resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
June, 2007, Vol. 07, Issue 06
Glimpses of the Big Picture: Leptins
By Leon Chaitow, ND, DO
The topic covered in this article is relevant to practitioners of all disciplines, particularly those who are providing health care services to people who suffer from conditions as diverse as chronic inflammatory conditions, autoimmune diseases, neuropathic pain, obesity, diabetes, thyroid hormone resistance (e.g., unexplained hypothyroidism), many cardiovascular diseases, syndrome-X, food cravings ...and more. Before getting to the unlikely link that can connect these apparently unrelated diseases and conditions, a background setting is called for.
An image I like to use when explaining contextual issues in relation to health is that of an iceberg floating in the ocean. The visible portion of the iceberg - perhaps 20 percent of its total mass - simplistically can be seen to represent those aspects of the patient that we observe, palpate, assess, discuss and evaluate. These divinations result in a greater understanding of the unseen inner workings of the patient - equivalent to aspects of the unseen, underwater portion of the iceberg.
And then there is the ocean itself, in which the ice mountain floats. In relation to the iceberg, this would include elements such as the relative salinity, temperature and pH of the water, as well as the weather, currents and more. In relation to the patient, the context includes multiple influences - environmental; psychosocial, biochemical and biomechanical; past and present; intermittent and constant; acute and chronic - that affect the individual from cradle to grave.
The complexity of such interacting influences, overlaid on the person's genetic and acquired characteristics, as well as the symptoms being manifested, often seem too daunting to make sense of. Hence, the reductionist approaches of so much of health care, whereby modifications of single aspects of this confusing edifice are attempted in order to nudge it toward more normal function. This may be done via diet, medication, nutritional supplements or herbs, needles, manual treatment, exercise, hydrotherapy, better breathing or posture, homeopathy, and many other options. Any of these interventions might modify etiological features sufficiently to encourage the self-regulating functions and systems of the body toward better health.
Lifestyle changes might be suggested that appear to offer more fundamental health-enhancing possibilities. Here, treatment is not a feature, but rather the initiation of changes that aim to align the individual more closely with evolutionary imperatives - offering a chance for homeostatic functions to operate more efficiently. Such changes might involve reforming nutritional, exercise, sleep and other basic behavior patterns.
Many such changes are common sense. Practical lifestyle modifications have been demonstrated to lead to profound influences on well-being and health enhancement. These suggestions range from more exercise, adequate sleep, balanced/reformed dietary habits (avoiding or modulating intake of high-sugar, high-fat junk food and stimulants such as caffeine and alcohol), as well as better breathing and relaxation methods. Other simple choices also are now available, backed by solid scientific evidence; much of it relating to hormones produced by white adipose tissue (fat), such as leptin.
The Leptin Story
I am grateful to Judith DeLany, LMT, with whom I have happily co-authored three books, for drawing my attention to the rapidly-evolving area of leptin research and putting together a summary for use in one of our revisions. Credit for collating a great deal of the information outlined below belongs to her. Recent research points toward basic lifestyle changes that can have profound influences on the evolution of diseases. Due to space constraints, I will outline only some of the most pertinent information, with appropriate references that can be used to expand on the summary below:
A simple plan has been devised8 to help regain normal leptin levels and thereby, balance the hormonal cascade discussed above. Although this plan may not be ideal for every one, it is presented here for the majority who it is suggested should benefit from its use. The foundation of the plan contains five basic rules. Breaking any of the rules or guidelines (below) can lead to setbacks.
Rule 1: Never eat after dinner, not even a snack or glass of wine or juice. Allow 11-12 hours between dinner and breakfast. Generally, finish eating dinner at least three hours before bed. This rule is designed to allow leptin, melatonin, cortisol and other chemicals to balance during the night. Individuals with night-eating syndrome have abnormal hormonal patterns apparently associated with nocturnal eating.9
Rule 2: Eat three meals a day. Allow 5-6 hours between meals. Timing is crucial, so that insulin levels can drop, glucagon (produced by the liver) can rise, and fat metabolism can kick in. If this occurs a couple of hours before more food is eaten, fat stores can be utilized until the next food is eaten. Snacking between meals sends the insulin back up and fat stores remain untapped. Therefore, snacks are to be avoided. Protein and carbohydrate portions are the size of the palm of the hand and most vegetables can be eaten as desired. Peas, carrots and corn are taken in moderation.
Rule 3: Do not eat large meals. Eat slowly and, if overweight, always try to finish a meal when slightly less than full. Eating slowly allows time for hormonal signals to reach the brain before overeating occurs. Smaller meals allow for better digestion. Do not overstretch the stomach and reduction in overall caloric consumption can be achieved.
Rule 4: Eat a breakfast containing protein. This helps set the hormonal cycles for day and night. Compromising this can have hormonal effects during the day and into the night, disturbing sleep. Weigle, et al.,10 showed that an increase in dietary protein from 15 percent to 30 percent of energy produced significant weight loss, presumably "mediated by increased central nervous system leptin sensitivity."
Rule 5: Reduce the overall amount of carbohydrates eaten. Unless one already is on a low-carb plan, chances are that too many carbohydrates are routinely consumed. Regarding carbohydrate influences, Garg, et al.,11 note, "Compared with the low-carbohydrate diet, the high-carbohydrate diet caused a 27.5 percent increase in plasma triglycerides and a similar increase in [very low-density lipoprotein]-cholesterol levels; it also reduced levels of HDL cholesterol by 11 percent."
This brief summary suggests that eating regular, balanced (low-sugar, for example) meals, including a protein breakfast; avoiding snacking between meals and reducing overall carbohydrate intake; and getting enough sleep can beneficially impact a huge range of diseases, including those that involve excessive inflammation.
If you or your clients are overweight, suffering from inflammatory conditions and/or any of the long list of conditions mentioned by researchers investigating leptin, these simple changes could offer a way of beneficially influencing health. When they do, this represents an example of contextual health care, as discussed at the start of this article.
Click here for more information about Leon Chaitow, ND, DO.
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