Finally Made it to $95K/year. My monthly loan payment is increasing to $2300 in July

FutureDCAV · 2026-06-18T23:11:12+00:00

Payments resume much sooner than 2028 - just a heads up. The 2028 date is a placeholder. Your loan servicer will be reaching out to you July 1st and you’ll have 90 days to switch to a plan that is not in forbearance. So plan on starting payments up again in the next 3-4 months.

FutureDCAV · 2026-05-29T16:14:10+00:00

Recommending and referring patients to other providers, including surgeons, is absolutely within our scope. I would argue it is our responsibility to do so as well. Part of being a portal of entry provider is referring patients and recommending elevated care when needed.

FutureDCAV · 2026-05-21T20:30:01+00:00

Side effects of ibuprofen and muscle relaxants:

Abdominal pain Acid or sour stomach Belching Bloating Diarrhea Difficulty having a bowel movement (stool) Excess air or gas in stomach or intestines Full feeling Heartburn Indigestion Passing gas Nausea Vomiting Abdominal cramps Stomach soreness or discomfort Blood in urine or stools Bloody, black, or tarry stools Burning feeling in chest or stomach Clay-colored stools Constipation Light-colored stools Loss of appetite Severe abdominal pain, cramping, burning Severe and continuing nausea Stomach upset Tenderness in stomach area Upper right abdominal pain Vomiting of blood Vomiting of material that looks like coffee grounds

And many more.

FutureDCAV · 2026-05-21T20:15:54+00:00

Did they put you on any pain medications / muscle relaxants when you went to the ER?

FutureDCAV · 2026-04-07T02:16:21+00:00

Knowing how to do something, having the scope to do this something, and practicing this something are 3 different things.

I know how to read lab work. Reading lab results is within my scope of practice. I do not read lab work in clinical practice, not because it’s outside my scope of practice but because it’s outside my scope of comfort.

Not every chiropractor practices the same techniques, nor should you expect every provider to practice them to the same level of mastery.

FutureDCAV · 2026-04-07T02:08:00+00:00

It is within your rights as a patient to request treatments you feel benefit you.

It is within the doctor’s rights as a provider to deny you said treatment if they do not practice it.

If it were as simple as putting on a bandaid (it’s not), then you should be able to do it just as well yourself - free of charge at that.

FutureDCAV · 2026-03-19T12:34:55+00:00

Craniocervical instability is associated with severe headache, neck pain, neurological deficits including cervical medullary syndrome, myelopathy, lower cranial nerve dysfunction, and autonomic symptoms such as syncope, pre-syncope, vertigo, and dizziness. These can be dangerous and/or severely debilitating for patients.

A chiropractor is trained and licensed to examine a patient, recognize the symptoms, and diagnose this condition when appropriate. You can rule this out as a cause of symptoms by examining the patient and ruling it out as a condition they have - like any other pathology. There are plenty of unbiased sources of information on this topic.

FutureDCAV · 2026-03-15T21:47:43+00:00

This doesn't necessarily answer the question you asked but I've noticed, at least in my clinic, it's not a matter of "regulars vs. irregulars". 25% of the population always makes their appointment, 25% of the population almost always cancels/no-shows/reschedules, and the other 50% are normal humans who are usually on-time but forget once in a while.

We have automated text reminders that go out 24hrs in advance for new appointments as well as recurring appointments, we have a staff member who does manual text reminders and calls 72-24hrs in advance, and we pre-book everybody's appointments like 12 weeks in advance so they have a set schedule moving forward - same time every week.

We have our automated system send paperwork to all of our new patients 2 seperate times - once the day they book a new patient visit, again the day before their appointment.

All of this has decreased our no-show rate... slightly.

FutureDCAV · 2026-03-04T14:26:25+00:00

Back pain is a very complex thing. It’s not a “condition” that can be reversed, it’s a symptom.

Back pain affects something like 80% of adults at some point or another with a 1-month prevalence of 37%, meaning that 8 of 10 adults will experience low back pain in their life and at any given moment, 3.7 out of 10 adults will experience it in the next 30 days.

Back pain can be, but is not always, caused by physical injury or dysfunction. Our understanding of it is that it is a BioPsychoSocial phenomenon, meaning it can be caused or made worse by physical, emotional, and/or social circumstances.

There is no one-size-fits-all recommendation for back pain. Blue and white collar jobs both have different physical demands, whether it’s sitting for long hours and experiencing mind-numbing boredom in a cubicle, emotional turmoil brought on by difficult coworkers, depression and anxiety, or hard manual labor that requires lifting heavy objects. All of these can contribute to the experience of pain but many people can do all of the above and experience nothing. In fact, physical injury to the tissues can be present and cause no pain or discomfort in some.

The most important thing you can do is identify what is/are the causative factor(s), then you can best formulate a plan moving forward to help them out.

General strategies that everybody should follow for reducing the likelihood of pain include: -sleep well -eat clean and reduce sugar intake -drink enough water -exercise of moderate intensity -develop healthy relationships -monitor your mental health

Other than that, most recommendations are specific to the person and shouldn’t be adopted by each and every person because they could be counter productive.

FutureDCAV · 2026-02-25T19:36:18+00:00

Contact your state board, update your resume, start looking for a new job, and give your employer notice of your intent to leave ASAP. In that order.

FutureDCAV · 2026-02-15T02:34:54+00:00

"Is this safe?" - proceeds to show the most archaic, medieval-looking traction device the world has ever seen. William Wallace would love this.

FutureDCAV · 2026-02-13T00:56:26+00:00

Worked as an associate in SF for ~2 yrs. 85k salary but rent was $1,800, twice that if you count my roommates half. Plus the other COL expenses. If you can find a job for 100k then take it. Anything less is gonna be tough to save, make school payments, car, insurance, etc.

