Germaphobia Vs. Immunology

Full disclosure, I am a germaphobe and have suppressed my obsessive tendencies since I discovered them as a pre-teen. Like most of us, I was taught about hygiene around the 5th grade. You know, when kids are on the verge of stinking if they don’t shower often enough. Since that time when I learned about bacteria and other germs, I made sure to wash my hands often. Then, one day around 7th grade, I watched an after-school special (Gen X-ers will remember those). It was about a kid who was an obsessive hand-washer due to his OCD. As I watched this kid struggle I had an epiphany. I was that kid! My hands were chapped. I avoided touching things, just in case. I would never drink from someone else’s cup or share a spoon. I was a germaphobe!

A phobia is an extreme or irrational fear. I had taken it to the irrational level thinking everything I was doing could keep me from catching a germ. At the time I realized my folly, I understood that trying to protect oneself completely is impossible. As I have studied, I learned why trying to do so is dangerous. I am afraid that with the response to COVID-19, we are becoming, as a civilized society, germaphobes. The risk of such phobic behavior has the potential to be infinitely more harmful than the novel coronavirus we have been trying to stop.

Immunology is the study of the immune system or how the body responds to foreign substances or infectious organisms. The basic tenets of Immunology concern exposure to a pathogen and the body’s ability to fight it off. There are many weapons against invaders so, keep in mind that I am just touching upon the very basics. B-cells seek out pathogens and attack them. T-cells find infected cells and kill off the cell so the pathogen cannot reproduce. This process can take a week or more. Whenever these types of cells go to work, they create armies of these antibodies and they also record the way they attacked the antigen so that should a person ever be exposed to an antigen again, the body will be ready to the point where the likelihood of another infection is extremely low. This is why when I was a kid and had chickenpox, my parents made my siblings play with me to get it, too. That way, we would all have it and would develop lifelong immunity to the disease. In addition to T and B-cells, and there are many different types, there are also substances that we can ingest that help boost our immune system. This is seen when a newborn, who does not have an active immune system, is given antibodies through her mother’s milk or when people get an immunoglobulin shot.

The key to developing a strong and healthy immune system is to gain exposure to a wide variety of germs and letting our bodies fight off those antigens and build armies against them for the future. If we are never exposed, we cannot develop antibodies to fight off the infection. This is the basis for vaccination, expose a person to a virus so their immune system can develop the antibodies necessary to fight it off if exposed to the virus again. If enough people in a community have developed the antibodies to fight off an infection, herd immunity is achieved and the spread of the disease is negligible.

There are germs on and around us at all times. Most perform a vital function in the balance of life. If a host becomes immunocompromised, germs can proliferate unchecked. We have to keep our immune systems ready to fight off diseases. What we do not exercise becomes weak. If you completely isolated yourself for long enough, you would not be exposed to any new or changing germs. When you entered into society again, you would most likely get sick from some antigen that your peers had already developed immunity against. This is the danger of prolonged social distancing! We need to share our germs to survive as a species. You cannot develop a strong immune system by isolating yourself. Likewise, if we kill off or block the germs we need to maintain ecological balance with copious use of disinfectant wipes, excessive hand sanitizing and washing, and ubiquitous use of masks, we will not only throw off the balance but we will also have a more severe flu and cold season than we have seen in a very long time.

The notion that we need to shelter in place until a vaccine is developed, is preposterous. We are so focused on the virulence of the Coronavirus that we are completely ignoring the fact that now is the time most of us should be sharing and therefore building up immunity to the flus and colds that will hit us later. These are the same flus and colds for which they have never created an effective vaccine. It is shortsighted to focus only on COVID-19, and that is just from an immunological point of view, the social and financial dangers, notwithstanding. Viruses move through communities quickly. If we have not developed herd immunity to COVID-19 at this point, which I truly believe we either have or are close, then let’s fight it head-on. Those with compromised immune systems and others with higher risk factors need not be in the fray. Those are the individuals who should shelter in place. The rest of us need to share our germs. If we remained isolated, there will never be a good time to rebalance.

