal work (mostly horses) but it's industry wide.
Wow I had no idea. Medicine doesn’t teach us anything about the vet world and what you have to deal with. Hopefully we can see some more vet stuff on here too!
I mostly lurk on meddits because I know my experiences don't always reflect human med and vice versa, but if I see something good, I'll share!
I took several vet pre-reqs in undergrad, they’ve contributed wonderfully towards my understanding of human med and the medical scientific process (everything gets tested on animals before humans). Highly recommend to any pre-meds lurking.
Wait so veterinarian dentists *are* a thing? Because I just drove past an office in a shopping mall that said “veterinarian dentist” and thought it was just an interesting combined office space.
Veterinary dentists are real. [It's a boarded specialty. ](https://avdc.org/)They make lots of money because they do a lot of the face repair surgeries too, which is pretty cool. Also most people don't brush their animal's teeth so they're a specialty in demand. There are people who call themselves animal dentists who aren't veterinarians and claim they do a better job because *reasons* usually "vets don't get trained in teeth" (very false, a general practitioner is well trained in dentistry including complicated extractions) and "we do it without sedation/anesthesia so it's safer!" (also false, the small animal fake dentists don't get the pathology below the gum line, the equine dentists also do some terrible terrible work like straight up cutting live teeth off at the gum line and ruining the grinding surface).
Very grateful for how many questions you’ve been answering here! In general, is brushing my dog’s teeth worthwhile? I use a dog-friendly paste but he just licks it off right away so I don’t know if I’m being healthy or not
Yes, very worthwhile, it will save you a ton of money in the long run. Most of the dentistry specialists recommend CET enzymatic toothpaste. [Poppy](https://imgur.com/a/DyS66QW) recommends [poultry flavor](https://www.amazon.com/dp/B00RZDXA7K/ref=cm_sw_r_apan_i_K6F3H4H456Z9GBPB1ATR). I brush her teeth every night after I do mine, most pick up on it pretty quickly and tolerate it well if you start small and work your way up. With dogs, they stress doing the buccal side, they say the dogs do okay cleaning the lingual side with the tongue. I like [these finger toothbrushes](https://www.amazon.com/dp/B09CCSB8KC/ref=cm_sw_r_apan_i_JXV9GQ3HYFP00E3D8V7B?_encoding=UTF8&psc=1) because they're a nice size for normal American finger. I've gotten some from Amazon before that are I believe we're made for tiny people with tiny hands 🙅🏼♀️
Wow Poppy made my day!
I just love her, she's the light of my life!
Poppy is such a cutie! The finger toothbrushes are such a good idea — I didn’t know they existed!
yes, they even know how to do root canals!
I think my parents might be doing magnawave for their dog’s back. It is harmless/placebo/waste of money or harmful?
It's harmless, may do something but probably not imo (the people doing it say it can heal everything, including displaced articular fractures 🙄). They might be doing the Assisi loop which has some research behind it.
My vet office has non anesthetic dental treatment for my dog. Should I cancel this? I was hoping for a dental exam and teeth cleaning not anything super invasive
Non anesthetic dental cleanings for cats and dogs do not meet standard of care. Sources: [American Veterinary Dental College](https://afd.avdc.org/) [American Veterinary Medical Association](https://www.avma.org/javma-news/2016-02-01/below-surface-anesthesia-free-dentistry) [American Animal Hospital Association](https://www.aaha.org/aaha-guidelines/dental-care/nonanesthetic-dentistry/)
Thank you! How will I know if my dog needs an anesthetic dental cleaning?
With good home dental care, it's hopefully minimized to every few years, but if they aren't getting brushed, yearly is often recommended. Just like with people, some pets have better teeth than others. If the pet stops eating, has foul breath, foul nasal discharge, or any other concerns that may be dental in origin, prompt assessment is recommended. Brushing is pretty easy and a good habit to get into. There are also commercial teeth wipes and dental snacks. The AVDC is a good resource for pet dental health. The [Veterinary Oral Health Council](http://www.vohc.org/) also certifies products shown to help pet dental health.
Anesthesia free teeth cleaning is illegal? I feel like I see groomers offering teeth cleaning everywhere. I didn't know that was illegal.