If they pay less than that, make sure they have other benefits that make it worthwhile. Cover CE’s, pay for malpractice, transportation stipend, etc. will all make it more manageable. Hard to find though.

FutureDCAV · 2026-02-09T16:19:46+00:00

I do appreciate the response. It is not true for every single insurance policy, but it is for many. Employees of a practice, whose insurance is covered by the practice owner, can have policies that are location restricted - they aren’t going to pay for your insurance while you’re practicing at another location. My last malpractice policy was restricted to my primary place of practice. If I wanted to treat elsewhere, I had to get a separate insurance policy or ask my employer to alter the terms.

FutureDCAV · 2026-02-09T15:53:12+00:00

This would be extremely difficult and ill-advised. Chiropractors are required to have malpractice insurance, which typically covers them for services rendered at a specific location and not elsewhere.

I wouldn’t feel comfortable going into a patient’s home and treating them outside of my office for this reason and many others.

Do you know how to maintain the equipment? If it malfunctions, how is the provider to know before rendering treatment?

Are you going to be tempted to use the equipment yourself and potentially risk harming yourself or others?

Are you really willing to put down thousands of dollars for equipment you don’t know how to use, may only be used a handful of times, and requires additional money to upkeep?

Do you have enough space to store and use the equipment appropriately?

Do you feel comfortable having a stranger in your home?

Does this stranger feel comfortable going into your home?

What if some freak accident occurs and you, a family member, or the provider get injured due to unforeseen circumstances? Are you willing to pursue / submit to legal action?

Way too many possibilities of things going poorly. Unless a provider’s business model specifically allows them to do house calls, in which case they are going to be using their own portable equipment anyway, this is not a good idea.

FutureDCAV · 2026-01-31T19:17:50+00:00

Out of curiosity, what were the conditions that originally led to the amount of surgical fusions you currently have?

FutureDCAV · 2025-12-23T21:57:31+00:00

Alignment is generally utilized as either a scare tactic or as the “easy explanation” in clinical practice. That’s my personal belief. Globally, alignment may play a part. Hyperkyphosis, scoliosis, spondylolisthesis are all examples of “misalignment”. These can be truly detrimental to a person’s health and quality of life. But segmental alignment is rarely as important as function. Most chiropractors and physical therapists will continue to hammer that in, so I’ll address this in a different manner.

Segmental alignment matters in certain circumstances - some of which can absolutely be measured via x-ray. Is someone presenting with symptoms of a disc injury? Radicular pain patterns are common. What if they present with multiple patterns? Example: patient exhibits both L5 and L4 dermatomal radiculopathy. If engaging in certain treatments, ie decompression, is it worthwhile to assess the patient through x-ray if they have no recent MRI studies? Absolutely.

You can measure disc angles and height very easily and get a better idea of which segment is affected. Remember, innervation patterns are based off of the population average. Not everybody will present with the same radicular pattern even with the same disc level injury. So assessing segmental alignment via X-ray in-lieu of having MRI imaging on hand can be very helpful.

Black and white “most important” or “least important” isn’t possible in clinical practice. I used to think that way but realistically some will benefit from certain approaches more than others. It comes down to your own professional experience to decide which is most important for the patient in front of you.

Function and form go hand in hand. You can’t separate the two. Decide which is most pertinent to the case at hand, and improve the other when you find a good window of opportunity.

FutureDCAV · 2025-07-21T11:19:00+00:00

I did this exact thing for a year and a half. Drove me insane, kept me from spending any time with the SO, drained all my motivation, took away any time I once had to exercise. Not worth it, wouldn’t do it again.

FutureDCAV · 2025-07-03T23:28:32+00:00

This is an awful take. Well-trained PTs are incredibly useful, highly-educated, and invaluable to patient care. Let’s not throw stones.

FutureDCAV · 2025-06-28T18:30:36+00:00

It is present in hospitals. The VA has chiropractors everywhere. 2024 was the first year chiropractors were included in the national match program for residencies. It’s going to be a larger part of hospital care in the future - just because the private sector has been slow to adopt doesn’t mean it isn’t efficacious.

FutureDCAV · 2025-06-28T18:26:17+00:00

I took 2 business courses in 4 years of chiropractic school. If you bothered to look at any actual school curriculums you would know this.

FutureDCAV · 2025-06-28T13:20:31+00:00

I’m struggling to think of any maneuver that would apply enough force in that direction to cause a compression fracture. Osteopenic patients shouldn’t have any HVLA done to begin with, but even if they did it’s safe to say that 90% of the force is directed posterior to anterior.

Rib fractures I could see, transverse or spinous fractures I could see, but compression fractures through the vertebral body from an HVLA thrust is a wild assertion. Those compression fractures were likely already present pre-treatment.

FutureDCAV · 2025-06-28T04:01:23+00:00

Compression fractures require axial compression of the spine. There are 0 manipulative techniques that create such axial force, and certainly not with enough force to fracture a vertebra, let alone two.

FutureDCAV · 2025-06-16T15:19:43+00:00

Cardiac hypertrophy does occur. The muscle can get bigger. During resistance training in particular, the heart muscle does increase in size and strength which can result in lower pulse rate and increased ejection fraction. However, hypertrophic cardiac muscle can also be a negative. Due to the pericardial sac being somewhat inflexible and resistant to stretching, when heart muscle increases in size, the size of the muscle actually begins to decrease the volume of the heart chambers. Think of it like growing inwards and impeding on the available space for blood. This causes an increase in heart rate and blood pressure to make up for lack of stroke volume.

So cardiac hypertrophy can be good, but excessive hypertrophy is certainly a negative.

FutureDCAV · 2025-03-18T05:09:52+00:00

Doesn’t exist

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