resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
"Doctor ... Always Do the Right Thing"
So says "Da Mayor" in the iconic Spike Lee movie. As a fresh grad questioning in-network versus out-of-network, it struck me that some doctors have explicitly skirted the issue, while others have argued adamantly for the latter and "sticking it to the man."
Halt Allergies With Moxibustion Therapy
An allergy is an immune system disorder in which the body is hypersensitive to normally harmless substances in the environment.
News in Brief
D'Youville Vet Program Gets High Praise; A Moment of Silence for Dr. Paul Reginald ("Reg") Hug.
Don't Trust What a Patient Says
When a patient presents to the office for care, they typically have a specific complaint in mind – lower back pain, whiplash, sinus congestion, sciatica, etc.
Employers Need Chiropractic First and Sooner
From the Journal of Occupational and Environmental Medicine comes a study that gives excellent direction to employers (and insurers) regarding the management of low back problems (LBP).
CRREW Rallies for Ongoing Acupuncture Relief Effort in the Philippines
On November 8, 2013, Typhoon Yolanda (Haiyan) made her way through the Philippine Islands, leaving in her wake at least 7,000 people dead, millions homeless and complete communities destroyed.
The Importance of Knowing Mainstream Lingo
There is a secret lingo within mainstream medicine of which the vast majority of acupuncturists and Chinese medical professionals are unaware.
Shared Mechanisms Between Computer-Assisted Mechanical Adjusting and Contemporary Acupuncture?
Can contemporary acupuncture provide clues to the mechanisms responsible for pain relief provided by computer-assisted mechanical adjusting instruments, and clarify whether certain mechanical frequency combinations are superior to others for modulation of acute peripheral pain?
Working With The Yuan-Source Level: Resonance and the Extraordinary Vessels
How do we stay fresh with our medicine? As healers, how do we balance our medical selves with creative artistry? Chinese Medicine is not a fixed dogmatic entity, but a living system, reliant on a mysterious force called "resonance."
We Get Letters & E-Mail
Imagine What More Could Be Achieved With Your Support; A Lesson in Hygiene: What Do You Do in Your Office? Open Letter to the Profession.
The Boston Benevolent Chiropractic Clinic: Standing Up for the Needy
Our chiropractic assistant, Bridget, greeted an arriving patient at the Emmanuel Church in downtown Boston. She said, "Hi, Michael, good to see you. It's been awhile. Have a seat and Dr. Ken will see you soon."
Replenishing and Restoring Jing
I learned an important principle from my great Taoist Master Sun Hak. He taught me that all people "leak" Jing, and that we can mitigate or stop this leaking, and as a result strengthen our life force, develop enhanced adaptability and lengthen our life.
Medical Qigong for the Heart: Part I
According to the Center for Disease Control and Prevention, heart disease is the leading cause of death in the United States, affecting people of all ages and backgrounds. Coronary heart disease, in just the United States alone, costs close to 109 billion dollars a year.
Vibrational Medicine: Frequency Micro-Current and Color Acupuncture
Vibrational medicine involves the application of various forms of energy frequencies to the body for pain relief, healing and rejuvenation. Vibrational medicine will become a major growing trend in our medical systems for the following reasons:
The Search for the Origin of the Wiggle Technique
When Bob had adjusted me previously, most of the time I knew what he was doing. But this time, he had me lie on the treatment table in the usual side-posture position, and he "wiggled" my sacroiliac with the fingers of both hands, while stabilizing my pelvis with his forearm.
Wellness: A New Buzzword at the Aging in America Conference
Aging in America is "the nation's largest gathering of a diverse, multidisciplinary community of professionals in healthcare, social service, government, business and philanthropy with expertise in providing services and products for older adults."
Home Sweet Medical Home
While the Affordable Care Act (ACA) has received its fair share of praise and criticism since its adoption, few question the value of its emphasis on collaborative, patient-centered health care.
Medial Knee Pain: 11 Potential Causes (and Corrections)
We have all seen patients with medial knee pain that either has no traumatic origin or lasts well beyond when it should be resolved. How can we help these patients? Here is an overview of clinical scenarios and how we can provide conservative care.
Deciphering the New CMS-1500 Claim Form
Q: I am confused about how and when to use the new 1500 form, particularly block 14 and block 15. What is required and how do I properly fill out these fields? And do I actually have to use this new form or may I continue using the old version?
News In Brief
Pacific College of Oriental Medicine obtains grant funding from NIH; Yo San University of Traditional Chinese Medicine Announces New President; Kentucky Gets Licensed; PCOM Receives Approval from WASC to Offer FPD.