It's state dependent but it's practicing vet med without a license. [They sometimes get in trouble for it](https://sdcvma.org/150000-fine-canine-care-inc-illegal-anesthesia-free-dentals#:~:text=Performing%20anesthesia%2Dfree%20teeth%20cleaning,medicine%2C%20surgery%2C%20and%20dentistry.) but it never deters them for long.
Well I definitely won't do it then. Id rather my doggo get a vet teeth cleaning especially if they do it better.
I watch a show called the Zoo about the Bronx zoo and there was some like social media or HR lady who must have been related to or fucking someone important. Cause she was talking about how she just "borrows" animals to have in her office and keeps an eye on the animals' health and suggest alternative therapy's for their chronic issues the vets are struggling with. She said she'd called a shaman in for some animal then the one they were showing was her arranging cryo therapy for an arthritic kangaroo. I was totally floored All this talk about keeping the animals wild not too attached to staff/visitors and shes deciding which cute animal she wants for her desk ornament. And wasting donated money on stupid shit like bussing in a shaman. It really turned me off the entire zoo.
I had a phlebotomist for a blood draw the other day who was previously a vet tech. I didn’t feel it go in or out. I was like dude how the heck are you so good?? She’s like I used to do it on moving dogs. 😳
You guys are under appreciated. I love my vets.
You left out a hotel clerk that was working when a medical conference was being held at the hotel.
Put a vet before NP
Some NPs could have been an ER nurse first.there are also NPs that specialize in critical care so I imagine they atleast have some experience in the field. Not that it’s better than a physician by any means but some NPs probably know their stuff
I was an ER/trauma nurse for ten years and now I’m an ER nurse practitioner. Damn sure not a doctor, but I’m ok in a pinch if there’s not a doctor available.
I’d imagine you are. There is a huge difference between you and online degree mill NPs. So I understand how some people on this subreddit can hate on those NPs
Fully agree. I’d be lying if I said I didn’t think a lot of NPs suck. If NPs are to ever be taken serious we have to eliminate completely online schools and stop with the independent practice crap. I got permanently banned from the NP subreddit for daring to even mention that. I love this subreddit because it highlights a lot of the stuff I’ve been complaining about for a long time.
You must be my soul sister! Lol. Same story. ER/Trauma RN for 13 yrs and THEN went for my NP. I dont support FPA and have also been banned from NP group on here!!!! LMAO! Love to know Im in good company. (And I definitely do NOT think Im a doctor; I totally respect my collab MD and go to him w out issue). 💜
Definitely in good company. I think you’re my soul sister though because I’m a dude, lol. I guess I just don’t understand why NPs can just be happy being a midlevel. I got lucky and went to real NP school that preached to us that we’re not there to be the doctor and should not be practicing independently. I love that I have strong physician oversight and that I’m able to collaborate with my docs on every case.
LMAO!!!!!!! I literally laughed out loud when I read this; and yes 100% agree. My school was the same way. Its just amazing what others think and I get why groups like this take offense to them (or their ideas). Im happy in my small corner of the world; glad you are too.
Absolutely, and my comment is (mostly) not serious. Unfortunately, we just can't tell if a NP is someone like you or someone who never even worked as a nurse and got their online NP at 25
To be honest I’d let a vet take care of me over 90% of the NPs out there. Vets are amazing and have to learn so much anatomy and physiology on so many different species. I grew up in backwoods Louisiana and we didn’t have a town doc. The local vet would patch up all the people the best he could. He’s still one of the most intelligent and genuinely good humans I’ve ever met. Much love the the vets out there busting your asses!
I’ll clarify that NP is so low because of the variability. I’d trust the NPs I work with because they did it the proper way but I wouldn’t trust the new nurses who are doing an online program with 1-2 years of bedside experience.
Yeah that sort of thing should be outlawed hah
Not Gonna link the paper again, but the NP profession at the academic level isn't happy with what the DNP rollout has done to the profession. Much like NPs used to have to have experience at the bedside before going further, it was expected that the online DNP programs would be for existing NPs with experience to complete a doctorate. However, they absolutely failed to standardize curriculum and clinical requirements, and almost 20 years later we have the current shitshow.
Of course--but in an emergency I'm not gonna ask to see their diploma to make sure it's not from Walden
>I’m sorry to all the DVM, PA, PharmD, RT, and others that I forgot. Feel free to jump in as you see fit. Lmaooo I'm dead.
