Thank you, and happy anniversary.

Six years ago, I took a pretty big gamble. At what turned out to be near the peak of the real estate market, I bought a building that had, since the 1960s, been a veterinary office. I spent an ungodly amount of money to convert it from an animal doctor's office to a people doctor's office, and closed my otherwise thriving practice in Kent to focus all of my efforts on an entirely new beginning in Litchfield.

While I enjoyed my practice in Kent, I came to feel that it was too limited. I opened that practice directly from my internship and graduation, and took my first few years in practice to start adding onto my  base knowledge. My first milestone was achieving board certification in clinical nutrition, followed a few years later by passing another specialty board, and becoming a Fellow of the International Academy of Medical Acupuncture.

My goal had always been to become a holistic GP, the physician that people could turn to for drug-free treatment for all types of disorders, not simply back pain, neck pain, or headaches. And in Kent, I was able to acquire and build on those skills. But I realized that to become the type of physician that I wanted to become, I needed a location that needed me.

So when the vet's office in Litchfield went on the market, I jumped at the opportunity. And though it was a massive financial gamble, by that point in time, I had become mildly inured to that sort of thing. After all, I had left a journalistic career that had put me among the top 5% of freelance writers in the country to go back to chiropractic college and start from scratch.

Still, to be honest, I was a little nervy. This time was a bit different. Now I had a family, two kids, and a house with a mortgage; and here I was adding a second mortgage to the list, while rebooting my practice. You would have to be made of stone not to get a little jittery.

To keep disruption to a minimum, I planned to move my office over the course of a weekend, and start seeing patients just a day or two thereafter; and this was all to occur almost minutes after my general contractor pulled his last employee from the building.

The trouble was, I lacked a Certificate of Occupancy.

I scheduled the inspection for two days prior to re-opening. The inspector, a very nice man, was also thorough -- and found one electrical problem which prohibited him from issuing the certificate.

In a panic, I called up my contractor. His receptionist, no doubt used to such calls, assured me that all would be fixed in record time. And to his credit, it was. The electrician was out the next morning, and corrected the out-of-code electrical wiring. I invited the building inspector back for the following morning.

He came. He approved. He issued my Certificate of Occupancy.

And 45 minutes later, on April 6, 2007, my first Litchfield patient walked through the door.

Within months, I realized that I had made the right decision. Growing mostly by word of mouth, patients started coming to see me, not only for what chiropractic adjusting could do for them, but also for nutritional and acupuncture treatments for a variety of disorders. Within the first year, many  of my Kent patients who had stayed behind returned to the Litchfield practice (rightfully grumbling about the longer commute, it might be said).

Six years later, I have co-created, with the help of my patients, the practice of my dreams. I have patients coming to see me, not just from Litchfield county, but from Massachusetts and Long Island. Each new patient is a welcome guest and a new puzzle for us to solve together. Each day, my skills are challenged, my knowledge stretched, my spirit expanded.

And I would be utterly remiss if I didn't say thanks to Teresa Tuz, my oft-suffering office manager. Teresa had run the Kent office, and (probably against her better judgement), decided to continue the fun with me in Litchfield. She has managed the office through blizzards, floods, blackouts, faced head-on the interminable idiocy of health insurance billing, and along the way has become part of the spirit of the office. I mean, let's face it: When was the last time you heard patient and staff erupt in shared laughter at a doctor's office? But that happens many times a day at Teresa's desk.

The office has also been enriched by my tenants: Dave Pavlick, an extraordinary social worker and expert in the field of neurofeedback, and Christine DC Decarolis, one of the most dedicated massage therapists I have known. She is not only dedicated to her craft, but also to her community, to which she contributes in numerous ways.

Last night, after finishing my chart notes for the day, I locked the door, walked away from the office, and turned to look back. Six years ago, there had been nothing but an empty building, a vision, and a willingness to risk almost everything on that vision. Today, that building has become a place of hope and healing for many. My deepest thanks to everyone who has helped make it so.

The Thing About Water

It was many years ago when the first warnings came out. In fact, a 1999  study found that 22 percent of bottled water brands had at least one sample containing chemical contaminants at levels above strict state health limits. It wasn't long after that when a study from Goethe University at Frankfurt found that a high percentage of the bottled water contained in plastic containers was polluted with estrogenic chemicals.