New Leadership Era at the WFC
The World Federation of Chiropractic recently announced not only a new president, as is customary every two years, but also an incoming secretary-general, marking the first time since the WFC's inception in 1988 that someone other than David Chapman-Smith, Esq., will serve in that capacity.
Changes in Herbal Medicines from Ancient Times to the Present
The classical literature of Chinese medicine remains highly relevant in the modern era, as many of the basic theories and herbal combinations emphasized in clinical practice were first established in texts that are nearly 2000 years old.
Don't Trust What Your Patients Say
When a patient presents to the office for care, they typically have a specific complaint – lower back pain, whiplash, sinus congestion, sciatica, etc. They are often not interested or engaged in what they consider "unrelated" personal health history.
Low Melatonin Linked to Risk of Advanced Prostate Cancer
Epidemiological and experimental studies suggest the hormone melatonin, which plays a role in regulating the sleep-wake cycle, may play a role in the development of prostate cancer, as lower melatonin levels have been associated with an increased risk of prostate (and breast) cancer.
April, 2007, Vol. 07, Issue 04
Part I: Chronic Problems Related to Gallbladder Dysfunction/Disease
By Dale G. Alexander, LMT, MA, PhD
The common theme of this three-part series relates to how gallbladder dysfunction and disease progressively place a drag upon general physiology by impeding venous and lymphatic return. First, I will describe the various somatic markers I have experienced with clients associated with the progression of gallbladder dysfunction or disease via the inflammatory process.Next, I will postulate how gallbladder dysfunction might functionally affect the rest of the digestive tract and blood sugar regulation. Further, I will describe how gallbladder difficulties might participate in many hiatal hernia reflux problems, esophageal problems, chronic headache patterns and the existential questions of life.
The purpose of these descriptions is to add to your library one of the more common progressions I have encountered when working with clients who state they have a chronic problem or pain that "just won't go away" even after care from other competent professionals. Typical somatic complaints will include the persistence of one or more of the following: right shoulder and upper back with or without radicular symptoms (pain or numbness into the shoulder, elbow, arm or hand), neck pain and headaches, including migraines, and interestingly, left hip problems.
Additional markers which indicate involvement of the gallbladder include: pain or limited motion of the left side of the neck;1 progressive loss in the range of motion or freezing of the right shoulder; recurrent upper-to-middle right-sided rib subluxations, with accompanying muscle contracture or spasm; reduction in the ease of lateral excursion of the right hemi-diaphragm; hiatal hernia complaints; a marked reduction of ease in spinal flexion and extension during motion testing; and a history of external hemorrhoids. Rarely are all of these reported or identified in an initial interview and session with a client. Yet, over time, they do begin to reveal themselves.
I have selected this progression because it tends to fly under the radar of medical testing, often for years, until its dysfunction becomes acute. I would hasten to add that if one has trouble with their gallbladder, the normal function of their liver is questionable. It is beyond the scope of this article to explore the influence of both organs simultaneously, yet the inflammatory response of the liver produces almost identical somatic profiles.
It has been my consistent clinical experience that gallbladder dysfunction tends to precede the identification of chronic liver dysfunction. Thus, it becomes another example of how the body uses an ailment as the "canary in the coal mine" to signal us that something deeper is amiss. Following the removal of the gallbladder, some clients have received a diagnosis of moderate to severe liver dysfunction, including cirrhosis or non-alcoholic fatty liver disease many years later. This is the nature of progressions.
One of the principles of the Inside-Out Paradigm© is to seek to comprehend how the body is organized to move and recycle its fluids back to the heart and lungs, especially the low pressure systems of lymphatic and venous return. Whatever might impede this flow can progressively create the breeding ground for various pathologies to begin. In the interim, a client's quality of life is insidiously diminished. Our role in therapeutic touch is to enhance their quality of life and to serve as part of their early detection team.
The following description is anecdotal and represents extrapolations of functional physiology (how one thing may relate to another) that are based on my clinical experience. Please do not consider these ideas to be proven fact. I propose that varying degrees of gallbladder dysfunction is an unidentified variable in many somatic profiles because of its "anatomic centrality." In normal anatomic position, which can vary, the gallbladder sits just adjacent to the inferior vena cava, in fascial communication with the portal vein of the liver and just anterior to the transverse colon, in approximation to the abdominal confluence of lymph trunks, often referred to as the cisterna chyli.2
Inflammation of the gallbladder in response to neural excitation or gallstone formation can literally decrease the "rate of flow" of the fluids within the low-pressure venous and lymphatic vessels. When inflamed, the gallbladder swells to occupy more space, thus pushing on these more flexible tubes, creating a "pinched-hose effect." The reduction of the timely return of these fluids back to the heart and lungs places an accretive strain upon the many tasks of maintaining physiologic homeostasis and upon a client's perception of life and themselves.