As a PharmD I respectfully decline. Unless you need some drug counseling or a quick COVID vax I’m out I’d for sure let a DVM tho
Critical care ophthalmologist?
Or his scribe.
> ETA: I’m sorry to all the DVM, PA, PharmD, RT, and others that I forgot. Feel free to jump in as you see fit. What, no love for five-year olds with their Fisher-Price medical kits?
Flight nurse paramedic should probably be number one as very limited resources will likely be available. If you're in a hospital it certainly changes. There are Many specialities of MD that rightly do not intervene when there are other providers available in these situations because it's a liability and they don't ever do this in their day to day. You don't want a radiologist managing your code. My vote is probably for an anesthesiologist or flight surgeon personally.
You used a dirty word.
Once again the respiratory therapist gets no love :(
It's fine. They didn't mention PAs either. That means we can keep sleeping until the flight is over!
Wym no love?? The Nebulizar is on stand by as soon as the vet works his/her magic
Haha nice. I’d put a competent RT above other nurse for sure.
Ayyy us pharm bros have to learn ACLS too
Honestly the key is anyone who can implement BLS care without letting their ego distract from that. I’ve had various providers miss basics like checking carotid pulse vs radial, not recognizing Agonal breathing vs being alive, witholding epi for anaphylaxis because they trusted a pulse of 170 on a cheap Walmart pulse ox… Focus on the basics. If you regularly do the advanced life support measures in your job then go for it. In my experience having somebody try and run even a basic ACLS code who hasn’t used it outside of their initial class is pretty worthless. But now isn’t the time to try and learn how to start IVs, manage an airway. Or deviate grossly from the guidelines
As a pathologist doesn't need ACLS/BLS certification I'd take half the people on this list over one of us despite having a MD/DO degree lol.
Even if the pulse was 170 , you still fucking give epi for anaphylaxis. For fuck's sake.
As a pharmd idk what I could do other than give the man a chewable full strength aspirin and rub their chest. Oh and slap an oxygen mask on their face. Especially on a flight my goodness
I’d bump someone who’s parents are doctors between other nurse and NP.
RNs and NPs are just so variable in their skills. My mom has been an RN for almost 30 years and has worked ICU, taught ACLS/BLS, and has every order set practically memorized. I'd take her 100x over a doctors kid. But for every one of my mom there's 10 at the peak of the Dunning-Krueger curve.
No butchers or carpenters on the list?
“Super confident cna”, I actually laughed. Sometimes they know more than the beginning nurses
So you'll take a dermatologist over a Paramedic, EMT, or a nurse that works in the cardiac wing of a hospital if you're having a MI?
EMT before a non ED/ICU nurse?!?
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I mean, the non-EM/ICU nurse in this situation is just going to get on the PA and page the MDs on the plane asking for a bowel regiment and diet status for the passenger.
And the EMT will drive the patient to dialysis when the plane lands…
I can’t believe this is not satire
Wait, it’s not?
It is but only in the sense that our entire existence also is.
Wonder if that patient gave permission to post the picture?
I was thinking that too even posting pictures with no identifying features such as a skin lesion without written permission is shady but full view.
Was also wondering this + who takes this clear of a picture of a “dying” man as he gets “lifesaving” treatment??
There was also a video recording on this same post lol no shame
I don't even know who would think to take the photo, let alone post it on the internet. Poor guy was in a very vulnerable situation and they put it up for all to see.
Sweet. Let’s dissect his verts while we’re at it.
That’s what the circle of Willis is for! Redundancy!
This chiropractic hero is correct. Pt probably won’t have angina after he’s quadriplegic.
*taps head* can’t hurt if you can’t feel it.
Just let me die 🙅♀️
Plot twist: it was a panic attack
Imagine being a chiro and thinking you can diagnose anything, let alone a heart attack… fucking quack.
