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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.
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.
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.
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.
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.
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.
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.
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.
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."
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.
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.
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.
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.
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.
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.
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.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
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.
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.
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.
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.
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.
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.
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."
January, 2008, Vol. 08, Issue 01
Part IV: Chronic Problems Related to Gall Bladder Dysfunction/Disease
By Dale G. Alexander, LMT, MA, PhD
In this article, you are invited to consider the relationship between the progression of gall bladder dysfunction, migraine headaches and the existential questions of life. Chronic headache patterns often have a correlation to the cognitive dissonance of mental and emotional conflict in which one feels split, torn or confused between competing urges, behaviors or decisions in their life.
While the gall bladder is not the only organ that reacts to the stress of emotional and mental dissonance, it is among the first responders.1 And, because of its anatomic centrality, it exerts an enormous influence upon vascular efficiency, especially, I propose, upon blood flow to and from the brain.
I previously have described the body's stereotypical response to stress as a "cringing of the body's sacs and a shortening and narrowing of its tubes." The net sum of these reflexive reactions invariably includes the muscular tube of the esophagus pulling the head down and forward upon the neck. Let us remember that the esophagus has its fascial mooring to the sphenobasilar junction and therefore, may directly communicate gastrointestinal tensions from the abdomen to the craniocervical relationship (the base of the skull to the cervical spine) as its fibers shorten and narrow.2
The gall bladder as an organ is a sac as well. The stress-related effects of its cringing or resulting inflammation can neurologically provoke contracture of the right hemi-diaphragm and the lesser omentum. A shortening of these structures in their relationship to the lower esophagus mechanically adds a downward tension, further ratcheting the head inferiorly upon the neck.3 Additionally, the gall bladder tends to discharge its tensions into the spinal cord through the phrenic nerve circuit, which has its nerve roots between C3, 4 and 5.
Releasing the tensions of these cervical segments often is my first step in assisting clients with migraines. Let us remember that the nerves supplying the longus colli and capitus muscles and the scalene and levator scapulae muscles receive their neural supply from C3 and 4. Also, the neural supply for brachial plexus begins at C5, allowing for a distribution of tensions from the gut tube to be communicated to the neck and upper extremities. Contracture of and from any additional upper extremity-muscles, via their fascial relationships in sum, may further exert a downward pull of the cranium upon the neck.4
Most often, clients describe that their migraines begin as a building tension in their middle-to-upper neck spreading up and forward into the cranium, usually affecting one or sometimes both sides of their head and usually one eye more than the other. When a client reports their pain begins "within or just behind their eye" then moves backward, I request that they go back to their physician or seek further medical testing to rule out the possibility of cranial or cervical pathologies.5
My clinical experience suggests that compression within the intricate matrix of the craniocervical relationship is a significant contributor to chronic migraines. The simplest way to conceive of this is to propose that the brain gets either too little blood (ischemia) to maintain its complex functioning and starts painfully screaming for more supply; or to imagine that the compressive elements described earlier have substantially slowed the drainage of blood and lymph from the brain, creating painful pressure; thus, either ischemia or pressure build up produce the same result. And I propose they may co exist in different parts of the brain.
Earlier, I noted that gall bladder dysfunction has a potential effect upon vascular supply to and from the brain. I already have described two of the mechanisms via its influence upon the esophagus and through the discharge of phrenic neural tensions into C3, 4 and 5 that may impede delivery of fresh blood or slow the venous and lymphatic drainage from the brain.
A third proposed mechanism is the heart's inability to supply the brain and body simultaneously in the face of a congested or inflamed gall bladder, reducing the speed and volume of venous blood flowing into the inferior vena cava and then into the right atrium via the tricuspid valve.
As was noted in my last article,3 the heart's tricuspid valve acts as its primary feedback regulator of pressure and "the important factor determining the amount of blood pumped by the heart is still the rate of entry of blood into the heart."3,6 Thus, it is proposed that reduced speed and volume of arterial blood has a domino effect upon its distribution as it exits the heart through the ascending aortic arch into the subclavian, vertebral, external and internal carotid arteries and through the descending aorta. In response to the intensity of a moment or, more commonly, in response to a protracted period of the mental and emotional dissonance, anguish, confusion or conflict, the neurocirculatory regulators of the heart go on tilt, unable to equitably supply all channels. Some tissues get more blood than others - too many fires to put out simultaneously.
This assertion suggests that lack of blood flow to the brain is more likely to trigger a migraine. I harbored this assumption for many years, yet my clinical experience during the last eight years and escalating success rate in assisting clients with migraines, indicate it is blood being retained in the cranium, which tends more often to be the trigger.
How is this possible? I return to the basics of our evolutionary physiology as humans. Simply stated, the body has developed a tendency to preserve fat, retain fluids and to congest blood (when the flow has been slowed for whatever reason). The notion that the body would congest blood during a disruption of its normal delivery schedule or in response to a gradual reduction of delivery (timing or volume) is similar to how the body tends to respond to even the prospect or the actual experience of famine, by hoarding what it does have.7 This description represents a slight variation of the blocked drainage thesis proposed earlier. Nothing is 100 percent. Both the retention of blood and inadequate supply are accurate postulations within my experience, and other possibilities exist as well.