In my opinion, and I share this with many other professionals who are much smarter and more educated than I, it is now time to ease back into society. It should be a process. Stop wearing your mask unless you are symptomatic, have a high probability of being an asymptomatic carrier, or around people who are known to be susceptible. Ease up on the sanitizing of every surface. Shake hands. Hug. Meet with friends and neighbors. Be social. Obviously, do all of these things with those who do not appear to be at risk or with those who may have been exposed. Staying inside might have been important while we were analyzing the threat and flattening the curve, but now it is time to save lives by not staying in.

Photo by Tai’s Captures on Unsplash

 

 

“Do you accept Kaiser?” “Yes, we do, sort of…”

We get calls every day asking if we take Kaiser patients. Of course, we do! However, we are not contracted with Kaiser so that is a bit of a misleading statement but let me explain. Kaiser Permanente is one of the largest health care providers and insurance companies in California and its innovation has become revolutionary. Kaiser is both an insurance company and provider of healthcare which has given it a unique way of managing the growing costs of healthcare while still providing quality care.

As a provider, Kaiser does not actually provide chiropractic care. They have acupuncturists, physical therapists, and, of course, all of the traditional medical professionals. At least, as far as I know, they do not employ chiropractors to perform chiropractic care. As an insurance company, they have some policies which include chiropractic care. Kaiser does not actually manage chiropractic benefits for their clients. Instead, they contract out chiropractic benefits to a company named ASH or American Specialty Health. If a chiropractor wants to be on the list of providers for the people who have chiropractic benefits on their Kaiser policy, they must be contracted with ASH.

I am not contracted with ASH nor do I have plans to become contracted with them. ASH is an  HMO or health management organization and their model of business is not compatible with mine. HMO’s are willing to cover patients in acute pain who have an injury on their list of conditions suitable for chiropractors to treat. They have models that require justification for care through paperwork. I like more flexibility in treating my patients and I hate extra paperwork. HMO’s have done well in reducing the cost of care for insurance companies. In theory, this means lower premiums and copays for patients.

So, how exactly do I take Kaiser patients? I am glad you asked. First, most Kaiser patients do not actually have chiropractic benefits. So, it makes no difference whatsoever to see an in-network or out-of-network chiropractor. We have a great practice with very affordable fees and super friendly staff. Why wouldn’t you want to see us over anyone else?

For the patients who actually have chiropractic benefits through ASH we can still help. I may not be contracted with ASH and therefore have the privilege of taking a reduced fee in exchange for a policy that will tell me that I can only see a patient six times before having to file another report to get a few more visits until they decide that the patient should be better so they are not paying anymore; then, by the time I get done writing reports and fighting the insurance company, I have wasted enough time and money to make it completely not worth it; but, I can see patients with Kaiser/ASH at no additional cost to the patient.

I routinely accept patients’ regular copays as full payment for care. Compare that to a doc who will take that copay for the six visits the insurance company gives and then charge full price once the insurance company deems their lingering issues resolved. Of course, sometimes patients prefer my monthly care agreement because it works out to be less expensive than paying their copay every time. Either way, it is a better deal for the patient because they are not under the scrutiny of the insurance company but still enjoy the contracted copay or less. In addition, they get great care and it can be completely customized without strict policy guidelines. In that way, we are happy to take care of Kaiser patients and everyone else who has insurance whether we are in-network or not.

***Photo by Miguel Bruna on Unsplash

Our Complicated Decision to Remain Open

I want to thank everyone for sharing their thoughts and concerns with me regarding whether Thomas Chiropractic should remain open as “Essential” during the pandemic. It is an extremely complicated decision and, for now, the responsibility rests completely on my shoulders. After much thought and prayer, we have decided that it is best for the community, my staff, and our families to remain open. As such, Dr. Karp will be working today from 7:30-12:30 and 2-6. We will continue with normal hours until further notice.
 
