A recent study found that an herbal formula used in TCM can reduce the risk of people with prediabetes from developing Type 2 diabetes by 32 percent. In other words, simple, inexpensive and safe herbs are as effective in preventing Type 2 diabetes as the prescription drugs acarbose and metformin.
If you are concerned about your risk of diabetes, my suggestion is to start with the safe and proven methods that have been in use for centuries.
Patients have frequently come to me saying that previous doctors have told them that their illness is "all in my head."
My response has always been, "Absolutely!"
Virtually all diseases -- from allergies to cancer to heart disease -- have a mental or emotional component. The only diseases which are free of this association are those which are directly traceable to inherited genetic malfunction. One of the core principles of Traditional Chinese Medicine is that all disorders manifest themselves both physically and emotionally, and the doctor who diagnoses or treats only the physical manifestations of an illness is failing his patient. The distinction between mind and body is a false one. They are merely different faces of the deeply intertwined functions of life.
Western medicine is slowly catching up to this 3,000-year-old concept, as a growing body of research demonstrates that what influences the emotions influences physical health. The most recent article to joint this corpus is this study, which shows that among primates, immune system functioning is closely tied to social rank. Female macaque monkeys lower on the social scale had lower-functioning immune systems; but most importantly, when the monkey moved up or down the social hierarchy, their immune system followed.
If you look at all of the research on illness and social environment, I don't believe it would be too much of a stretch to conclude that changing one's friendships and social organizations can have a dramatic effect on health. But it goes beyond the old bromide "those who lie down with dogs are going to get fleas." In other words, it is not simply exposure to noxious organisms and toxins that will determine our health, but the entire social milieu in which we exist which determines our health.
So what does this mean to you and your health?
Take a look around you. Who are your friends? Is your social circle based on mutual respect? As is the case for many men, their peers and friends are also often their competitors in their games of pleasure, but winning and losing can be grounds for either contempt or camaraderie. Women similarly compete, sometimes in sports, but more traditionally through more subjective measurements than game scores or race times, and sometimes through surrogates such as their children. "Winning" and "losing" in this environment is amorphous at best.
Examine the formal social structures to which you belong. Is your church, synagogue or temple one in which the beauty of the person is celebrated? Or is personal esteem torn down in obeisance to a vengeful, demanding cosmos? Similarly, how respected do you feel by the other members of your book club, health club, or guild?
If, in any of these realms, you do not feel respected, it may be time to change venues. The respect others have for you not only influences your own self-esteem, but may be part of the cause of health problems you have been having.
To change your health, maybe you first need to change your friends.
Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.
Encouraged by a recent conversation with a patient, I purchased a new translation of the Yellow Emperor's Classic of Medicine, or Neijing Suwen. The Neijing is the fundamental text of Chinese acupuncture, written in the second century BCE, and continues to have relevance in its exposition of the guiding principles of Chinese medicine. Interestingly, much of its analysis is also congruent with a more modern understanding of physiology.
As I re-read this classic, I was once again struck by the importance that the Neijing places on both environment and mental health as a component of disease. Western medicine is only today beginning to catch up to where Chinese medicine was over 2,000 years ago. The idea that the healthy individual adjusts his habits to suit the season contradicts our modern way of life, where we use technology to create an environmental bubble in which we believe we can live without having to change ourselves, even while our surroundings go from freezing to sweltering and from desert to swamp.
It is a false belief, of course, as our technological bubble has as many holes as a piece of swiss cheese; and furthermore, evolution has not adapted us for a static, pasteurized environment. We need our cold and hot, our wet and dry, even our bacteria, in order to be healthy. Indeed, the Chines doctors of the Han period were probably the first environmentalists of humanity.
