A Frank Discussion with Your Medical Doctor

The purpose of this blog post is in no way to belittle or degrade the medical profession. My best friend is a medical doctor and I have several friends whom I admire and respect who are medical doctors. Furthermore, I have many medical doctors who refer patients to me on a consistent basis. No, this article is for those medical doctors who refuse to educate themselves on the benefits of alternative health care. Lately I have had a few medical doctors tell our mutual patients that they should not get adjusted anymore. Every single one of them cited arthritis as the reason why they should discontinue care with me. I hope this article will educate you as a patient of such physicians and maybe even influence some of them to do some research.

First of all, arthritis is a very generic term. Medical doctors routinely use it for any ache or pain in a joint. Most of the time calling it arthritis is technically true but over simplistic. It seems to me like they use it liberally because they do not want to explain what is really going on. Arthritis means is inflammation in a joint. It can be caused by auto-immune conditions like Rheumatoid or Lupus but more often it is caused by wear and tear. This is rarely explained to a patient so I am going to.

When doctors tell you that you have arthritis, most of the time what they are saying is that they can see signs of degeneration on your x-rays. Examples of degeneration are decreased joint space, bone spurs and misalignment. Essentially, instead of seeing nicely aligned joints with smooth edges, they see jagged edges with varying degrees of misalignment. This happens over time. How quickly is determined by how dysfunctional the joint is. The more dysfunctional the quicker it degenerates. Dysfunction of a joint means it is either not moving properly or not moving at all.

In the spine, the vertebrae have discs that can degenerate. Usually, this is associated with a disc herniation or bulge. Degeneration in the spine can lead to stenosis or narrowing of the openings where the nerve roots travel. Spinal degeneration or arthritis can come in varying degrees and complications. I am very aware of the risks involved with adjusting a highly degenerative spine.

Let me repeat that. I am very aware of the risks of adjusting a spine that has arthritis or degeneration! I also know the benefits. For this reason, I am very frustrated with these MD’s who are telling my patients to stop. Do they think I am unaware of my patient’s condition? Do they believe that I have no regard for my patient’s health? To be honest, I don’t believe they consider this, at all. I see fear derived from ignorance.

The truth is that an adjustment of a degenerating joint can be very beneficial. Retraining the joints to move properly can decrease inflammation and increase the nerve flow to that area which will at the very least slow down the degenerating process. Increased function will lead to improvement to the health of the joint. Are there risks? Of course. There are risks to everything. I believe the greatest risk is doing nothing. It is certainly the most predictable risk.

Trusting in your chiropractor to know when to adjust or not is important. Communication is the key! If you have a condition and you are unsure of your chiropractors awareness of it, express your concern. On that same note, avoid taking advice from people who don’t know. They shouldn’t be making recommendations about things of which they are ignorant. That doesn’t seem to be stopping some of them. If you stopped chiropractic care because your MD told you to, but have’t discussed it with your chiropractor, its time to have a frank and open discussion with all the parties involved, OK?

Pillow Talk. (About Actual Pillows, Not the Other Kind)

Ah, the frustration of finding the perfect pillow! Have you found yours, yet? Once you do, your spouse or kid will probably steal it or your dog will chew it up. Or, do you have that pillow that has been perfect for longer than you are willing to admit and it is just moments away from disintegrating in the middle of the night as you blissfully rest? I know how it is. I wish I was writing this article with the perfect solution for everyone. Alas, there is no perfect solution but there are some general guidelines that can help.

First off, finding the right pillow can take time and you may need to invest a little in several different pillows. How much is up to your commitment to a perfect night’s sleep and how important it is for your neck to feel good in the morning.

The most important factor to consider is that you need to keep your head and neck is a neutral position relative to the shoulders. If your head is closer to one should over the other or flexed forward or extended back, you are no longer in a neutral position. This can put a strain on the joints of the neck and cause shortening of one side of the neck muscles and conversely lengthening of the other side. Because we spend so much of our lives sleeping, it is vital that you keep your neck and head in a position that puts little stress on all of the structures.