Since then, the research has just kept piling on the fact that water stored in plastic containers simply isn't safe. Over the past few years, research uncovered the fact that the plastics commonly used for water bottle storage release a chemical called bisphenol-A into the water. Bisphenol-A (aka BPA) is what is known as a "xenoestrogen." Xenoestrogens are chemicals that act like estrogen in our bodies, fooling us into thinking we have more estrogen inside us than we do. This creates numerous problems, for males and females alike. Estrogen dominance is a frequent cause of perimenopausal health problems, and the presence of too much estrogen-like chemicals in men can cause infertility and unwanted physical changes.

Bottle-makers began switching over to "BPA-free" plastics, and all seemed well and good for a few years, until more recent news came in: A full 33% of all plastics leach toxins into food and water, regardless of whether they were BPA-free or not. In addition to xenoestrogens, other toxins were released into the water in as little as 2-3 days, according to a Swedish study.

This would not have a major effect on products such as reusable water bottles, such as those used by cyclists and runners, as those are emptied within hours, long before toxins or xenoestrogens would be able to leach into the water. Which is why I'm comfortable using BPA-free reusable water bottles as one of the rewards for the members of my DocAltMed Fitness Team.

However, it never sat so well with me that the water coming from the bubbler in the reception room of my office was stored in plastic bottles. Even though I had been assured by my suppliers that the plastic was BPA-free, the most recent studies made it clear that there was little doubt that the water I was supplying to my patients was tainted.

One of the key tenets for me as a doctor is that I must walk the talk. The only way, in my mind, that I could possibly have the authority to tell people to fundamentally alter their lifestyles is to live a healthy lifestyle myself. (Thus the bike (or trike) sitting by the door, where I park it after riding it to work.) And it seemed to me that giving people water which has likely been sullied by toxins was probably not in keeping with my core principles, particularly when you consider the amount of my professional life I spend cajoling people to imbibe the stuff.

But it wasn't easy to change. I searched high and low for bottled water companies that would deliver in old-style glass carboys. And, in fact, there is one -- in Baltimore. The Center, apparently, is outside of their delivery area.

Then again, who needs bottled water, I thought? All I really need is a cooler/bubbler, a glass carboy, and a water source. So I had the well water at the Center tested, and it was clean of all of the contaminants that I could test for. In addition, it is moderately hard, giving the well water a pleasing taste.

So a couple of weeks ago, I fired my bottled water company and we went online with our clean, fresh, local water. After getting everything all set up, Teresa and I noticed an enjoyable side benefit. As you draw water from the tap, and the bubbles pop to the surface of the carboy, they make a pleasant and happy "Ping!", very unlike the "blurp" of the old plastic bottles, which sounded a bit like an old man's response to a fatty meal.

So if you would like to sample our very tasty well water, and experience it's delicious Ping!, stop by the Center for a glassful. You don't need to be a patient. Just thirsty.

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.

A Big Win for Chiropractic Patients

No matter where you stand on health care reform, the new law is a big win for chiropractic patients. Although the coverage of health care reform reported nary a whisper about chiropractic physicians, the legislation is set to affect chiropractic physicians and their patients in some very profound and positive ways. First and foremost, the law contains anti-discrimination provisions, which will require insurance companies to cover the full scope of chiropractic services. While you, as a patient, may not see, it, insurance companies have set up a number of roadblocks in front of your care. The first one is that most insurance companies will only pay for one, or maybe two, of the many therapies that a chiropractic physician can perform. So if you need more care than a hot pack and a spinal adjustment, you're out of luck. Either your chiropractic doctor provides the service for free (which is what most of us end up doing) or you get charged an additional fee for your chiropractic insurance "benefit."

The second roadblock is that insurance companies have artificially restricted the diagnoses for which chiropractic care is covered. Usually anything outside of purely musculoskeletal conditions is also outside of your insurance "benefit." Do you suffer diabetes, or heart disease, and are seeking alternative care? Sorry, not covered. Are you looking for fertility treatment that has proven more effective than in-vitro fertilization, is safer, and costs far less? Oops, your insurance doesn't cover that. Would you like acupuncture -- a research proven treatment -- for those chronic sinus infections? We're sorry, but your "benefit" doesn't cover that.

In fact, I'll bet you didn't know that your chiropractic physician could treat those conditions. He can, and that's only the surface. Chiropractic doctors are skilled in treating those chronic conditions that are usually very poorly managed by drugs. But you've never been able to get that care because your insurance company refuses to cover it. In some cases, insurance companies have forbidden chiropractic doctors on their plans to even tell patients that they can provide those services.