Living in harmony with one's environment is stressed as an important health measure throughout the Neijing. Environment and season dictates the healthy person's sleep schedule, type of work and foods to be eaten. And so it is with the season we now entering:
"The three months of the spring season bring about the revitalization of all things in nature. It is the time of birth....During this season it is advisable to retire early. Arise early also and go walking in order to absorb the fresh, invigorating energy. Since this is the season in which the universal energy begins anew and rejuvenates, one should attempt to correspond to it directly by being open and unsuppressed, both physically and emotionally."
These words were written over 2,000 years ago, but are no less true today. Research published this month has found that our very genes work in synchronicity to the seasons, and this is the very same effect that the Neijing refers to as "universal qi." With the seasons of the earth encoded in our DNA, genes are turned on and off in accordance with the time of year. Not only are our wake/sleep cycles altered, but our bodies are attuned to the type of nourishment that we should be receiving at that time of year, and genes are turned on or off accordingly. The authors of this study conclude that a "loss of rhythmicity or a change of phase may alter the physiological array or rhythms...leading to metabolic derangement and disease, i.e., chronopathology."
Diseases currently linked to chronopathology include cardiovascular disease, depression, pancreatitis, ulcers and other gastrointestinal disorders.
So how does the Neijing suggest that we respond to the changes wrought by spring?
"On the physical level," it suggests, "it is good to exercise more frequently and wear loose-fitting clothing. This is the time to do stretching exercises to loosen up the tendons and muscles. Emotionally, it is good to develop equanimity."
Nutritionally, the book recommends reducing our intake of sour flavors, and increase sweet and pungent flavors. Good spring foods include onions, leeks, leaf mustard, Chinese yam, wheat, dates, cilantro, mushrooms, spinach and bamboo shoots.
This is good advice for any time of year, frankly, but it particularly makes sense in the spring, as we transit from our cramped and immobile winter selves to our more active summer selves.
The need to keep oneself physically and mentally in harmony with our environment is why I have many of my patients return at each solstice or equinox. These astronomical events, representing the change from one season to the next, are good markers for us to take stock in our health and adjust what needs to be adjusted. Sometimes the adjustment is needed in the spine, sometimes in the diet, and sometimes in the acupuncture meridians. But it just makes sense to prepare yourself ahead of time for the challenges -- and joys -- of the upcoming season. Once again, the Neijing offers us wisdom on this:
"Treating an illness after it has begun is like suppressing revolt after it has broken out. If someone digs a well when thirsty, or forges weapons after becoming engaged in battle, one cannot help but ask: Are these actions not too late?"
It is always my goal to be the doctor who treats the illness before it appears.
Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.
Self-appointed "skeptics" frequently point to practices such as mine, claiming that I'm engaging in nothing but voodoo witchcraft, preying on those so ill and so without hope that they will grasp at any straw proffered them, ante up any outrageous fee desired, and dearly pay for the false hope which I and my colleagues allegedly peddle.
My patients, of course, know the reality is far different. They know me as a hard-headed pragmatist, whose foremost rule is "Find it, fix it, and get out of the way." They know me as a doctor who will rather unflinchingly -- though I hope not unkindly -- point out how they have contributed to their own ill health, while also finding ways they can repair the damage. And they know that my fees are modest; I am unlikely to bathe in gold coin anytime soon from the revenues of my practice.
What they don't know, unless they ask, is that each discipline that I practice, whether it is chiropractic, acupuncture, or herbal/nutritional therapy, is supported by a wealth of scientific research that supports every modality that I use.
When I have used acupuncture to treat children with Tourette's syndrome -- usually successfully, I might add -- I can point to not just one, but several studies that support and guide my intervention.
When I blend a custom herbal formula for a patient suffering from a cold or urinary tract infection, I am relying on studies which show me that the herbs in question are more effective than anything in the MD's formidable arsenal. Though of course, the FDA would have the fantods were I to be so foolish as to make the claim that herbs can actually kill the bacteria causing the infection, even though studies exist demonstrating that very fact. So I won't make the claim that herbs can help cure the common cold, even though substantial research exists supporting that statement.