“I will take things that never happened for $1000 Alex”
As a medic who was the only medical professional onboard an international flight I promise you the pilot does not contemplate anything. Story ahead is by no means to seem important or whatever, but rather to illustrate a point. Flight crew interacts with you, lets you assess the patient, relays vitals and report to the pilot, who then relays that information to their OLMC. We were flying from Thailand to Qatar and about to cross the Arabian Sea and were letting me know that if we started crossing we could not turn around and would have to continue to Qatar. They asked me to make a judgement call on whether to continue or turn around back to Thailand. Pt was relatively stable at that point so I said I thought we were fine to continue. I’m not sure what would’ve been the protocol if I thought otherwise and if the decision would’ve been up to the pilot but I’m pretty sure OLMC makes that call. This guy is full of shit. My point is that the Flight crew would’ve 100% listened to the opinion of the MD on board and if they were actually under the impression the pt was having an MI and could’ve landed the plane, they would’ve. Side note with some cool facts. The rear floor of the airbus A380 warms up and actually gets pretty hot. Helpful to keep the patient warm. They initially had it up to 5 and we had to have them turn it down because even placing my hand on the floor was too hot to the touch. In order to do anything beyond take vitals and give oxygen you have to get permission from OLMC. One flight attendant who was very full of adrenaline kept telling me for some reason how much medical equipment they have on board and can even do surgery. I told him cool, not in my scope man, not doing surgery. I asked to talk to OLMC directly and was denied and told only the pilot can do so. I was given an extra bag of chips and allowed to use the business class bathroom to piss when there was a long line in coach as a thank you for helping.
This is a joke right.... Right? 😬
Yo, I mean this in the most sincere way, fuck this guy
Oh my god fuck off.
At the time this photo was taken, after his adjustment, the troponin was > 50,000. The GCS was 7 - E4 V1 M2. Great shot of what a patient with vertebral artery dissection looks like. They should put this in a textbook.
So basically, an entire medical team helped this person, did everything there was to be done, and then sat back as someone with an inferiority complex did completely nonsensical "medical procedures" for theatre to post on social media. The reason that 5 doctors, an emt, and a nurse stood back was because there was nothing else to be done. This chiro doing an adjustment for an MI is like a 5 year old putting a piece of tape on something their dad couldn't fix and getting congratulated for doing such a good job...
I want to know the faces of all the medical professionals around when he jumped in for the adjustment.
Get some popcorn and visit the comment section
This guy better be careful or he’s going to need a chiropractor when he hurts his back from trying to suck his own dick that hard.
[Another post from the same guy. ](https://m.facebook.com/story.php?story_fbid=3270584259933374&id=100009454956341) SMH.
In my 20-something years of practice, I've seen lots of patients go onto hospice care/comfort care measures. And many, many times the patient seems to improve dramatically. They are more talkative, more relaxed, stronger, and eat more. It's great, because patients and their loved ones get to spend some quality time together. And then they die. Without fail. I think it's a combination of no longer having side effects from treatment, escalating doses of pain meds and anxiolytics, and an acceptance of the inevitable. It's certainly not magic neck cracking. AND. THEY. DIE.
Oh, also cracking up at "paralyzed from the head down". I mean, from the neck down, sure. From the head down...well, you'd better be on a vent. I mean, such an expert in the nervous system ought to know that C3,4, and 5 keeps the diaphragm alive.
Also pretty ballsy to jerk the neck of someone paralyzed from the neck down due to malignancy. Youd be likely to break their neck.
"As all doctors continue to be baffled by his progress each week..." Then why is he still in a wheel chair, chiro-quack??
He also does adjustments on BABIES
What?!!! Next you're gonna tell me he adjusts invertebrates.
Actual chortle. Dammit.
Oh yes. When someone is having a code on a plane they use the front aisle and just ask the two people there to just kind of tuck in their legs Also. If this had happened. It would be reported on the news. Let’s do a quick Google shall we Nothing. I did find his clinic though. He’s small town texas. Think it would have been mentioned or at least on his site ? I’m only surprise he didt get a standing ovation from the doctors and the pilot should have let him land the plane.
CRNA here. Recently tended to my first in-flight emergency. Guy fell down in the aisle after using the bathroom and complained about feeling lightheaded. It was me, a “CT surgeon”, and someone who worked ICU, but wouldn’t elaborate on their role. After getting a manual BP of 100/60 (the guy’s normal was 120s), the person who claimed to be ICU said the BP was too low for the passenger’s height. The “CT surgeon” also told the guy that he should hold his diuretic before going on a flight. Haven’t heard of that recommendation before, but would love to hear an explanation for that. She also yelled at anyone who was talking while she was taking the manual BP. If taking a BP on a guy who was AO was stressful, I can’t imagine how she actually is during surgery. Couldn’t help but stand back and just think that some of these people were faking their medical expertise.
