The first 30 minute period is used to gather the history. This is usually done with the mother or father alone and not in front of the patient. It may be helpful to bring another person to stay with the child, or the child can stay with the medical assistant while the history is taken.
The second 30 minute period consists of an evaluation of the child. Often, gentle osteopathic manipulation is done. The parent may be in the room, or the parent may wait in the front. Some children do better when the parent is not in the room and the child is accompanied by our specially trained medical assistant.
The last 30 minutes are used to explain the findings of the doctor to the mother, father, or caregivers and to recommend a course of treatment.
For the first visit, you are encouraged to come at least 15 minutes early to acquaint yourself with the center and to fill out any additional papers that are needed.
Please review the new patient form, fill in the necessary information, and sign the "consent for treatment" and "HIPAA privacy form."
You can find this form through our Dropbox link by clicking on the button below.
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Dr. Centers practices traditional osteopathy, integrative pediatrics, and nutritional based medicine. Therefore, coming to Dr. Centers for an appointment may be very different than doctors that you have seen in the past. Moreover, Dr. Centers and physicians at the HOPE Center are specialists in Osteopathy in The Cranial Field, especially as it applies to children. Dr. Frymann, Fr. Centers teacher, was an original student of Dr. William G. Sutherland, DO the founder of cranial osteopathy. Dr. Sutherland in turn was a student of Andrew Taylor M.D. the “discoverer” as he called himself of Osteopathy.
Osteopathy, was the word Dr. Still used to describe a unique practice of medicine which focused on helping patients discover health, instead of focusing on disease. Dr. Still felt that regular or allopathic medicine placed too much of an emphasis upon the disease and very little emphasis on the patient who had the disease. The mainstream medicine of Still’s day looked at a disease and studied how a person became ill. In contrast, Dr. Still believed that we should study health and how a person becomes well.
Fundamental to Dr. Still’s discovery of Osteopathy is the principle that structure determines function. “Osteo” comes from the greek word which literally means structure. Dr. Still noticed that if the body has a change in its structure such as tight muscles, dysfunctional connective tissue, or misplaced bones this will cause a change in the function of the body. For example, tight muscles and misplaced bones can interfere with blood flowing through the veins or press on nerves causing too much stimulation to an organ or body part.
Osteopathic manipulative treatment as practiced at the Children’s HOPE Center is a process in which the doctor uses very gentle pressures, traction forces, and positioning to encourage the dysfunctional tissues to relax, unwind, and return to a more functional state. This unwinding process in which the physician follows the path of the initial trauma is a techniques discovered by Dr. Sutherland and used extensively at the HOPE Center. Therefore, the experience with Dr. Centers will be quite different than just about any other doctor you may see.
The first person you may meet, as you arrive at the Center is Monica Madrical. Monica is the HOPE Center’s medical assistant and patient coordinator. Monica is well trained to perform routine medical procedures such as finger-sticks, vital signs, and to coordinate the care with the doctors. You will recognize Monica by her friendly smile and compassion and care that she gives to patients and their families. Monica is also fluent in Spanish and serves as a translator for patients from Spanish speaking countries. Monica will check new patients in and ask them to fill out all the proper forms.
Then when the time comes mother or father will be invited to sit down in the doctor's office to provide the child's history up to the present time. The parents are asked to speak alone with the doctor rather than providing this important and perhaps rather painful information in front of a child. Even the child who does not talk or communicate still takes in the essence of what is said around them.
If you have any medical records, reports, x-rays, MRI images or other reports to enhance your history, please bring them with you.
Now, it is time for the child to meet with the doctor. The examination will include the customary examinations of heart, lungs, eyes, mouth, throat, abdomen as well as the structure of the feet, legs, pelvis, back, ribs and head by a gentle comfortable application of the physician's hands. If the child is old enough and capable, they will be studied standing, walking, creeping, crawling, skipping etc. The child’s body will also be carefully examined for motion. The doctor may look for differences in the length of legs, in toeing or out toing of feet, and overall movement of the body. Very gentle pressure will be used to evaluate motion of the soft tissue. The doctor will pay special attention to the tissue around the brain and spinal cord. This can be done by evaluating motion within the sacrum which is the triangular shaped bone at the very bottom of the spine. This is very important since this bone is connected through the dura or covering of the spinal cord to the base of the skull. Therefore, if the sacrum has a problem ---this problem can be transmitted to the base of the skull or the brain itself. The doctor may also evaluate the pelvis (which is connected to the sacrum), the entire spine, the face, and the teeth. He will likely spend a considerable time palpating the delicate bones of the head. The is made of nearly 30 bones. Each of these individual bones have slight movement and influence the tissue underneath them as well as the flow of fluid around the brain known as cerebrospinal fluid. The bones are like handles to palpate and influence the tissue underneath them.
Osteopathic palpation and manipulation does not usually hurt. Adults find the experience profoundly calming and relaxing. During manipulation many patients report feeling like they are floating on air or in space. Many times infants who are unfamiliar with this sensation may cry. The pressure that is used is extremely light so despite crying the child is not experiencing physical pain. In addition, the unwinding technique oftentimes retraces the path of injury and the infant or child may actually be re-experiencing the original trauma and thus releasing from the body. Once trauma has been removed from the body through osteopathic treatment it is frequently noted that crying during treatment ceases. This generally takes three to four treatments. It may take longer in infants with severe trauma.
Finally the parent, or both parents, if possible, will again meet in the doctor's office for the results of the diagnostic evaluation and recommendations for the treatment of the child. Thus is the time to gain a better understanding of the problems and a clearer picture of the treatment that seems appropriate. We may discuss dietary guidelines and nutritional recommendations as well. Lab test or other treatments may be recommended. A program will be designed for the individual child to help that child better function in his life and reach the optimum of his potential.
An initial course of treatment may be prescribed. This is often 8-10 treatments one week a part which allows the doctor to treat all body areas. The frequency of treatment may be accelerated for patients coming from far away. Follow–up treatments are usually shorter and the child continues to be evaluated based on the improvement that is seen from the previous treatment.
Lastly, you may from time to time encounter other doctors, residents, medical students, and volunteers. The type of treatment done at thee HOPE Center is highly unique so physicians, medical students, and other healthcare providers come from all over the world to study our unique approach. Medical students and residents typically stay at the Center for a month at a time and learn from the doctor. You may also encounter a number of undergraduate (pre-medical) volunteers that typically volunteer a half a day once week. Premed students may volunteer for as long as one or two years. Most of these volunteers go on to careers in the health profession.
Osteopathy employs a wholistic approach to treating the child’s body, using gentle hands-on techniques to support the body’s self-healing abilities. The osteopath is most interested in free motion and alignment of the body framework and its relationship to organ function, circulation, and the nervous system. Treatment and management are tailored to the individual patient.
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