And when I explain to an acupuncture patient that Qi is a life-force running through their body, and that the flow of this Qi can be altered by placing needles at certain points along that flow, I know that I am using a time-tested analogy for a phenomena that we are only beginning to touch upon in Western science. It is likely that this Qi is actually a form of intercellular communication, and that acupuncture alters the nature of that communication. When you begin to change the body's command and control systems, your results are going to be powerful and intersystemic, which is why both acupuncture and chiropractic have such profound effects on people. Chiropractic adjusting, through its influence on neural communication, and acupuncture, through its alteration of intercellular ionic flow, are both acting on a meta level, thus their widespread effects.
With all of that said; with all of my adherence to the logical discrimination of disease and therapeutics, and my hard-headed emphasis on results, I cannot ignore the power of my patient's spirits, nor their immeasurable will to survive, improve, and in some cases achieve a level of health they never thought possible. Where does this will come from, and how does it manifest its results? Most importantly from my perspective, how can I help my patient harness that power?
Multiple studies have shown that intercessory prayer have little effect on disease outcome. Nonetheless, it is often through their religion or spiritual beliefs that people harness that powerful exercise of volition which dramatically alters the course of their disease.
Despite increasingly frequent forays into this domain, the realm of the spirit remains largely opaque to the otherwise piercing lenses of science. There is some evidence that our brains are hardwired, as it were, to engage in spiritual practice; to "believe" in unquantifiable, unmeasurable forces which help to direct our lives. And those familiar with the work of Carl Jung and subsequently Joseph Campbell will recognize the hero myth as the unifying essence of almost all religions. Neurological research has shown how the regular practice of meditation, independent of the specific religious tradition of the meditator, can create long-term alterations in our brains. Nonetheless, these scattered breadcrumbs only beg the question of how these beliefs unlock such potent personal power that the course of a disease can be radically altered.
This is a question worthy of consideration, particularly today, when much of Christianity celebrates the birth of its central figure. And as I drove home from a family gathering last night, I could not ignore the beauty and tranquility exuded by the churches I passed, all decked out for their celebrations and lit with candles for their midnight services. There is a compelling power there, not just in Christianity, but in any religion as it expresses the majesty of its office in our affairs. From the miraculous birth of Jesus to the transcendental satori of Gautama Shakyamuni to the revelations of the cave-dwelling Muhammad, there is a common thread from which has emerged some of the most beautiful expressions of art, literature and music of which humans are capable.
To that I would add religion's ability to give us the power to manifest our ideal selves in the physical realm as well as the sphere of ideas. While I cannot explain it, I would be a fool to ignore it, though it is clearly not in my scope to harness it. That is more truly the realm of the priest, the roshi, the imam. As a doctor, I must remain ecumenical to best serve my patients.
To me, this day marks both a beginning and an end. It is the end of the work year for me, and over the next week of "vacation," I lay the foundations for beginning the new year. I am looking forward to the changes I hope to bring about, both personally and in my practice. And I know that this question, the role of spirituality in health, will be one which will invite me back to ponder its challenges throughout this year. I am looking forward to the conversation about to ensue.
And I am also, as always, incredibly thankful to my patients who continue to be my most influential teachers. Thank all of you for your trust in me, and thank you for permitting me to join you down the short segment of your path that we are traveling together. I hope my guidance has not led you astray, but assisted you to become more of who you want to be.
And to all of the readers of my blog, thank you for your attention and your feedback. You encourage me to continue these public musings and consider new topics and new approaches.
Happy Holidays to all! I look forward to seeing you in 2012.
Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.
It may be entirely apocryphal, but I was once told that in ancient China, it was the practice to pay your doctor when you are healthy, and your payments would stop when you are sick. This economic model -- the wellness model -- makes far more sense than our current system, in which physicians, including myself, make more money from you being sick than being healthy.
