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Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
December, 2002, Vol. 02, Issue 12
Living in the Laboratory
By John Upledger, DO, OMM
One day in September 1998, I went to the dentist to have a cavity in a lower molar filled. I had a slate of patients that afternoon, so my dentist suggested I go without anesthetic.It took one shot of air into the cavity to convince me I was not of the ilk to have a non-anesthetized filling. That single squirt of air put me into orbit.
Consider that the right lower molar is innervated by the right mandibular nerve, which feeds into the trigeminal ganglion. This ganglion receives input from the other two branches of the trigeminal nerve: the maxillary and ophthalmic nerves. That shot of air sent a shock into my trigeminal ganglion, which then went straight into the trigeminal nuclei. These nuclei, which are bilateral, extend from the upper pons down through the medulla and into the upper spinal cord.
It just so happens that the trigeminal system has the most plentiful connections to the reticular alarm system of any of the 12 cranial nerve systems. My connections were obviously effective. I found myself in a ready-alert condition that wouldn't quit. I even tried to talk to my reticular alarm system to soothe it, but the relief was only temporary. Then I tried visualizing a gauge from 1 to 100, with the needle pointing at the number representing my level of alertness. My needle was at about 90, nearly to the max. With a lot of hard visualization I was able to get it down to about 30, but every time I got tight again the needle would shoot up to 90.
This went on until the dentist was able to see me again the next week. It was after hours, so he was slightly rushed. As he froze my jaw, he explained that he was doing a mandibular nerve block instead of the usual "infiltration," since it worked faster. Of course, my mouth was full of instruments, so I couldn't object.
As he injected the lidocaine near the medial aspect of my right mandibular ramus, I felt excruciating pain. It felt like he was sprinkling hot embers on my chin from the lip to under the mandible, and from the mandibular notch forward to the vertical midline of my chin. What went on for minutes felt like hours. My rational mind knew instantly that his needle point had pierced my mandibular nerve. In my mind's eye, I could see the two or three cc's of lidocaine fluid separating my nerve bundles and tearing apart the integrity of the supporting structures formed by the glial cells, as the hydraulic forces of the fluid wreaked havoc on my mandibular nerve. I could feel my trigeminal ganglion quivering with anxiety as it sent a continuous SOS message to my reticular alarm system.
At this point, I had to control an urge to run or attack my attacker. Instead I sat quietly, mouth wide open, with all the suction pumps and drills making their noises. I'm sure he did a nice technical job, but by the time he was finished nearly an hour later, I was on full alert.
That evening, the right side of my mouth stayed numb and lacked motor control for about five hours. Then, at about 3:00 a.m. I awoke with an extremely sore throat. It was on the right side, extending through all the hyoid-related tissues down to my right clavicle. The sore throat evolved into a cough which stayed in the throat, above the clavicle. By the next day, the pain was complemented by neck stiffness and right-sided temporal head pain, which involved the right occipitomastoid and the right temporoparietal sutures.
To make a long story short, I was a mess. Unfortunately, I had to fly to Detroit to do a three-hour CranioSacral Therapy presentation the next day. I did fine, but had to work harder to concentrate, and my throat, neck and head still hurt quite a bit. I flew home totally exhausted, which is unusual for me. Instead of recovering, I was deteriorating.
Over the next few weeks, I received sessions in a variety of modalities - CranioSacral Therapy, energy cyst release, SomatoEmotional Release, myofascial release, chiropractic -and started to feel some relief. Then came Sunday, September 27, 1998. My whole world opened up when the root causes of my troubles presented themselves. At this point, my wife Lisa was getting a bit concerned about me. I had never been so exhausted and miserable for such a prolonged period of time - three weeks. I called the dentist's office to find out exactly what he used to inject my mandibular nerve. It was lidocaine with epinephrine.