I have weighed the risks and contemplated the solutions. My patients who also have “Essential” jobs have pleaded with me to help them stay healthy so they can perform under the stresses and strains of the current situation. I have patients who are in the tender and tenuous stages of healing where any loss in momentum could be devastating. I have other patients who have a very difficult time functioning without regular chiropractic care. Finally, I have an abiding and sincere belief that chiropractic adjustments support the immune system to such an extent that patients who continue care have a demonstrably better chance of fighting off any virus.
 
Our office is well equipped to maintain proper social distance. We have a decent-sized lobby and six separate treatment rooms. People sign in with a new or freshly cleaned pen. With the decrease in patient visits since the call to limit social contact, the number of people in our office at any given time has not exceeded the recommendations. I appreciate many of the suggestions given regarding sterilization. The truth is that it is impossible to maintain a sterile environment. We certainly do our best but we cannot wipe down every surface that someone might touch and keep it wet with sanitizer for the length of time necessary to kill the germs after anyone comes in. Providing masks, gloves, and disposable table sheets would be amazing but impossible. Even the hospitals are running low on these supplies and you cannot buy them anywhere. It is an expensive and logistical conundrum. That saying, I welcome patients who have their own masks and gloves.
 
At the end of the day, it is always safest to just stay home, even under non-crisis circumstances. As humans, life is a risk. I believe that the risk of spreading the disease in my office is low at this time. I know many of you vehemently disagree with me. I respect your opinion and your right to have that opinion. I will also remain your friend. I take this risk of my own free will and choice. The liberty and freedom to make such a choice are extremely sacred to me. If you choose not to make the same choice, I will be ready to help you, God willing, after the disease has run its course and life returns.
 
If you choose to also take the risk to come into my office for care, please do so of your own volition and exercise your own precautions. If you know me at all, you know that I am an advocate for individual responsibility, especially regarding one’s own health. I implore you not to come in if you are displaying any symptoms that might endanger anyone in the office. If you are an at-risk individual and you need special accommodations, please contact me. We can make arrangements while you wait in your car. Take the responsibility upon yourself to limit hand contact with surfaces that get touched often or to use a barrier when you touch any such thing. Avoid touching your face unless you have just cleaned your hands.
 
I hope you will respect my decision in this matter and understand that it may change as circumstances are so volatile. May we all remain supportive even in our differing opinions and show our greatest quality by expressing love even when understanding is lacking.

Thoughts On the Coronavirus and All Infectious Diseases

As with anything that dominates the twenty-four-hour news cycle, the Coronavirus or COVID-19 has a spectrum of concern. Please educate yourself on this virus by checking out the CDC’s website. I am writing to give my thoughts from a holistic healthcare provider and, hopefully, a reasonable perspective to help you navigate the fear while still protecting yourself.

You are starting to see memes about surviving the latest end of the world. Let’s be honest, every few years the news goes crazy about some infectious disease that could wipe out entire populations. The disease runs its course, many are infected, several die, and the disease gets under control and passes from global consciousness. Some diseases, particularly the ones they create a vaccine for, stay in the public consciousness because of the shot. These are, generally, very nasty viruses. There is definite cause for concern. However, we need to step back and avoid panicking so we can really fight the spread of such diseases.

Many have written articles about how to protect yourself. I would echo those which encourage you to wash your hands often and avoid close contact with potentially infected individuals. However, we still need to live and function in society. The best defense is not a mask, gloves, or boarding yourself up at your house, but a stellar immune system.

Antoine Bechamp in the 19th Century claimed that it wasn’t germs that cause diseases but that leaving our bodies susceptible to disease was the problem. He argued that there are always germs in great supply about and around us and that until we give them a place to thrive, they stay under control. To prove his point he drank a glass of water infected with cholera and never got sick, so the legend goes. He lived into his 90’s so he, at least, had something going for him.