If you look at any other industry, it is apparent that the medical habit of paying for failure is entirely topsy-turvy. Should you pay the airline for not getting you to Hoboken in time for Thanksgiving at Aunt Marcy's? Should you tip the waitress more for bringing cold coffee and yesterday's French fries? Of course not. But when it comes to health care, the sicker you are and the longer you take to get better, the more your doctor makes.
What brought this to mind recently was my daughter's acceptance into college, and the concomitant realization that I was now on the hook for a considerable annual fee to join the august club of College Student Parents. I was bemoaning my fate to a friend who also happens to be a patient. They just looked at me and said:
"You know what your problem is, doc? You get your patients better too fast."
Well now, there's a concept. In what other industry could I possibly be in where I actually hurt myself financially by improving my performance?
The medicopharmaceutical industry has neatly tied up both ends of this ribbon. On the one hand, they create new diseases, find ways of convincing you and your non-chiropractic doctors that you have it (adult ADHD, anyone?), then sell you on a lifetime of pills to fix it. The Great 20th Century Statin Deficiency is another example. Through corrupted research and savvy marketing techniques -- up to and including the use of prostitutes at medical conferences -- the pharmaceutical companies have deluded millions of healthy Americans and their medical doctors into believing that they must take their daily dose of statins to survive. Nothing could be further from the truth, of course, but there's nothing wrong with a healthy revenue stream, is there?
On the other hand, they market drugs as tools of disease prevention, all the time knowing that the nostrums they peddle do little to encourage better health. A perfect example of this are the bisphophonate drugs, such as Fosamax. We now know that bisphonates not only fail to create healthier bone, they also kill the very bone that they are supposed to strengthen.
Long before reaching that fraudulent extreme, however, there is a sound basis for wellness, or preventative care.
Both proper diet (a term I am loathe to use these days, as it has been sorely abused by the media) and exercise are, of course, the foundations of preventative care. But aside from these factors, what should be stirred into the mix of preventative care?
Here's what the research shows us:
And that's just chiropractic manipulation alone. What about the other services provided by chiropractic physicians?
Acupuncture is one of the therapeutic approaches I use the most for treating people with a variety of existing conditions. But does it make any sense at all to adopt a "preventative acupuncture" strategem?
The research on this topic is surprisingly vacant. While a number of studies have discussed the effectiveness of acupuncture for early intervention in disease processes, this is far from the idea of wellness. A few articles have noted that traditionally, regular acupuncture at certain points has been regarded as beneficial for seniors.
I'm not going to hold my breath waiting for some research to appear, however. Government funding for acupuncture research is only slightly higher than the homeopathic doses grudgingly dispersed for chiropractic manipulation. So how do we decide?
I remember when I posed this question to one of my acupuncture professors: How often should we have a patient return for preventative care?
He didn't break stride. "Of course," he said. "When the universe changes." And then he went on to discuss some observations of the more esoteric uses of Bupleurum.
The answer didn't make sense to me at first, but as I puzzled over it during the following week, I finally realized what he meant. The aim of acupuncture -- indeed, chinese medicine as a whole -- is to put the individual in balance with the environment. Any time that there is a change in the person's environment, they must respond by altering their metabolism and behavior. (This process is known as "homeostasis" in modern biology). Thus, when the universe changes, the individual can use assistance that acupuncture provides in adapting to the altered environment.
When does the universe change? We need look no further than directly around us to tell. When the fresh green of springtime appears, the universe is changing. When the leaves turn brown and fall from the trees in autumn, the universe is changing. At the height of summer, as the sun ascends to its northernmost latitude above the equator, the universe is changing. And, finally, in the dead of winter when the day's length reaches its nadir, the universe is changing.
The change in seasons does, in fact, affect our health. The fluctuation in communicable diseases, mental health, and the course of some chronic disorders is profoundly affected by the time of the year.
So, from a very practical standpoint, it makes sense to evaluate and adjust your position in the universe as the universe itself changes. And in the absence of more precise clinical data, it is on that concept that I rest my recommendations for preventative -- or should we say adaptive -- acupuncture.