And current medical opinion is conflicted about the exact etiologies of migraines. According to a recent Mayo Clinic Health Letter, "the cause of migraines isn't fully understood."8 Thus, our clinical postulations as a profession may actually shed light on a human vexation that has lived in the shadows for millennia.
The most common profile of clients who have come to my office with migraines have been people experiencing some kind of exquisite life transition and redefining who they are (e.g., loss of long-term employment; leaving someone they truly loved in order to regain their health and/or experiencing a nasty divorce; a serious injury or illness; the death of a loved one, etc.).
Exquisite life transitions unearth the existential questions of life. They rock our carefully constructed world. And these transitions often tweak the gall bladder. Eighteen years ago, I personally experienced the theorized notion that the gall bladder consistently demonstrated itself to be highly correlated with the emotions and thought patterns of blame, bitterness and resentment proposed by Lansing Barrett Gresham, the founder of Integrated Awareness.8 He had developed his empirical model through the use of energetic touch with different body sites and specific organs relating the emotional, mental and spiritual themes of what his guests would address during, after or between appointments. Over the ensuing years, I repeatedly have confirmed these associations with clients along with many additional correlations introduced in his second book The Body's Map of Consciousness, Volume I: Movement.9
Let's consider the number of colloquial phrases within the English language that reference the human neck and cranium as a bridge to how existential questions may participate in the gall bladder's progression toward dysfunction and its relationship to migraine headaches: "You're a pain in the neck"... "You give me a headache every time I see you,"... "I get a splitting headache whenever I have to go to work/school/(fill in the blank for yourself)"... "I'm fed up to here (hand raised to one's chin)." These phrases clearly communicate elements of blame, bitterness and resentment.
To my sensibilities existential questions reflect the cornerstones of our identity - how we perceive our relationship to self and others. What do we believe in our heart of hearts is possible for us to feel, experience or achieve? Who am I now and who do I wish to become? What is my life's purpose? How do I desire to contribute to humanity? Did I choose to be here in the first place?
Quite often these foundational queries are veiled - unconsidered and unanswered in the web of a client's chronic somatic profile. I find that exploring such questions with clients is a major contribution that allows them a context for reconsidering, refining or redefining their sense of self and what is possible for them. Commonly, I encourage clients to seek out qualified therapeutic counseling to more fully delve into these queries.
Existential questions of life reflect the full scope and continuum of consciousness including whatever one considers as sacred or divine. Among the many possible there is one question that to me reflects the bookends of the continuum: Did I choose this life?
I have experienced this question to be the most important. I used to imagine this was only a question of one who lives in California. Time and experience have shown to be universally relevant. When we accept the premise and embodiment that we actually choose this life, then most of what we blame and resent others for is placed into a larger perspective of personal ownership. We more naturally gravitate toward accepting the responsibility and willingness to risk creating a life that works for us. We recognize our ability to co-create our reality and we accept that randomness exists as well. The process of embodying this premise can take some time.
The other bookend of the continuum is represented by our belief that we are a biological accident, sent back to "earth school," rejected by God or any other rationale that dispossesses us of the inherent capacity to choose and learn from the positive or negative consequences of our choices. These inevitably lead us into a spiral of victim-consciousness, feeling as though life happens to us with varying emotional flavors and behaviors of compensation, hiding, comparing one's self to others, blaming others and resenting them - making excuses for what we have or haven't done and feeling less worthy than others.
It is my personal and professional experience that we all wrestle with this alligator and others. Having specialized in working with chronic ailments, it continues to be my experience that the inclusion of a client's existential cosmology is a significant variable to the healing process. In response, clients report their awareness expands toward a more spacious possible future, one in which they perceive new choices and options for themselves. Further, the more at peace we are within ourselves, the less (I postulate) we feed the inflammatory cycles that so often are associated with chronic conditions.
It is quite interesting that in ancient Hebrew the word "reconciliation" means to "change through the gut."11 Reconciling the deep losses of life with its seeming inherent unfairness and to come out the other end without blame, bitterness or resentment is a process for which we all can experience compassion and challenge.
For the record, it's not the gall bladder per se, rather its anatomic centrality in the dance of psyche and soma that characterizes its importance. I am not proposing that if one can dial up with the right answer to the existential questions of life that they will be happy, age gracefully and won't be hit sideways by some random event. There is no inference of causation stated here, only the postulation in common sense that protracted internal turmoil participates in the stress and progression of gall bladder dysfunction and chronic migraine headaches. It is how we perceive life and what is possible for ourselves (based on our answers to existential questions) that is central to the degree to which we experience the ongoing grinding effects of degenerating stress toward various pathologies.
In conclusion, allow me to acknowledge that I have fallen short of my stated goal to be able to distill all that I wished to share in this article and to complete the gall bladder series with a crescendo. Instead, I am surrendering to how I perceive anatomy, physiology and consciousness elements work together, by sliding the focus of our attention from one arena to the next, recognizing their inherent interconnectedness and relatedness is simultaneous and ongoing as a unified sentient organism.
My next series of articles will build upon elements of this one and will describe another progression toward dysfunction/disease of similar stealth and insidiousness - one that has been anecdotally estimated to affect approximately 80 percent of the population. Stay tuned.
I wish to acknowledge Katie Truax, Glenn Gaffney, LMT, and Jake Rutherford, MD, for their editorial assistance.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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