The most common error a practitioner makes is to predict that emotional factors are the primary source, or that physical factors are the primary source of a chronic problem. In my experience, both represent slices of the pie that might contribute to resolving the chronic problems of clients.
According to Dr. Barral, the developer of visceral manipulation, the gallbladder tends to be the most reactive organ outside of the brain and spinal cord to emotionally charged events. For example, receiving the news that a loved one has died, witnessing an accident, or being unexpectedly fired from one's employment are among many possible triggering events.1
"Sympathetic innervation of the gallbladder is from the celiac ganglion, and innervation from its peritoneal surface from the phrenic nerve. Contraction of smooth muscle within its walls depends on the vagus nerve, i.e., biliary excretion is under parasympathetic control."3 In my articles on the "Phrenic Circuit," I endeavored to set a foundation for how the body distributes these internal tensions through its complex neural net and specifically within the shared cervical portions of the spinal cord which overlap the origins of both the phrenic nerves and the brachial plexuses;4 the latter being the vitalizing source for the shoulders and upper extremities.
It's the presence of chronic inflammation that we need to hold clear in our field of awareness. Its presence is inferred by the persistence of the somatic complaints detailed earlier. I have personally worked with people for many years until the underlying source(s) of their somatic complaints emerged. This is how I may offer a description of this progression to you. Acute inflammation of the gallbladder and/or the passage of a gallstone stuck in the common bile duct usually requires medical attention.
It's prudent for us to refer clients to their physicians when we suspect such a chronic problem and/or when our best efforts fail. Usually, blood tests and an ultrasound scan are ordered to check for the presence of gallstones and any possible infection. Quite often, if there are no stones, the notion that the gallbladder is a relevant variable is dismissed. There is a second test, called the Function Test, to check if the gallbladder is actually working at all. It's important for us to educate our clients that this is an option. The test is not a pleasant experience, as one has to swallow a liquid that places a demand upon the gallbladder while its capacity to function is being monitored. If it no longer is functioning, the possibility of infection or other pathologies increases. In one such instance, the client's gallbladder was diagnosed as precancerous.
Gallstones are made up of calcium bile salts and cholesterol. The actual process of how and why they are formed elicits many possible opinions with few definitive conclusions.
The statistics detailed in Dr. Barral's second book, Visceral Manipulation II, note that within the U.S., 8 percent of men and 20 percent of women over the age of 40 are affected by gallstones and that 2 million surgical procedures are performed every year to remove the gallbladder.3 Not all gallstones produce adverse symptoms paradoxically. Larger gallstones unable to exit the gallbladder might lie dormant for years. However, to my sensibilities, they contribute to the organ's chronic inflammation and do have an effect upon venous and lymphatic drainage.
When initially interviewing a client, take note of whether their parents, grandparents or siblings have had such difficulties. Of all the somatic markers noted earlier, the progressive stiffening of the spine exhibited by a reduction of ease to flexion and extension during motion testing is an indication that the chronic problem is progressively affecting the client. I have seen this repeatedly.
I cited the case study of a client in an earlier article who had experienced the freezing of his right shoulder. All of my attempts to assist its re-mobilization failed. I encouraged him to see his physician and two large gallstones were found. Though encouraged by his physician to have them removed, he declined. Now, many years later, he is struggling with rectal cancer.
The inference here is not to be taken as cause and effect. However, when fluids of the body are unable to find their way to all the cells and/or fluids are impeded from returning to the heart and lungs in a timely manner, it is my postulation that this sets the stage for many possible pathologies to emerge.
The main idea for your consideration is that gallbladder dysfunction and disease may progress in insidious and subtle ways. It's our responsibility to be alert to its possible presence and progression. For all of us, let us be aware that eating large quantities of fried, processed, heavily spiced, or greasy foods may contribute to gallbladder dysfunction.
In the second installment of this article, I will describe what often happens when bile sludge or small gallstones partially or fully occlude the opening through which both bile and pancreatic juices flow into the duodenal portion of the small intestine; the ramifications for digestion and elimination; and the simultaneous role of reducing venous and lymphatic drainage and the timely return to the heart.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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