See you when the universe changes!
On the surface, it was just another typical moment in a chiropractic physician's office. I was walking down the hall from one treatment room where I had just left a patient with an injured knee, to check on another patient who was receiving care for a painful shoulder.
But on that short walk down the hall, I was actually walking the long divide between two health care paradigms. While the patient with shoulder problems was receiving what would normally be considered "standard" treatment -- heat, ultrasound and chiropractic manipulation -- the patient with the bum knee had several acupuncture needles inserted around her knee and ankle.
In one room, the basics of applied physiology were being utilized: Heat was being used to perfuse the injured area with blood, bringing with it oxygen, nutrients, and other supplies for healing, and taking away the detritus of repair. Ultrasound was altering the permeability of the cell membranes, allowing the injured tissues to more readily imbibe the blood's bounty. And joint manipulation was restoring normal physiological shape and function to the ligaments surrounding the joint.
But in the other room, a completely different process was apparently taking place: The normal flow of qi, a nebulous "life energy," was being restored. Excess yang, represented by the heat of inflammation, was being quenched by employing the water principle of the body, as water is always used to put out a fire; meanwhile, meridians controlling the patient's earth energy were used to nurture the damaged tissues.
How do I, as a doctor trained in both eastern and western medicine, reconcile these two utterly divergent approaches? One is so clearly logical and wrapped in the science of the west, while the other explodes with image and allegory, as if the needles tell a parable of health in their placement and actions.
And with increasing frequency, I find that I not only combine these disparate therapies in my practice, but in the treatment of singular patients. Some patients receive both chiropractic and acupuncture. Some are treated with eastern herbs and western physiotherapy. Others are treated with western nutrition and acupuncture.
"Do I contradict myself? Very well then I contradict myself," said the poet Walt Whitman. "I am large, and contain multitudes."
Perhaps the best way of uniting these two approaches to human health which do not speak the same language either literally or figuratively is to apply the principles of scientist and philosopher Alfred Korzybski which can be best summed up by this statement:
The map is not the territory.
That's a mouthful, I know. An easier way to understand the concept is to imagine two maps of the same place, for example Ansonia, Connecticut.
One map is a road map. It clearly shows all the roads in the area, what their names are, and where they go.
Both maps show us the exact same territory. But they provide us with entirely different types of information.
In the pursuit of understanding, we all too often forget that the theories and hypotheses that we make -- the maps, as it were - are only maps. They are not the territory itself. The map of the human body developed by western medicine is certainly not the only map, nor is it the "true" map. It is merely a map that shows us certain characteristics of that territory. Imagine the arteries and veins as roads, the organs as cities and villages, the nerves as railroad tracks...you get the picture.
The map developed by Traditional Chinese Medicine shows us different features of the human body. Instead of roads and tracks, we see the swamps and the forests, the peaks and the valleys. Entirely different information, but also of great value as I help my patients navigate their way back to health.
Is one more valid than the other? I think it would be the height of arrogance to claim that the western medical map was superior to the eastern. After all, 100 years ago, the eastern map of human functioning was already highly detailed and had been refined for centuries, while western medicine was still scrawling "here be dragons" on the margins of its crudely-drawn understanding.
I employ both, because I find both to be useful. They help me and my patients reach their destination. And as I continue to proceed along the twin paths of east and west, I find that I can increasingly see one in the other. From the road I see the hills, and from my path in the hills I can hear the hissing of cars on the road. I think -- I hope -- that my patients will be the beneficiaries of this understanding. As the wise Siddhartha said, "In the sky, there is no distinction of east and west; people create distinctions out of their own minds and then believe them to be true."
I'm kicking off this year's fall/winter lecture series with what I think may be one of my best -- and most important -- lectures ever. It will be held at 7 p.m. at the Litchfield Community Center, on September 22.
The title of the lecture is What To Do When The Drugs Don't Work, and will discuss the ways that alternative medicine can assist people suffering from chronic illness.