I am not suggesting that anyone take a flight to China, not that there are any available, to prove the superiority of your immune system. However, we can and should do all we can to keep our immune system performing well. I could write a whole article on keeping your immune system healthy. I will sum up some good ways by saying you need to eat well, drink plenty of water, exercise, get enough sleep, avoid sugar and alcohol, and get adjusted.

I know, I am a chiropractor and I always figure out some angle to work adjusting into the solution. The truth is that chiropractic adjustments have been shown to significantly boost one’s immune system.

Right now, the Coronavirus is not really prevalent in our area. There are a few cases that have been quarantined. Health officials are doing a good job of educating people about what they can do if they suspect an outbreak. In our office, we are taking the normal precautions to ensure that we are not a source location. Please, keep up on your care. Staying healthy, like I mentioned earlier, is still the best defense.

 

This Chiropractor’s Perspective on Mandatory Vaccination

I have stayed away from the topic of vaccinations in my practice because it is very emotional for both sides of the argument and it is not necessarily relevant to what I do as a chiropractor. However, this is more about freedom and healthcare and I am finally ready to share my thoughts. I know some of you will disagree on different points. To that, I say, great! Science is all about looking at an issue from several angles and sharing perspectives. Science does not own truth nor does it ever espouse it. Science seeks to hypothesize, observe under certain conditions, and theorize. That saying, I am very concerned with any side of an argument that claims to use science to hammer their agenda to the point of a mandate.

State Senator Richard Pan, who was a practicing pediatrician turned politic, has been working very hard to make vaccinations mandatory. I am sure he has his reasons and some of them may be pure but it also seems like he is being supported by those who stand to make a lot of money from the sale of these vaccinations. He started out a few years ago by passing a bill which made it illegal for parents to sign a vaccine waiver on grounds of religious or moral opposition which forced parents who are concerned about the damage a vaccine may cause to their child to get a waiver signed by a medical doctor. Now he is going after the medical doctors who signed those waivers and looking to establish a panel to overturn their opinions and make it harder, if not impossible, to get a waiver.

A few years ago, Senator Pan paraded several medical doctors who testified that they would sign waivers if they felt it was warranted. Apparently, that was a charade to pass that bill because now he does not want any individual doctor to have that kind of authority. Let’s be very clear, he is not interested in your research, your opinion, your morals, or your beliefs. Right now he is seeking to make it mandatory for all children who attend a public school to be vaccinated unless his handpicked panel decides otherwise. This is not about science, it is about control derived from money and power.

The argument for mandatory vaccines and the talking points behind them have spiraled to fear mongering. They use the theory of herd immunity as the basis of their argument. Herd immunity is the theory that if a high percentage of people are immune to a disease, presumably through vaccination, then the disease can be contained. It is not a terrible theory but there are holes in it. They also claim they need herd immunity to protect the children who cannot be vaccinated. They claim that we are putting these children at risk. Interestingly enough though, they make it sound as if unvaccinated individuals are the ones spreading the disease. This thought has been pervasive enough for the mayor or New York City to pass a decree that the unvaccinated are not allowed in the city or they will be fined.

To these points, I beg for a more scientific approach or just plain and simple logic. It is not an unvaccinated person who spreads disease but a person who has the disease. You cannot share something you don’t have or have never had. In fact, vaccinated children are 100% more likely to spread a disease they are vaccinated for than unvaccinated children. Within two weeks of being vaccinated for measles or chicken pox, there is a shedding period where the person can be contagious. It is rare but possible. Whereas, it is still impossible for an unvaccinated person without the disease to spread it.  Besides, if you have so much faith that vaccines work, why should you be worried if you and/or your kids are vaccinated? Finally, if you are worried about the children who are unvaccinated getting the disease, I can understand the concern from your perspective but are you willing to claim that your concern is greater than the parents’? Herein lies the debate. Do you have the right to act on your differing opinion on a child who is not yours?