First synthesized in 1937, lidocaine is a stable local anesthetic, also used intravenously to treat cardiac arrhythmias, especially during catastrophic events such as myocardial infarctions. As an anesthetic, it prevents the generation and conduction of the nerve impulse. The main site of action is in the nerve cell membrane. Supposedly, there is little or no residual effect upon the neuron when lidocaine is used in the small doses required to interrupt impulse generation and conduction. Conventional thought is that when the gross effect wears off and sensation returns, the drug is gone. However, in our Upledger Institute workshop "The Brain Speaks," we have gotten the distinct impression that local anesthetics are stored for long periods of time between the lipid layers of the neuronal membranes. This, in turn, has a long-term effect on the neurons in question: it produces post-anesthesia hyperexcitability.
If you think about your teeth - their crowns, root canals, fillings and things that just don't feel right, or remain hypersensitive to heat, cold, sugar, what have you - it could be that the innervation to these teeth has remained hyperexcitable because of residual effects of the local anesthetics in the neuronal membranes.
Now, let's consider the epinephrine. A synthetic version of a natural hormone that comes largely from the adrenal gland, it's used with local anesthetics because one of its effects is to constrict the blood vessels with which it comes in contact. This keeps the local anesthetic from being too rapidly cleared from the site of injection. The result is a prolonged anesthetic effect. Functionally, epinephrine is adrenalin. Whatever the name, it has a powerful effect upon the sympathetic nervous system. It raises heart rate, increases blood pressure, inhibits visceral activity, and generally increases the alertness of the reticular alarm system. But my reticular alarm system was already riding high. It did not need an epinephrine boost.
Now, back to that Sunday in 1998, when my concerned wife treated me with CranioSacral Therapy. She began by "arcing" from my feet, then coming up to my mandible just to the right of the midline. As she placed her hand there, I began to experience the same strong taste I had in my mouth when the dentist injected me with lidocaine and epinephrine. The taste remained for most of the session. Soon Lisa was releasing a tremendous "energy cyst" from my anterior mandibular region just to the right of the midline, and from the ramus of the mandible on that side. I felt the effects of her work in my right ear, all of my lower teeth on the right side to the anterior midline, some of my upper teeth on the right side, into my head and neck, down into the hyoid and into the right clavicle and shoulder. The related muscles were all very much involved.
The overwhelming sensation was deep ache and pain in all these structures and tissues. In my imagery, the right mandibular nerve had been damaged by the injection. It was also clear that Lisa was removing energy and subatomic particles that were residual within the nerve. As I visualized this energy ,I saw electrons derived from the nerve injection material that had spread throughout the course of the mandibular nerve into the trigeminal ganglion. The ganglion was trying to contain these toxic energies and electrons, but wasn't completely successful. Some of these energies and electrons had spilled into the maxillary and ophthalmic nerves, as well as into the spinal cord, thus creating effects in the neck and throat.
Much of the cranial dysfunction was the result of the toxic effects upon the meninges, especially by challenging the magnetic crystals located in the dura and the pia mater. It has been shown that there are 100 million single-domain magnetite crystals in a single gram of both dura and pia mater membranes, and five million per gram of brain tissue. I'm sure errant energies and electrons or other subatomic particles could easily stress these systems and result in pain and dysfunction.
After Lisa cleared most of this toxic residue, I experienced remarkable relief. I thought we were finished. No sooner did I get that thought than a crown on the 2nd molar on the lower right side began to hurt again. This crown had been less than comfortable for the decade I'd had it. It had felt hypersensitive and somewhat out of place. Lo and behold, the same thing happened. In my imagery, residue of the local anesthetics began to clear and more energy cysts released. As this occurred my crown began to feel more comfortable in my mouth.
That's when I started feeling much less tired, more comfortable, and less wired. Certainly there was a more to go, but by that time I was well on the road to recovery.
So, what's the moral to this story? There is perhaps no better way to learn than by living in your own laboratory.
Click here for previous articles by John Upledger, DO, OMM.
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