From diabetes to heart disease to osteoporosis, 45% of Americans suffer from one or more chronic diseases. Chronic diseases cause 7 out of every 10 deaths; they significantly impair your quality of life; and they account for 81% of all hospital admissions.
The bad news is that these diseases are poorly managed with drugs, and even when they are, the side effects can make the 'cure' almost as bad as the disease.
But the good news is that many chronic diseases can be prevented or controlled without drugs.
It will be a 90-minute lecture, and at the end, you will learn how to take control of your health and prevent or manage your chronic illness without becoming dependent on medicines. Using research and science-based strategies, Dr. Jenkins will demonstrate why non-drug therapies are more effective, less expensive, and better for your health.
All seminar attendees will receive a workbook which will help them develop a custom health plan that matches their needs. Attendance is free of charge, but registration for the seminar is required. Call 860-567-5727 and ask Teresa to reserve your seat.
Believe it or not, the treatment of mental health problems constitutes a fair amount of my practice. People who are stuck in the chiropractor = back pain paradigm get all squinty-eyed when you bring this topic up. But the fact of the matter is that every chiropractic physician has had training in the evaluation and treatment of depression, anxiety, and other behavioral issues. It is part of our standard education. It has also been a substantive part of my postgraduate education as well.
While the squinty-eyed among us may find this hard to accept, the use of drugs to manage moderate mental health issues is (thankfully) on its way out.
The first death knell in the pharmaceutical paradigm was sounded several years ago, when the American Psychological Association published a groundbreaking article, Listening to Prozac, which found that the effect of the most common type of antidepressant medications such as Prozac were largely due to the placebo effect -- that is, Prozac works only because people believed that the pills would work, because their medical doctor told them so. According to this and subsequent studies, SSRIs -- the class of drug to which Prozac belongs -- are almost next to useless.
With the pharmaceutical option on the ropes, people suffering from anxiety and depression are increasingly looking to their chiropractic physicians for relief.
And, fortunately, we have some answers.
First of all, since chiropractic doctors don't live in the pill-for-every-ill world, we're more comfortable with approaches like talk therapy. I, for one, have a ready list of therapists with a variety of skills and specialties whom I frequently turn to for co-management of these disorders.
And as you might imagine, mental health problems are no mystery to Traditional Chinese Medicine. Interestingly, TCM diagnosis and analysis of these problems is very sophisticated. Though, in the peculiar idiom and allegory of TCM, the diagnoses have some inadvertantly humorous names, such as Plum Pit Qi, Oppressive Ghost Dreams, and my all-time favorite, Running Piglets:
I'm very sorry Mrs. Jones, but you've got a bad case of running piglets!
Humor aside, through the intelligent use of acupuncture and herbs, I have been able to help many people with depression and anxiety disorders.
Another drug-free approach to mental disorders is through nutrition. Nutritional treatment for depression has made great strides since the mid-nineties, when the approach was generally to just throw St. John's Wort at the patient and call it a day.
Today, I am most likely to order a couple of laboratory tests which can tell me a great deal about the physiological origins of the patient's mental complaints. Much can be understood about the neurotransmitters and hormones that affect mood with relatively inexpensive urine and blood tests.
That information takes much of the guesswork out of treatment, and allows me to objectively measure the patient's progress.
Finally, there is the lifestyle counseling that chiropractic physicians revel in. Changing diets, changing exercise, changing habits -- all of these can greatly contribute to mental health.
So, can chiropractors help people with anxiety or depression? Indeed we can, and in this office we do so nearly every day. It is not quackery; it is solid science and clinical decision-making. And, unlike the alternative drugs, the research shows that chiropractic care for mental disorders works.
Every organization needs principles. Even the bad organizations, the ones that rob you blind, pick your pocket and leave you bleeding in the alley (think "insurance companies") have a set of guiding principles, however warped and twisted they may be.