For side sleepers the biggest issue typically is finding  a pillow thick enough to take up the space between the shoulders and the head. This is especially hard if you have broad shoulders. A firmer pillow is usually your best bet because it will hold its shape all night. Down pillows tend to be fine for the first few hours then compress during the night. I, personally, sleep on a water based pillow that holds it shape really well but is soft enough to be comfortable. It has over a gallon of water in it so it weighs a ton which makes it hard to change the pillow case, but what do you do?

Back sleepers typically need a fairly thin pillow or no pillow at all depending on the curvature of the upper back. The shape of your neck will largely determine the style of pillow. If you have a good curvature (which is ideal), a pillow that helps maintain the arch can be great. If your neck is unfortunately straight or reversed, then that style of pillow might be very uncomfortable. Some say that using a pillow as a neck orthotic to restore the ideal curvature is a good idea. I could definitely make that argument but sacrificing sleep might not be worth it.

OK, I know the what you are thinking, “I switch from side to back all night.” Let me say it right now, unless you are just the right structure, there is not really a pillow that is dual purpose. Sorry! If you have a pillow thick enough to take up the space between the head and shoulders, it is going to be too thick to sleep on your back and vice versa.  Furthermore, if you are a stomach sleeper, there is no way to keep your head in neutral and still breath unless you have a slot for your mouth and nose.

There you have the basic guidelines. Happy hunting. FYI, just because pillows are expensive doesn’t mean they are going to be a good fit for you. Still, cheap is cheap. The pillows I sell in my office are around $50, if that is useful. Good luck and sweet dreams!

Pregnancy and Chiropractic

First of all, yes, it is completely safe to receive chiropractic adjustments when you are pregnant even at 9 months. In fact, it can be very beneficial. Shoot, my wife’s OBGYN is my top referring MD. Why? Because when his patients are suffering from the ravages of pregnancy, all he can do is be a sympathetic ear or recommend Tylenol. He knows that chiropractic care is safe and can help manage his patients symptom where options are limited.

For those who are unaware, pregnancy can be really hard on a body. For the record, when we men argue that we are the tougher of the two genders, women can always trump the argument by simply mentioning pregnancy and child birth. Trust me, no man is tough enough to withstand. Add to that list the duties of motherhood and it is game, set, match. During pregnancy the fetus becomes top priority. This means that the body will compensate and adjust to keep the baby viable. Nutrients needed will be taken from whatever source available. In addition, the shape, weight, posture, and the mechanics of the body, especially the core, change and adapt for the growing baby. Combine that with the production of the hormone relaxin which softens up all of the joints to allow the baby to be birthed, and the potential for dysfunction is inevitable.

Getting chiropractic adjustments during pregnancy helps the body cope with all of those changes. When joints and ligaments become lax, the muscles tighten to compensate. This alters the mechanics. The adjustment helps restore the body’s mechanics and therefore reduces the secondary and tertiary responses like muscle spasms. Proper function will make it easier to carry and deliver the baby and will also help joints maintain coordination which positively affects the nervous system. Properly functioning nerves will promote better health, in general. A classic example of this is managing heartburn. When my wife was pregnant with our 2nd child, she had terrible heartburn. We found that adjustments were much more effective than antacids in controlling it because of the connection between the nerve roots in the midback that go to the esophagus.

Chiropractic care during pregnancy is not just effective for low back pain relief and heartburn, it is also helpful in treating tension headaches, foot pain, hip pain, mid back pain and tightness, shoulder soreness, constipation, and much more.

Keep in mind that predicting a schedule for treatment during pregnancy is impossible. The body changes too fast. Some women need chiropractic adjustments every so often and others may need an adjustment several times a week. The key is to keep things functioning as best we can and not let it get bad.

Finally, during pregnancy the body does not heal as well. If you are pregnant and experience trauma or just have a traumatic pregnancy, be patient. It will take time after the delivery to heal up properly. If you are adjusted during pregnancy and again after delivery, your healing time will improve dramatically.

Chiropractic and the Healing Process

In this world of instant gratification, realistic expectations are often scarce. We have instant coffee, fast food, automatic deposit, etc. We demand results quickly and for most things we get them. Unfortunately, healing is not an instantaneous event. It takes time. Don’t get me wrong. I am as impatient as anyone. I like to see or experience improvement quickly. However, when it comes to healing, there is still a process.

This article was written to help you understand the healing process and what to expect on your road to recovery.

