Ask the Doctor
- Open diabetic ulcer?
- Why two conductive garments?
- Carpel Tunnel Syndrome?
- Foot fractures?
- Severe pain in the soles of the feet?
- Pacemaker?
- What is the difference between Cooling Cream® and Bio-Freeze®?
- Why should you use ReStore with every patient?
How do I treat a patient with an open diabetic ulcer?
There are 2 ways to address the issue of treating a patient with a diabetic foot ulcer or open wound. The challenge is to avoid touching the open wound in order to limit the possibility of infection.
- Place a self adhesive electrode distal to the wound if possible so that the signal goes through the wound area.
- Using a conductive sock, cut out the area of the garment that would touch the wound.
If the patient uses ReStore during his morning treatment at home or in your office during the day, he will have more energy and be in a better mood which can help with patient compliance. The niacin in the ReStore can vasodilate the skin which will also help heal the wound itself. I would suggest purchasing a soft "doughnut" or create one by cutting one from a common sponge to place around the wound so that the patients can avoid putting direct pressure on the wound. Finally, you might consider treating the wound directly with hydrogen peroxide as a disinfectant.
The ReBuilder® is a unique form of TENS device. It is designed specifically for treating chronic intractable pain of the feet and hands, symptoms often associated with diseases such as peripheral neuropathy and other neurological disorders* . Both extremities must be treated simultaneously with two identical surface-area separate conductive garments. Although the garments are similar in surface area, there is a separate right sock, left sock and a separate right glove and a left glove because of the anatomical differences in the extremities. Garments are sold and delivered as individual units of right and left. For the ReBuilder to be used correctly, you will need two garments. Click here to read more.
How is the ReBuilder® used for Carpel Tunnel Syndrome?
Click here to watch the treatment protocol using the ReBuilder for the Carpel Tunnel Syndrome
What is the experience/recommendation with ReBuilder and fractures? Any contraindication? Footbath vs Premium Socks for fractures?
For best results at home, he should use the conductive socks dry, in conjunction with the new microwaveable foot warmers. This makes it easy, causes vasodilation for more local blood flow because of the heat, and when used dry, the garments create an electrical field that induces the signal to be created by the tissue itself rather than by direct contact with the sock via wetting the sock or using the conductive lotion. When used dry, advise your patient that he may feel a different sensation, one of a tingly feeling or a static electricity sensation, but that it is OK. Using ReStore is sufficient for supporting the healing. ReStore will elevate your patient's mood, give him more energy, and vasodilate the foot for faster healing.
What do I do if I have a patient with severe pain in the soles of the feet?
First we need to know the probable etiology.
Plantar fasciitis and localized peripheral neuropathy can be treated by treating just the soles of the feet. One way to do that is to fold a common washcloth in half, get it wet, place the carbon rubber electrodes between the folds, thus making the washcloth the electrode (a paper towel can substitute). Then place a baggie over the foot and put the foot into the heated foot warmers to vasodilate the blood vessels on the plantar surface. Do the same with the other foot and treat for 30 minutes. Use Benfo Spray directly on the entire foot afterwards to supply benfotiamine transdermally. Let it stay on for a minute or so and then dry the feet. As a final finish, apply cooling cream on the entire surface of the foot.
Suggest that the patient apply cooling cream only on his feet at night, without any other treatment and treat himself as directed in the morning with the ReBuilder.
If you do not have the microwaveable foot warmers or conductive garments, you can use the footbath with a quarter inch of warm water and electrolyte. Drop the electrodes into the water and place the feet in the footbath, thus focusing the treatment on the soles of the feet.
If this does not help with the first 30 minute treatment, then reduce the treatment time to 10 minutes at a barely perceptible intensity setting.
If the etiology is a sprain, then treat with the footbath and electrolyte, finishing with cooling cream only. The electrolyte can balance the electrolytes in the feet thus reducing edema. Treat again (usually at home, 2 hrs later) with a simple cold water treatment to help reduce bruising.
- If this does not work, then the ReBuilder is probably not indicated for further use.
Remember to use the Tinel test on the wrist to check for early spreading of peripheral neuropathy to the hands. You can treat the hands with socks as a mitten if you do not have the conductive gloves handy.
Tinel Test. Fingers should slowly begin to close about 20% with 4 or 5 taps if there is no neuropathy in the hands or beginnings of carpel tunnel syndrome. You can use your two fingers to tap in place of the rubber hammer if necessary. Using your 2 fingers is a simple way to demonstrate how common neuropathy and carpel tunnel syndrome is. About 33% of the people you test with no symptoms will test positive, and then they will admit that they have, indeed, felt tingling or pain in their hands.