I've always liked to think of my practice, the Center for Alternative Medicine, as one of the good companies. And for most of its existence, it has only had one stated principle. In organizational management language, its mission statement would go something like this:
The mission of the Center for Alternative Medicine is to provide therapeutic interventions in a health-affirming environment to eliminate disease and dysfunction and enhance the well-being of the residents of Litchfield County and surrounding areas, without regard to race, age, sexual orientation, gender or financial status.
I've always preferred the short version: My job is to make people better using whatever means I have at hand. I'll take on all comers.
But the fact of the matter is, even the plain-language version embodies a number of underlying principles. And it wasn't until I was preparing a speech for the annual meeting of the Connecticut Society of Medical Assistants that, for the first time in 15 years, I sat down and actually elucidated them.
What came out of it was interesting. My 7 Core Principles, I've come to call them. And they truly are the principles that make this doctor, and his practice, tick.
This is latin, meaning "First, do no harm." It is my job as a doctor to, more than anything else, avoid injuring my patients. This principle is why I became the type of physician that I am. Although the mainstream medical community pays lip service to this principle, you could hardly call it a guiding element of medicine's philosophy. If it were, you would see a lot less blather about rising malpractice rates, and a lot more effort directed toward reducing malpractice. (Did you know that the number one cause of non-traumatic death in the U.S. is medicine? And that's according to published research.)
In contradistinction, my interventions for the same conditions are far safer and at least as effective, if not more so (fertility treatments, for example. Recent research has found a higher success rate for acupuncture than for the far more risky IVF.)
This simply means that I place my focus not on a single system, such as the cardiovascular system, or the pulmonary system, or the digestive system. Instead, I evaluate patients in terms of these systems' interdependence. Or, as the brilliant Buckminster Fuller in his dense eloquence has stated: "Synergy is the only word in our language that means behavior of whole systems unpredicted by the separately observed behaviors of any of the system's separate parts or any subassembly of the system's parts. There is nothing in the chemistry of a toenail that predicts the existence of a human being."
Understanding the whole by examining the interconnectivity of its parts -- the data network, if you will, that allows the brain, heart and stomach to coordinate their activities -- has led me to solutions for patients who have suffered for years and whose well-known specialists proved ineffective. In fact, it was precisely because they were specialists that they could not see the solution.
Another way of saying this is that when the only tool you have is a hammer, everything looks like a nail. Any repairman worth his salt will equip himself with an array of tools, of the finest quality possible. A chiropractor who only adjusts has only a hammer; the medical doctor who only dispenses drugs posesses only a wrench.
I've got wrenches, hammers, pliers and a full set of torx drivers, by gum. And I'm not afraid to use 'em.
An accurate and finely-grained diagnosis is the key to success when you are doing alternative medicine. To properly treat my patients, I need to know more than that they simply have a case of sinusitis. I need to know why. I need to know what put that patient in a state that made them susceptible to this bug, and why they responded as they did. With that knowledge in hand, I can then go about fixing the underlying problem. To my mind, this is better than patching it over.
Ok, I did use some fancy words here, but I could find no others that could capsulate my intended meaning. I have found over the years that the greatest success comes when I work together with my patients to solve a problem. I work often as a mentor, a coach, a teacher. But I advise and recommmend -- never do I dictate. I work as a partner with my patient, and we each shoulder part of the burden.
This type of care cannot happen if a doctor is standing on a pedestal issuing commandments. The feedback and course modifications necessary to any successful outcome is missing in such a relationship.
Many of my patients come to me with problems they have dealt with for two, three, or five years. Rarely am I going to get a resolution in a week or a couple of visits -- though sometimes I have seen it happen. And for all my patients, I am looking not only how their health is now, but how it will be 20 years down the road. Because right now is the time to create the environment for future health.
Call me lazy if you want, but I prefer to figure out how I can provide the most benefit to my patients with the least intervention. This reduces the patient's costs, and it also refers directly back to principle #1. By minimizing my interventions, I also minimize any risk to the patient.