Those who claim the moral high ground in favor of forced vaccinations are missing the greater points of liberty and the slippery slope that can lead to the loss of all freedom. I firmly believe that almost everyone should get adjusted on a regular basis and that society would benefit from it. Would you be comfortable with me pushing to pass a law that forced you to get your children adjusted regardless of your opinion about chiropractic? What if I was reasonable at first and just said they needed a couple of adjustments? What if later I told you they needed more? What if I said, at first, that you could get a waiver if your chiropractor (and only a chiropractor) said your bones were too brittle or you have joint laxity or some other condition that might cause harm, only to then tell you that your chiropractor is not qualified to make that decision and we need to have a panel of experts whom I choose to make that for them? At first blush, this is ridiculous, yet, we are at this point right now with our rights to choose the care we feel best for our children as the stakes.

If forced vaccinations for children going to school passes, what is next? Will this smarter-than-you panel of medical doctors then decide that adults must be vaccinated? Will they decide that you have no options? Will we start fining people as they have threatened in New York City? Does this sound like a conspiracy? It is! But unlike the people who are trying to convince you that the earth is flat, this conspiracy has a lot of money and power to back it up.

Again, my point is not whether you should or should not vaccinate your children. For what it is worth, my opinion is that vaccination started out as a pretty good idea. It was a risk vs. risk scenario. Introduce a little of a disease, let the immune system work its magic and create a great chance at immunity. The risk on both sides is always real. We have taken it too far, though. The pro-vaccine side seeks to dismiss any risk that the diseases, let alone the rest of the chemicals in the cocktail, pose any risk. Yes, those risks seem to be small but they are real. For some people, the risks are not only real but imminent. For those opposed to vaccines, they tend to inflate the risks. Most people who are vaccinated are not going to have a severe reaction. For those that have had severe reactions, however, it can be absolutely devastating.

I get that having the measles, mumps, rubella, diphtheria, tetanus, pertussis, chickenpox, shingles, polio, etc. can be very bad and even life-threatening. Step back from the fear and consider that the chance of infection is still very small in the United States and the risk of death is almost statistically completely improbable. Now, one can argue that it is because of the vaccines that these diseases are almost non-existent. That is a reasonable assumption but I can counter that disease comes and goes regardless. I had chicken pox as a kid. Almost everyone I know did. It wasn’t fun but it wasn’t deadly. Now, I am immune. If I keep my immune system in good shape, I will never get it, or shingles, again. No vaccine needed. Chickenpox was super rare when they came out with the vaccination. Since then, shingles and chickenpox (the same virus) have been on the rise. Maybe it is a coincidence but I reserve the right to scientifically observe to think otherwise. Observation takes time, by the way. It is OK to wait and test. There is no crisis. Furthermore, are you comfortable giving your infant a vaccine for a sexually transmitted disease like HPV or hepatitis because they may choose to be promiscuous when they are teenagers? I’m not. I would rather teach them the consequences of such actions and encourage proper behavior.

The argument as to whether you should or should not vaccinate your children based on the risks on both sides of the argument is a very personal decision and should be considered with much research. Unfortunately, the research is very thin. When, how much, and what kinds of vaccines a child needs, has changed with time not based on research but on theory. Either way, your right to do so or not should be unalienable. Forced vaccination raises the same ethical arguments of the Nuremberg Trials. I am far less concerned about the possibility of more disease or more injuries. Those will cycle. If you do your best to stay healthy, your risk for either is very low. I am much more concerned about the loss of freedom. What happens when you disagree with your doctor about a procedure for you or your child in the future? Will you be forced to do the procedure anyway? Will your child be taken from you? It sounds crazy but please consider that control is always the end game even if it sold for benevolent reasons.