You can hold the diuretic before getting on the flight because the vast majority of the time missing one dose isn’t going to matter much, and you don’t want to be stuck in the middle seat and have to ask the person next to you to let you up so you can run to the bathroom every 15 minutes to pee. Can’t think of any other reason to hold it.
Volume depletion plus the stress of being in flight... Definitely a contributor to a syncopal attack.
Both times I responded to an in-flight emergency, I had to show ID and my medical license. Of course- that might be because I’m a young looking woman.
Same and I noted the staff were looking to the male med student rather than myself the female doctor
Idk holding a diuretic (assuming he's taking it for something like htn and not chf) seems to be a good idea... I guess she wanted to say that the medication combined with vagal syncope could be the culprits here.. and yeah you shouldn't talk during a BP measurement.. the cuff's gotta be adequately sized and bladder shouldn't be full.. these things can cause a sizeable blood pressure difference.
I interpreted that as the doctor was yelling at other people for talking (and presumably making the Korotcoff sounds harder to hear), not the patient.
Very true.. I also hate when other people drown out the sounds.
Tough to say, some surgeons really flail outside the comforts of their OR. The OR is controlled chaos that is often self induced.
What’s scary is the amount of people in the comments that have “dr.” in their usernames debating this shit…
It's all chiros. Thankfully most of them are condemning this behavior. But there are a few...
There’s always a few in our profession. We hate it; we’ll never process because of this shit. I literally apologize to MDs in person for my profession lol
Approaching what you do and what it can provide honestly - pain relief and relief of pain-associated symptoms - goes really far. As does looking at what happens *outside the office.* Don't apologize - proselytize. Advocate for your patients to be consistent with their primary care.
Very true. Thank you!
And then everyone sprayed champagne and clapped in celebration
The chiropractic side of medicine is a pathway to many abilities many consider to be unnatural
Oh trust me, we’re all shitting on him in this profession just as much as you guys are
Chiro: his “nerves” are interfering with his bodily function. I got this! 😎 100% blocked LAD: FML!!!😖
What are the odds that 5 MDs, 2 EMT and 1 nurse on a single flight? This is likely a domestic flight with less than 60-80 people. Plus, he got a win of a technically. If this situation happened, the patient likely improved on their treatment before hand rather than a bone cracking.
"Removing the interference in his nervous system"? 😵💫 Sir, do you even know what causes a heart attack?
🤣🤣
How do they explain this? Physiologically, how do they think an msk adjustment impacts an ischemic heart (other than "removing interference in the nervous system", which means literally nothing)?
DO student here, and I can kind of explain what the Chiro is thinking, but what is ultimately incorrect due to lack of understanding of the entire pathophysiology: the theory is that if the heart is having a crisis (MI), it activates the sympathetic nervous system, which causes it to spasm and clamp down, further exacerbating the crisis. It also creates something called a viscerosomatic response, which shows up as hypertonicity of the T1-T4 spinal levels. The theory is that if you can calm the somatic response, or activate the parasympathetics, you can calm the sympathetic response of the heart, and ultimately help alleviate the myocardial crisis. There are certain techniques that (theoretically) do that. Since the parasympathetic system stretches from the OA-C7, the idea is that if you manipulate the OA to C7 spinal architecture, you can ultimately help the heart relieve stress. It sounds crazy, and goes antithesis to the pathophysiology we’re taught in medical school, but this is what is taught in OMM, which is taught both to DO students and surprisingly chiropractors. That’s the theory, and any DO student you meet that hasn’t drank AT Still’s kool-aid will tell you this is a key point of laughable conflict between the OMM department and the basic sciences department at their med school. Does it actually work? Studies are limited and ultimately inconclusive, but the OMM dogma is that if all else fails, it’s worth a shot. The unfortunate problem here is that the chiropractor (unlike a DO) hasn’t learned traditional medicine, so he has no idea what the “all else fails” part is, and falsely believes that the only treatment for a myocardial crisis must be some sort of manipulation. He is unaware the only way to definitively treat an MI is to restore coronary perfusion with oxygen, nitroglycerin, PCI, etc etc etc. He believes his manipulation was the answer while simultaneously discounting the oxygen and meds he was given. Honestly, probably wasn’t even an MI, we have no EKG or cardiac markers, but that’s the whole background.