To me, therapeutic minimalism has a certain aesthetic appeal to it. Occam's Razor proclaims that the simplest answer in science is most often the correct one. And, the most minimal of equations, e=mc2, explains nearly an entire universe in four simple symbols.
So that's it. My Core Principles, if you will, the entirety of my practice philosophy. I found that developing and elucidating these core principles to be a valuable process, one that has given me insight into my professional past and a glimpse into its future. I recommend this process for anyone, especially to examine your personal life. You might discover some things about yourself that you thought you didn't know.
I've just been selected as one of the on-line experts at MDinfo.com. Don't be confused by the name. There are a lot of smart doctors on there handing out good advice.
If I do say so myself.
Sometimes I kind of feel bad about always pointing out the shortfalls of my medical colleagues, as I noted a couple of posts ago. But then I get yet another reminder or two of why I just can't get the warm fuzzies about them. My most recent bout of slap-me-Emma-I-must-be-sleeping medical foolishness began late last week, when a patient told me that her MD did not mind her seeing me, so long as I was not trying to treat disorders like diabetes and asthma.
Screeech! Back that up a second and replay it. Don't treat diabetes? Or asthma?
I'm sorry, but the most common form of diabetes, Type 2 diabetes, is the quintessential lifestyle disease. It is caused by a combination of couch potatoism and a lousy diet, usually leading to obesity. Any doctor, medical, chiropractic or otherwise, should know that fact, since just about everybody else in America does.
And, frankly, I'm the quintessential lifestyle doctor. To say that my knowledge, skills or tools are inadequate for the treatment of diabetes is like saying that a Porsche is an inadequate car for the Autobahn. OK, even to me that sounded a little cocky. But you know what I mean.
I don't think I even need to point to the research here, except to remind my readers that time after time, the research has demonstrated that lifestyle intervention should be the first line of therapy for diabetes. Ergo, the first stop for someone with this disorder ought to be a doctor board-certified in, nutrition, perhaps?
I'll grant you, however, that alternative treatment of asthma might be a little obscure for the average MD to have picked up on. But the research is there.
For example, in October, 2002, Ray Hayek, PhD, released the results of his 420-patient study at the International Conference on Spinal Manipulation. Dr. Hayek found that patients treated with spinal manipulation for asthma improved not only symptomatically, but demonstrated positive immunologic and hormonal changes in laboratory testing. (For you citation mavens, the abstract may be found here.)
Another study, albeit of small size, found that children combining chiropractic treatment with medical management of asthma experienced a substantial decrease in symptoms with an increase in their quality of life. (Look here for details.)
Which brings me back to one of my earliest experiences as a chiropractic physician. A little over a year after opening my first practice, a patient came busting through the door of my office, clearly in distress.
She was having an asthma attack, and communicated to me that she had left her inhaler at home. I had my assistant call for an ambulance, but I also knew that the arrival of a volunteer squad in my rural town might not be quite timely enough. Having heard the stories as a student doctor of chiropractic physicians treating asthma, I did that which I was best trained to do.
I had the patient lay face down on the treatment table, while I palpated the thoracic vertebrae for restrictions, and adjusted them with a quick thrust.
As quickly as it began, it was over. The patient sat up, already exhibiting patent relief, and within a minute was breathing normally.
I lectured her on the foolishness of being asthmatic and wandering about without her inhaler. When the ambulance arrived, she refused the ride and went home to obtain the missing pharmaceuticals.
So can chiropractic physicians treat asthma? Yes, and apparently quite well, thank you very much.
That said, it is clear that asthma is one of those disorders that lies at the intersection of conservative and pharmaceutical care, and patients with asthma would probably benefit best by appropriate employment of both forms of care.
It's just a crying shame that medical doctors, unaware of the research and informed only by longstanding bigotry, would advise our common patients to avoid the treatments which may help them most.