B.E.A.W.A.R.E. (Part 2)
For holistic practitioners, B.E.A.W.A.R.E. will be the most important acronym you will ever learn. For more information on the foundations of B.E.A.W.A.R.E, check out Part One on my blog. This medical pre-screening process which I have incorporated into my practice for over 30,000 patients, has proven effective in enhancing my ability to guide clients to appropriate treatment.
For patients utilizing holistic care, this evaluation tool provides valuable insight to the interconnectedness of body systems and how they communicate when there is abnormality or dysfunction.
Here are real-life scenarios of how the B.E.A.W.A.R.E pre-screening provided significant clues to the client’s overall health and wellness and led to restorative treatment.
B: Is for Bilaterality
It is very rare for conditions to occur on both sides of the body. When clients come in with symptoms on both sides, this is an automatic red flag.
Case 1:
A client came into our office with swelling on both ankles. Before the visit, they were seen by an impressive lymphatic drainage therapist but ultimately, the swelling came back. When I saw that both ankles were swollen, I immediately knew this was a bigger issue. Instead of moving forward with treatment, I decided to send her to a medical physician for another examination. After this assessment, the client found out that they had congestive heart failure.
E: Is for Extreme Pain
When a client is experiencing extreme pain, this is a red flag. Even if the client has a full range of motion, severe pain is a critical indicator.
Case 2:
A client reached out to me regarding a shoulder injury from body surfing. Although he had full range of motion in the shoulder, there was one spot that was hypersensitive. We utilized a tuning fork, not to treat the patient but rather to see if it brought on more discomfort. Which it did! This abnormality stood out to me, therefore I sent him to urgent care to get x-rays done. The results showed that he suffered from a fractured shoulder.
A: Is for Association with other New Symptoms
If a client comes in with a specific pain but is also experiencing different symptoms simultaneously, there may be an underlying issue.
Case 3:
During a recent telehealth session, a client was experiencing lower back pain. This type of symptom appears very common. When I asked if there was anything else unusual happening, they replied that they thought their urine looked a little pink this morning and hard to go. This added symptom was an instant alarm that there was a deeper issue at hand. I advised the client to see his primary care physician, and it turns out that they were passing a kidney stone.
In this specific instance, it was extremely important for me as a holistic practitioner to pay close attention to the symptoms the client was experiencing. Telehealth sessions must incorporate in-depth descriptors, as I cannot see the client in my office.
W: Worsening Despite Appropriate Treatment
Any practitioner should immediately re-evaluate their assessment and treatment when symptoms worsen or do not improve. Ignoring one of the most important and easily recognized warning signs of misdiagnosis is inexcusable. The real challenge lies in thinking not only of how to change the treatment but also to reconsider if the patient is amenable to what I have to offer in my profession.
Case 4:
A Patient came in with sacroiliac and hip pain. After a few visits and worsening we sent the client out for an ortho consult which was negative. Again, after seeing his condition worsening from the lightest session, we sent the client out for a second opinion by an orthopedic oncologist. A PET scan was done, and he was found to have metastasis of his cancer to the hip and pelvis. Surgery was performed right away.
A: Absence of Injury
We have seen conditions where the patient just wakes up with a problem or has no recall of trauma. This brings up a red flag as to what may be going on. If there are any lumps or bumps, we definitely want to send them out for further assessment.
Case 5:
Client had thoracic pain and was nagging him for a few weeks. No injury or trauma. No improvement, so he was sent for an ortho consult which was negative on x-ray. After a few weeks we sent the client back for another consult for a second opinion. MRI was done and it was found that the client had a large tumor behind the heart.
R: is Response to Examination
Case 6:
A client had an unusual reaction for his left tennis elbow. She had severe pain when she came into the office, although after she settled down there was little to zero discomfort. Client finally realized or was in denial that pain came on when she went up the stairs. She was sent out and found to have cardiac blockage.
E: is Emotional or Gut Feeling
Case 7:
There was a client who came in and had simply bumped her head on the cabinet door that was left open. Over a period of time her headache started to get worse and was not sleeping well. She was just seen by her Doctor who ruled it out as lack of sleep. I saw her gaze out the window and completely blank out for about 15 seconds. My gut feeling was that it was a seizure. I called her son who is a chiropractor immediately. She was taken to her physician and was found to have a double hematoma in the brain. She was operated on that evening and today she is completely normal. In this case, it was one of the best treatments I ever gave.
I learned much of my clinical philosophy and techniques by working and studying with the masters of the craft both alternative and medical. Through an artisan workshop approach, I learned the medical traditions of holistic care, although I’ve seen magic happen when working in tandem with contemporary medicine. As a practitioner of B.E.A.W.A.R.E., I have developed a deeper understanding of both professions and established life-long relationships that benefit both parties.