***Photo by Hyttalo Souza on Unsplash

 

 

Chiropractic Adjustments Help the Autonomic Nervous System

The Autonomic Nervous System has two major components, the Sympathetic and the Parasympathetic. As the name implies, these systems work without thought. The Parasympathetic Nervous System controls digestion, reproduction, waste elimination, and rest. The Sympathetic Nervous System controls activity, stress, and adrenaline. The quick way to remember is that the Parasympathetic is rest and digest and the Sympathetic is fight or flight.

The two components work opposite of each other. When one is running the other defers. I like to compare it to kids on a see-saw. When one is up the other is down. When you have two relatively equal sized kids, the see-saw works well, same as a good balance in the Autonomic Nervous System. Problems arise with imbalance.

When a person has dysfunction in the spine it tends to increase Sympathetic flow. All of a sudden, we have a big kid vs. a small kid on the see-saw. With increased Sympathetic flow, the body stays in a state of agitation at the detriment to rest and digestion. This can lead to a multitude of conditions and symptoms.

Chiropractic adjustments help to restore function which helps to balance the Autonomic Nervous System. In this way, Chiropractic can help with conditions that are not musculoskeletal in nature. Chiropractors often get a bad rap for claiming to work on things like heartburn, indigestion, sleep, constipation, heart palpitations, vision issues, and the list goes on. The truth is that many of these conditions arise because of an imbalance to the Autonomic Nervous System. So, when your chiropractor asks, tell him about all of your symptoms and conditions.

Chronic Back Pain Vs. Fibromyalgia

I have observed over the years that when patients are in chronic pain for a long time and seek help repeatedly from their medical provider, eventually, they will be diagnosed with fibromyalgia. Providers often diagnose patients with fibromyalgia as a way to encourage the patient to stop seeking care. The reality is that most of the time the provider does not have an adequate answer as to why a person has pain nor do they have any way to help. They label it, generically, as fibromyalgia. I empathize with these patients and their providers.

Fibromyalgia, one can argue, is not really a diagnosis but a description of symptoms. Etymologically, it means pain in the fibrous and muscle tissues. Most providers act like there is no real cause. Many providers assume the patient is either a symptom magnifier seeking drugs or just emotionally unstable. In my experience, more often than not, the real issue is chronic pain and can be traced back to a source with enough work. Finding the right professional to diagnose and then to treat can be daunting, however.

The causes and treatments for chronic pain are vast. Hope can be easy to sell but is often difficult to deliver. Possible causes can be osteoarthritis (wear and tear due to time or injury), auto-immune arthritis, chronic subluxations or joint dysfunction, poor posture, stress, muscle knots, referred pain from internal organs, hormone imbalances, etc., or a combination of all of the above. When I treat someone with chronic pain, I am not always successful. Sometimes, when I am successful, it may not be long-lasting. Most people I can ease some of their discomforts, at worst, or help them heal altogether. Patience and paying attention to subtle changes is the key to figuring out what is causing the pain.

It can be daunting to figure out a path to improvement. Chiropractic is a great place to start. If improving joint function and nerve flow helps, then keep going. If the help is only very temporary, like less than a couple of days of relief after months of care, then you may need to add massage or some other muscle or fascia work. After that, you will need to explore various internal issues. I would refer you to a good Naturopath or Functional Medical Specialist. Now you have to consider internal organ dysfunction. Gut issues are the most common. In addition, assessing hormone function is very important. Finally, do not rule out the psycho-somatic component. PTSD (Post Traumatic Stress Disorder) can make it so that healed physical pain lingers. The pain is no less real but one must manage their emotional issues before complete recovery is achieved. Temporal care along the way is still beneficial.

If you are suffering from chronic pain or have been diagnosed with Fibromyalgia, don’t be afraid to try a host of treatments. Start conservatively and work from there. Be wary of embellished claims of immediate or permanent relief but, also, don’t lose hope. At the very least, I am positive there is someone who can help you manage your pain.

***Photo by Jesper Aggergaard on Unsplash