resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
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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