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The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
January, 2013, Vol. 13, Issue 01
Freeing the Heart: The Role of the Autonomic Nervous System
By Dale G. Alexander, LMT, MA, PhD
This series of "Freeing the Heart" has evolved to offer our profession and other touch and movement therapies a conceptual framework for how we may collectively contribute to slowing the progression of cardiovascular disease.These ideas are extrapolations of my clinical experience that have assisted clients with cardiovascular problems and those that present with persistent chronic somatic problems. A descriptive summary of the concepts "Enhancing Central Circulation" is detailed at the end of this article.
From my point of view, the basic problem the human body faces in the aging process is that many variables combine to slow the "return of raw blood products to the heart" in the process of freshly oxygenated blood being reconstituted and delivered to all tissues and cells. Both the "quantity and the timely delivery" on both ends of the vascular system are key functional components of the heart's capacity to contract 100,000x's a day and to send blood efficiently over the estimated 60,000 miles of vessels.1 Obviously, the build up of fats inside the walls of these vessels is a primary component of the resistance to the efficient flow of blood, which I propose happens for most of us, not just some.2
Here is an anatomical interpretation of the progression of cardiovascular disease and I propose that the autonomic nervous system (ANS) has evolved three cards to play in its efforts to offset the inefficient flow of blood back to the heart.
I also propose that most progressions toward pathology will be accompanied by a decrease in the volume of freshly oxygenated blood. Whether it be a chronic somatic dysfunction, chronic illness, cancer or cardiovascular decline, such progressions reflect a compromised capacity for the body to manufacture in a timely manner and to deliver the nutrients, hormones and oxygen so desperately needed to maintain our health, contribute to our vitality and support our capacity to move, dance and sing.
In this theory, the autonomic nervous system has basically three cards to play at its reflexive disposal to keep up with the demands of producing and delivering freshly oxygenated blood. I am further proposing that these typically occur in sequence over the course of one's life. First, The heart works harder, and in some people, the left ventricular muscular wall may become thicker and stiffer and is most often identified as left ventricular hypertrophy. Second, the blood vessels narrow to push the blood through faster which, in many people, is identified as hypertension or high blood pressure. And third, the delivery of freshly oxygenated blood to "all body tissues" is decreased. My premise is that this latter progression is related to many chronic somatic conditions associated with the aging process, including most joint degradations, and might play a role in setting the stage for other illnesses including cancer.
Let's examine the concept of the heart working harder first. This happens when we exercise. It's normal, up to a point. However, if the resistance to the heart's expansion increases and, especially when this happens over a period of years, then the muscular wall of the heart's left ventricle thickens in its attempt to pump more blood. Many factors may contribute to the creation of this condition: internal tensions within the thoracic cage, atheromatous plaques made up of fat and cholesterol, scar tissue, extrinsic myofascial tension, reflexive righting reflexes and emotionally related identity and stress factors combine in my experience to provoke the dual innervation of the heart to strain in its efforts to provide enough push to send the blood throughout the vascular system and back to itself. Again, the time required to complete the loop and in sufficient quantity are the crucial variables that maintain circulatory efficiency.
At a certain point in the thickening of left ventricular wall, the additional effort of the heart actually decreases the amount of the blood being ejected. This is why left ventricular hypertrophy (LVH) is considered a very real risk factor in the progression of cardiovascular disease.3 In my view, increasing the force of the heart's contraction is the first card that the ANS plays as it spans both normal function and the possible progressive stages of dysfunction into pathology.
Considering hypertension and high blood pressure, what I sense has been overlooked is that the 60,000 miles of our human vasculature is principally innervated by the sympathetic division of the ANS as contrasted to the heart's innervation by both the vagus nerves from the brain and the sympathetic nerves from the spinal cord.4 This suggests to me that the narrowing of the vasculature system is the second card that the ANS plays in its reflexive efforts to push and rush blood back to the heart/lung complex in order to keep up with the process of producing freshly oxygenated blood. There appears to be no question that high blood pressure is a significant risk factor in potentially provoking plaque to break free and thereby triggering a heart attack or stroke.5
The third card that the ANS has to play is to prioritize moving the blood back to the heart as it's end goal and, by necessity, sacrificing the delivery of freshly oxygenated blood to some tissues along the way. Might this be reflected in the frequency of chronic somatic dysfunction that increases as we age? Further, this might contribute to the predominance of joint problems including the need for spinal surgeries, hip, knee and shoulder replacements as we age. I speculate that this is an under-recognized variable in the progression of many persistent chronic somatic dysfunctions. The consistent delivery of fresh blood containing its full constituents (oxygen, nutrients and hormones) is necessary to maintain vital human function and the health of all our various tissues.
Defining the problem more clearly often leads to targeting possible solutions. The following is an updated distillation from the previous article, "Enhancing Central Circulation" from the August 2012 issue of Massage Today.
The take away here is for us to turn our attention toward enhancing the central circulation of the human body. In the many and varied ways that touch and movement therapies have evolved and continue to improve their effectiveness, each may contribute their measure. Let us all commit to this direction and seek to assist as many clients as we can.
Author's Note: Many thanks to Annie Dundon, Glenn Gaffney, Katie Truax-Alexander and Dr. Ed Charlton for their editorial support and guidance.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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