The healing process has several stages. They can be broken down into three major steps:

1. Inflammation: Whenever an injury occurs there is damage to tissue. Tissue damage causes a reaction in the body that brings chemicals to take care of the damage. It causes swelling which keeps the affected area from moving too much. The reaction also generates heat, hence the term. I like to compare inflammation to firefighters putting out a fire. They arrive quickly and start shooting water onto the fire. Though necessary, often times the damage from the water is just as bad as the damage from the fire itself. This is even more true of inflammation. If not taken care of quickly, inflammation will begin to destroy the good tissue and cause a host of other problems. For this reason, ice is a powerful tool. Controlling the swelling with compression and an anti-inflammatory diet can also be very valuable.

2. Scar Tissue Repair: After a 2-6 days of inflammation, the body starts to lay down scar tissue. Scar tissue is weak and it complicated by the fact that it is laid down quickly and haphazardly. To further the analogy of a home damaged by fire, imagine a crew going in after the water has mostly dried and quickly supporting the overall structure with whatever wood they can find. They make it more stable than it was but it is not as functional and it is certainly not as stable. Scar tissue is supposed to be a temporary process that takes 6 weeks to 6 months depending on the damage. Unfortunately, many people do not do what it takes to get beyond this stage. As a result, they easily tear the scar tissue and the process starts again. This is the cause of chronic injury.

3. Remodeling of Tissue: When scar tissue starts to act like the original tissue, the remodeling process has begun. It is critical to get to this stage if true healing is to occur. This stage can last for a long time. For some tissues, like the nervous system, the process can be so slow it is almost imperceptible. For such tissues, support therapies like hyperbaric can help. In joint,  muscle, bone, ligament, tendon, etc., proper motion and function dictate this process. You have to train the scar tissue to line up all in the same direction and act like and be in sync with the surrounding tissue. Only at this point will true healing occur.

Unrelated topic: when you make a comment on this blog, you will automatically be entered into a drawing to win free chiropractic care for April.

It’s Not All About Pain, People!

Pardon my rant for moment and please consider what I am about to say. Pain is a symptom or an indicator. Pain is annoying. Pain can be frustrating. Pain can even be debilitating. Treating for pain, however, is a terrible way help someone get out of pain.

The origins of pain are not well understood and can be a very deep topic. That saying, from my study, most of our pain is distributed through the limbic center of the brain. The limbic system is really the emotional center of the brain. So, to me, pain is an emotional response. Ever notice that some people have a high pain threshold and others have little to none? Likewise, some cultures are very stoic about pain while others are extremely passionate. The very same stimulus can be applied but the reaction is completely different.

Don’t get me wrong. Pain is very real. I am not suggesting we write off anyone in pain with the idea that it is all in their head. What I am suggesting is that we keep pain in perspective. Bad pain does not always mean horrible damage. Likewise, some of the most serious damage to the human body can display very little pain. Furthermore, pain can be a good thing when it gives a warning that something can be harmful. Have you ever stepped on hot sand and immediately pulled away so you didn’t burn your feet? What if you were a diabetic with poor blood circulation and therefor poor feeling in your feet. Would you say that it was a good thing to burn your feet because you couldn’t feel it? Of course not!

Rather than focus on the pain of an injury, I like to focus on the rehabilitation or function. If we only treated for pain, very few people would ever recover. Rehabilitating an injury whether chronic or acute can be painful. Let me say that again, TREATMENT CAN BE PAINFUL!  Sometimes we have to break down a lot of scar tissue. This will be painful. When you are dealing with functional and physical medicine, like chiropractic, the end result is to get you functional which will eventually lead to less pain. By the way, this takes time.

Please don’t kid yourself that you can rehabilitate an injury without pain or discomfort. It is just not how the body works. Would you expect to work with a personal trainer to get in shape and never feel soreness or fatigue? Instead, focus on improving function and accept pain for what it is. In the words of the Dred Pirate Roberts aka Westley from The Princess Bride, -“Life is pain, your highness. Anyone who tells you differently is selling something.”

What do You Think of Socialized Health Care?


The debate is in full swing over socialized health care. It seems to me that it is only a matter of time before the politicians decide to take control of the rising costs. I can understand both sides. I am not going to even argue between both sides because it seems like the two sides are comparing apples and oranges. I think most agree that whatever we have right now is not a great solution for the masses. My point in witing this article is will it work in the US? 

