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Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
February, 2005, Vol. 05, Issue 02
An Obscure Side-Effect of Obesity
By John Upledger, DO, OMM
The sad passing in December of future NFL hall-of-famer Reggie White illuminates an obscure side-effect of obesity that also gives us some fascinating insight into the human body. White, who died at 43, topped out at weights exceeding 290 in the course of his career.While the results of his death weren't conclusive at the time of this writing, the coroner cited sleep apnea as having played a possible role.
Not to be confused with central sleep apnea secondary to brain dysfunction, White's type of sleep apnea is most common among men of large body mass. Like snoring, this sleep apnea is often secondary to the fatty enlargement of tissues in the nasal air passages at the back and upper areas of the throat. These patterns are generally characterized by gasping inhalations followed by long pauses during which there is little or no exchange of air via the airways into the bronchi and lungs.
Let's dig into the subject a little deeper and see what's behind all this. Involuntary respiration is controlled by nerve cells/neurons in the medulla oblongata located in the skull just above the upper end of the spinal cord. These nerve cells get their instructions from the pons, which is higher in the brain. The pons gets its information from several other brain centers then sorts out all the little details to develop regulations for breathing. I suspect some of the pons' incoming messages originate in the fat-enlarged tissues of the nose and mouth airways. These messages may then cause the pons to periodically hold back normal rhythmical inhalations.
Taken to the extreme, respiratory arrhythmias secondary to abnormally fatty tissues can take sleep apnea to the point that increased back pressure in the lungs can produce some degree of right-sided heart failure. The result is cyanosis, a bluish discoloration of the skin and mucous membranes that first appears in nail beds and lips. The discoloration comes from a reduced level of oxygen in the blood secondary to the compromised breathing that began with snoring and sleep apnea.
Now let's look at a molecule called "nitric oxide" (NO). This gaseous substance is attracted to lipid (fat) molecules. It is moderately reactive compared to inert gases such as helium, neon and argon, which do not react with other atoms, ions or molecules. What nitric oxide does within our bodies is remarkable. It has a great deal to do with the flow of blood through our vascular systems. With every heartbeat, a puff of nitric oxide gas is released from the endothelial cells where a great deal of it is stored. Endothelial cells line all our blood vessels, including arteries, veins, arterioles, venules and capillaries. So nitric oxide is released in some amount in every blood vessel.
The process by which nitric oxide causes blood vessel relaxation and dilation is somewhat complicated. It goes something like this: The puff of nitric oxide that's released from the endothelial cells of the blood vessels goes directly to the red blood cells (RBCs) where the nitric oxide molecules become attached to hemoglobin (Hb). The nitric oxide remains attached to the hemoglobin as assessments are made regarding how much oxygen is available to the body for its cellular needs.
Low oxygen levels cause more nitric oxide to be released from the hemoglobin. Higher oxygen levels cause hemoglobin to retain a higher percentage of nitric oxide. That makes good sense. When oxygen is low, nitric oxide causes blood vessels to dilate and deliver more blood to the tissues to increase the amount of oxygen getting to the cells. Incidentally, as cells take in available oxygen, most of it goes to intracellular mitochondria. There are thousands of mitochondrial organelles in the cytoplasm of each cell. The mitochondria make the energy that's required by every cell.
Back to our nitric oxide molecule travels. As nitric oxide is released by the hemoglobin, it emerges from the RBC after combining with the amino acid "cysteine" to form S-nitrosothial. In this form, nitric oxide will not be reattached by the hemoglobin as it travels through RBC cytoplasm. The nitric oxide is ushered out of the cell by specific proteins attached to the RBC membrane. It then enters the blood serum and the endothelial cells where the molecules are stored as nitric oxide. When it's time for the blood vessel to dilate, the nitric oxide goes to the smooth muscles in the blood vessel walls and causes the muscles to relax. This relaxation allows the blood vessels to dilate and pass more blood at a lowered blood pressure.
What does all this have to do with obesity? It was recently discovered that our paranasal sinuses produce a lot of nitric oxide. When nitric oxide is inhaled through the nasal airway, it gets into the lungs and increases the amount of oxygen that gets into the blood that is circulating through the lungs. The clearer the nasal passages, the more nitric oxide will be inhaled into the lung tissue. Hence, the more efficiently the oxygen will be absorbed via the lungs into the body vasculature, which then delivers the oxygen to all body cells.
Obesity often causes sleep apnea and snoring, which indicates a blockage of nasal airways. The nitric oxide delivery to the lungs then is reduced, as is oxygen absorbed through the lungs. Lowered oxygen levels in the body signal that the tissues need more blood to supply the oxygen. The physiological response is to raise the blood pressure to increase blood flow and improve oxygen supplies to tissues. Hence, high blood pressure occurs because nitric oxide isn't getting into the lungs effectively.
Hopefully, the passing of Reggie White will wake others up to a lesser-known but potentially deadly side effect of obesity.
Click here for previous articles by John Upledger, DO, OMM.
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