I suggest that you try these techniques on yourself first, then on one of your office staff to get familiar with the technique.
Remember to use ReStore to be certain that the healing nerves have full access to all the B vitamins, and to help the patient elevate his mood that might be depressed because of the chronic pain.
How do I handle a patient with a pacemaker?
The best practice is to call his cardiologist and ask him/her if they would please perform an ECG on this patient and turn the ReBuilder on during the test and see if there is any electrical interference and send a copy of the report back to us. Tell him that his patient will be calling for an appointment. Send the patient a loaner unit for the test and have him return it to you when completed.
With this document in your file, you are protected. So far, with over 2,000 cases, no one has ever had any interference with his ECG or any subsequent problem.
If your patient has a defibrillator built in to his pacemaker, you should consider avoiding using the ReBuilder or any other electrical device with this class of patient.
What is the difference between Cooling Cream® and Bio-Freeze®?
Cooling Cream is better because of its dual action.
First the patient's A-Delta nerve fibers in the skin are stimulated, sending the message of comforting warmth to the brain which distracts the brain's attention from the pain.. It also causes vasodilation which increases local blood flow which, in turn elevates the skin temperature to send these signals naturally thereafter, without the artificial effect from the Cooling cream. This increase in blood flow helps to heal the skin and its sensory nerve fibers, both the C-Fibers and the larger, A-Delta fibers.
Second, the tiny amount of menthol in Cooling cream (1/10 as much as in Bio-Freeze) temporarily blocks these heat sensing A-Delta fibers from sending the sensation of heat, and thus the brain interprets that loss of signal to indicate cooling, although the temperature of the skin remains warm to the touch. This blockage of the heat signal causes an inhibitory nerve in the nerve roots of the spine to release inhibitory neurotransmitters that then block the pain signal from the smaller C fibers in the skin responsible for the perception of pain.
Finally, Cooling Cream contains skin softeners and anti-oxidants like alph-lipoic acid, nerve fuel benfotiamine, healing tea tree oil, and tiny, microscopic amounts of aspirin that, when transdermally absorbed over time, helps heal the tissue and relieve pain for a longer period of time, sometimes permanently.
Bio-Freeze is designed only to numb the nerves by blocking the TRPM* receptors on the A-deltea fibers and this can cause permanent damage to the nerve if the patient has poor blood flow, poor oxygen perfusion, and/or small fiber neuropathy..BioFreeze offers no therapeutic value. Its own explanation of its mechanism of action describes its action to that of using ice. Ice vasoconstricts the blood flow and neuropathy patients need more, not less blood flow. BioFreeze should be reserved for your trauma patients with sprains only.
In conclusion, Bio-Freeze is helpful for temporary use only on acute muscle sprains, but may cause permanent nerve damage in patients with small fiber peripheral neuropathy, peripheral vascular issues, poor oxygen perfusion or poor oxygen blood saturation if used repeatedly.
Cooling Cream was designed specifically for the peripheral neuropathy patient. It reduces the sensation of pain safely, vasodilates the local blood flow, provides B vitamin nutrition transdermally, sooths irritated skin, helps heal tiny occult skin lesions, and can be used on a daily basis for long term relief.
Why should you use ReStore with every patient?
ReStore is an all natural energy and mood enhancement drink that can give your patient an immediate (10 minutes later) lift in mood and energy. It is full of all the B Vitamins with vitamin C and alpha-lipoic acid. When your patient drinks it just before or during his office visit, he will feel much better for the next 3-4 hours and his family, co-workers, and friends will be the first to notice. ReStore acts as a diuretic so he will feel the need to urinate within 30 minutes to an hour and his urine will be bright yellow because of the spilling over of excess B vitamins into the urine. This serves as an added re-enforcement of the value of your treatment. Your recommendation of nutritional supplements work in minutes rather than weeks!
For neuropathy patients it is essential because while you are stimulating the peripheral nerves, they will need extra nutrition. the niacin in the product will help release nitric acid and vasodilate the blood vessels of the skin, helping support the added metabolism of the small nerve fibers in the skin.
Serving ReStore and giving your patient a one month's supply with his very first visit allows your patient to serve it to family members and co-workers. this in turn can lead to subsequent sales of ReStore to them and possible referrals to "The doctor that gets results immediately".