Now, I know what you are thinking, “It works in Canada and Europe and people are not as antagonistic or supportive as the two camps portray.” I agree. All of the debate is focused on whether it will be right for the people. But, just as in everything there are other parties involved. I have yet to see much discussion about whether the providers are going to go for this. 
You see, the doctors in Canada and Europe have never really known anything different. They went to school with a certain expectation and are working under those circumstances. This will not be true for doctors in the US if we switch to socialized health care. Think about it this way. Most US docs went into healthcare because it is career where one can help and serve others while also enjoying a certain status and income level. Keep in mind there are two sides to this: the ability to practice as one chooses and the money. 
Lets talk money for a bit because that seems to be the major focus (though I will argue that for the majority of docs it is the lesser issue). Going to professional school is expensive. A lot of time and money is invested in the education of a doctor. As of now, the compensation in most cases is satisfactory but not as good as it used to be. I wonder what compensation will be under government regulation?  
The real issue, however, is not money; it is control. Doctors have taken a beating since the onset of HMO’s. Take a poll of any profession and job satisfaction has more to do with the ability to affect outcomes. If HMO’s are bad wait until the government decides to take over. Medicare is the classic example. Medicare dictates very specifically what a doctor can and cannot do. In additon, if you feel a procedure is warranted but the government does not, guess who wins? Accountability is good, but when a doctor spends more time justifying his course of treatment than actually treating people satisfaction starts to wane. 
The question then becomes how many doctors are going to stick around with changes that will limit their ability to treat patients the way they want to and with a cap on how much money they can make? The other question is whether the government will allow doctors to opt out of universal health care and take private pay only? If they don’t, will enrollment at professional schools decrease and will you see more doctors leaving the field for less stressful and more profitable professions? If they can do private pay how many docs will opt out? Either way, what will our access to health care look like? I don’t know the answers for sure but I can tell you as a health care professional I would opt out so as to avoid the pitfalls and the headaches of governmnt controlled “sick care” and if the government doesn’t give us choice… well I guess I will have to cross that bridge when we get there. 

What is Health?

What is health? I ask this question all the time both to others and to myself. When I remind myself of the answer on a daily basis, I have real purpose to my work.

The definition of health used to be the absence of disease. That is a pretty narrow definition and, to my way of thinking, isn’t really possible. I think everyone has something that causes dis-ease and therefore, by definition has a disease. For that reason I think we have evolved as a society into a broader more dynamic view of health.

Health can be good or bad. It is a spectrum, if you will. Everyone alive has health to some degree. It is kind of like the old saying “If I didn’t have bad luck, I would have no luck at all.” Some people have bad health and others have good health.

To me, good health means that all aspects of the body function as they should. This includes functioning with other parts of the body. Proper function and even synergy of the body relies on good communication. Good communication is in large part dependent on a properly functioning nervous system.

The nervous system consists of the brain, the spinal cord, the cranial nerves, the nerve roots, and all the nerves with their bundles that come off of the nerve roots. The most common area of the nervous system to have a problem is the nerve root.

When vertebra in the back is dysfunctional it irritates the nerve root which alters communication to the organs and other parts of the body that nerve root innervates and leads to disease. Chiropractic helps relieve the irritation of the nerve. Simple as that!

What’s In a Name?

So, I am sitting at my desk on a rainy morning anticipating the morning rush. I have a new patient in the hyperbaric oxygen chamber and the patient I had scheduled at this time to receive her report of finding called in to postpone due to the flu.

In my suddenly open schedule I determined to start a blog. But, what do I name it? I had a blog before but the name was not only too long but apparently too obscure. Nobody got it. To add insult to injury had a glitch where I couldn’t edit or add pictures. But, in the name of persistence and an outlet for my ideas on health I have tried again.

This time the name I came up with is “Optimal Health.” I use this phrase quite often through the day. I believe the pursuit of optimal health should be one of our top priorities. God gave us these bodies, shouldn’t we take care of them as best as we can?

This name also gives me an opportunity to discuss many aspects of health and health care. By the way, I am open to any suggestions for topics that I can research.

Here it goes!