But all of that ended with the passage of health care reform. Here's what the president of the American Chiropractic Association had to say:

“Regardless of how you feel about this legislation and its overall impact on the nation, it has to be recognized as an historic first for the chiropractic profession. We now have a federal law applicable to ERISA plans that makes it against the law for insurance companies to discriminate against doctors of chiropractic and other providers relative to their participation and coverage in health plans. Such discrimination based on a provider’s license is inappropriate and now must stop,” said ACA President, Rick McMichael, DC.

“While this does not fully level the playing field for doctors of chiropractic in our health care system, this is a highly significant step that has the potential for positive, long-range impact on the profession and the patients we serve. Congress has finally addressed the issue of provider discrimination based on one’s license, and they have said that such discrimination must stop.”

When this law finally goes into effect, that discrimination will stop, allowing you to utilize your chiropractic physician for the full scope of services for which he is qualified.

And that will be a good day for your health, and a great day for the health of this nation. Perhaps then we will begin to turn away from the pill-for-every-ill mentality that has made us one of the unhealthiest of the industrialized nations.

A Common Conversation

I had a conversation with a patient the other day, one that I've had all too frequently in the past. The patient, someone with chronic neck pain, had gotten impatient with the length of time it was taking her to heal, and had discontinued care. Now she was back in my office, after visits to the MD, PT, and the radiologist.

"I finally found out what was wrong with my neck," she said.

"That's great," I replied. "What is it?"

"I have arthritis!" she said. "My doctor took x-rays." She pulls out a manila envelope and hands it too me. "Maybe if I'd known a little sooner, I could have gotten this fixed."

I left aside for a moment the concept, always a little odd to me, that somehow I wasn't her doctor. I know, it's a chiropractic thing.

"Yeah, you probably do," I said. I ignored the manila envelope. "Doesn't really make any difference, though."

"What do you mean?" she said.

"Look, Sarah, you're 50 years old," I said. "Of course you have arthritis, everybody does by 50. Arthritis is just a medical term for wear and tear on the joints, and if after 50 years you don't have any wear and tear, that would be the surprising thing."

She just looked at me, clearly upset that I didn't share her enthusiasm for her newfound diagnosis and her (real) doctor's "discovery."

"Here's the thing of it," I said. "Those of us who treat a lot of this stuff know that there is often very little correlation between what an x-ray or MRI tells us and the pain and symptoms patients experience.

"Heck, studies show us that 30% of the population is walking around with a bulging disk in their lumbar spine, but most of them have no back pain. I've seen x-rays that showed massive amounts of 'arthritis' and disks that are virtually missing in action, but those findings had absolutely nothing to do with the patient's pain," I said.

"That's why I rarely bother with x-rays or CT scans or MRIs unless I see a red flag when I examine you. In most cases, it's not worth the radiation exposure or cost, because the 'arthritis' isn't the source of your problem."

"That's not what my doctor said," Sarah replied.

"I know," I said. "Let me ask you this -- what did your other doctor do after he found the arthritis?"

"He prescribed some painkillers for me, and I've been going to see the physical therapist."

"Great," I said. "How's it working out?"

"Well, sort of ok," Sarah said. "The painkillers were giving me a stomach ache, so my doctor put me on a different pill, but they aren't really much better than Tylenol. The physical therapy really helped at the beginning, but it's not been doing so much lately."

"Ok," I said. "Here's the thing. The wear and tear you've got isn't really the problem. Chronic pain like yours rarely comes from a single source. It's usually 2, 3, or 4 things all going on at once. If you don't tackle all of them at once, you won't really find a solution."

From that point, I went on to describe a suggested treatment plan -- one that I would have implemented a couple of months ago, had the patient not withdrawn from treatment prematurely.

The problem with this treatment plan is that it requires some lifestyle changes. Regular rigorous exercise, not a few lifts and stretches under the supervision of a mildly bored PT aide. Changes in diet, giving up some favored foods.

These protocols do work for chronic, degenerative conditions. But for so many people, the mental/emotional pain of change -- even healthy change -- is greater than living with physical pain.

By the time I was finished, I could tell Sarah was still unsatisfied with me and my answers. I understand her reluctance. It is much easier to hang your hat on a simple diagnosis -- "I have arthritis" -- than it is to tell your friends "I have a metabolic/muscle movement pattern dysfunction with inflammatory overlays."

Despite my 30 minutes of explanation, Sarah left that day without making any further appointments. I don't know if I'll see her again, but it's likely that if I do, her condition will be that much more farther advanced and more difficult to treat.

Over the years, I've had many patients like Sarah. And sometimes they do come back, and often, with committed efforts on both of our parts, we make inroads.

Sometimes, it's just too late.