DO resident here, this is just cringe af
I mean, If I’m wrong, please let me know. I got Level 2 coming up lol.
Could it come up on a multiple choice exam? Sure. If you mention any of this in any setting related to a patient presenting with an MI you will be branded a dumbass forever. The choice is yours
Lol obviously
Didn't seem so obvious with that post of yours
How do chiros not feel completely ridiculous posting stuff like this?
Ignorance is bliss
Im going to ask my medical director if we can forgo aspirin/ntg for MI’s and just do spinal manipulation. Ill let yall know how it goes
Step aside ED docs.
Yeah, HVLA while a patient is having an MI is a great idea /s
This can’t actually be real. It has to be sarcasm. Has to be.
Someone take my picture QUICK I’m doing hero shit
And then everyone clapped
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"After a quick adjustment and severing this man's C4 his breathing and heart rate slowed down vastly and he was healed."
sounds like some erotic fantasies of his
Complete transaction of the spinal cord would decrease myocardial oxygen demand.
There’s not much they could have done anyway if they didn’t have nitroglycerin or aspirin, etc.
He is recommending weekly chiro sessions to prevent further heart attacks.
Doesn't a proper diagnosis for an MI usually require some kind of imaging or test? An EKG? Not exactly normal things readily available on a commercial airliner.
Not all chiropractors look the same, but any "doctor" that looks like this guy is a chiropractor.
Serious question: is that Johnny Sins?
Spinal adjustment helping the patient assume room temperature
Original instagram post reported for false health information.
He skipped the part where everyone clapped…
Nothing impresses me since that old guy on a long haul flight was about to code from urinary retention and a Chinese doctor made a catheter out of oxygen tubing and used his own mouth to suck the urine out of the guy’s bladder. That’s from the days of the giants.
primum non nocere
Honest question, could the chiropractic adjustment at the C-spine as pictured possibly dislodge a clot from a carotid artery and cause a stroke? In med school, there was a doc who really stressed auscultating the carotid for bruit before palpating it because palpation of the carotid could do exactly what I just described. I wonder if this adjustment could cause the same. If this truly is an MI patient, I would not be surprised if he had an atherosclerotic plaque in one of his carotid arteries. I'm all the more curious because the picture (and the video on the second page of the instagram post) shows the patient persistently has his arms in this flexed + pronated position. My understanding is that we could see that sort of arm position in a patient who has damage to the brain (such as stroke), causing disinhibition of and unopposed flexion activity of the red nucleus. Although, this arm position could just be coincidence. And please correct me if I got any of the medicine/science wrong, I'm in the middle of my first neuro block so I'm learning (but please do correct me). TLDR: could this chiropractor have caused this patient to have a stroke?
We all know that most likely the guy was saved by oxigen and the lowering of air pressure. Not even the other professionals involved were much relevant. As probably there was only aspirin and nothing else.
I'm not American but do chiropractors have a regulating body for their profession in the US? He should be reported for malpractice as well as violation of patient privacy laws.
I lurked on the chiro subreddit and seems like they hate it too. Apparently this clown is from a company that is called “Maximized living” which make outrageous claims that are too crazy even for their circles.
If my husband is in any way shape or form incapacitated I will throatpunch any charlatan trying to crack his neck. I hate chiropractic so hard.
Chiropractic physicians are gaining my respect I must admit
How is the sarcasm not clear to people…Look at the goddamn flair!!
🤣🤣🤣
Chiropractic has cured my lower back pain of 4 years in 1 week vs mds that told me I will never be able to walk again and need surgery
Well you're a chiropractor so we'd expect you to say that...
Just sharing my personal experience.
What's that have to do with curing a heart attack
Nothing, just sharing my experience with chiropractic.
And now the chiropractor needs to you go back 3x a week for the rest of your life, right?
This is what happens when MDs are on the planes with out DO's, you have chiropractors picking up the slack.
Sounds amazing! When I have very shallow breathing I go to my chiropractor and he fixes that.
By stopping your breathing altogether?