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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
July, 2013, Vol. 13, Issue 07
Freeing the Heart: The Importance of the Vagus Nerves/Cranial Nerve X
By Dale G. Alexander, LMT, MA, PhD
In my clinical work involving clients who typically present with chronic somatic problems, it is truly a joy when markers emerge that reflect, "the means by which" their healing experiences occurred.Since beginning to write this series of articles on "Freeing the Heart," more and more of my clients are regaining their quality of life more quickly.
Additionally, for those clients who have progressions of degenerating physiological function, their bodies are expressing their symptoms in more classic medical ways allowing for clearer and more appropriate diagnosis and treatment. And, for those whose bodies have held sub-clinical infections, many for multiple decades, they are responding so fast that I am in true amazement.
My latest premise about human aging is that the vagus nerves, for many possible reasons, cedes the functioning of the digestive system to the enteric nervous system which is probably overseen by the celiac plexus. The ceding of this responsibility is proposed to be the result of the need for the organism as a whole to concentrate its efforts toward running of the heart/lung complex and its contributions to our ability to speak.
The progression of cardiovascular disease is an exceedingly subtle one until, it isn't. Let's be clear, our bodies are not that different from how we organize our lives. We prioritize and distribute our energies as the obvious needs present themselves, disregarding what we can and delegating to others what we must.
Consider this analogy: Life gets hectic in the family, more money is needed to make ends meet and one or both parents take on a second job to financially keep up with the expanding needs, wants and desires of their children. As a result, one or more of the children is assigned the cooking responsibilities or even does the shopping, planning, clean-up and taking out the trash to accommodate this loss of parental skill and supervision. Most everything gets done but without the finesse, organization or thoroughness of an adult. It's a crude analogy but, in the ballpark for our purposes.
So it is when our autonomic nervous system is evolutionarily focused on the higher priority of getting the next breath and pumping freshly oxygenated blood, digestion becomes a secondary priority. Thus, without the brain's monitoring the Gastrointestinal tract, digestion, assimilation of nutrients and waste removal all happens, but with less coordination and efficiency.
Two years ago, a former student of mine had sent me an article that referenced that the Vagus Nerves were composed of 90% afferent fibers and 10% motor nerves.1 This information was novel, but it floated by in my consciousness without me acting upon it. Then, more recently, I happened upon a book that validated much of what I have asserted over many years regarding the importance of the length and tone of the esophagus and also restated this 90%/10% ratio between sensory and motor supply inherent within the vagus nerves.2
It suddenly dawned on me that the style of stretching I had developed to vent pressure from the thorax might also be stretching the filaments of the vagal nerves. This technique was described in the "Equalizing the Pressure" article of this series (Massage Today, February 2012). Could it be that these gentle stretches might be stimulating the vagal afferent fibers such that the brain was again coordinating the body as a more unified organism? And, could it also be that the immune system was also being stimulated to wake up and began to recognize deteriorating physiological progressions and aggregations of bacteria and viruses that it previously had been too overloaded to notice? Admittedly, it is a curious idea yet, it has very significant positive implications.
Might this be "the means by which" such improvements for clients were being realized? It is a very possible therapeutic response to my constant mantra of the past few years, "if one can restore nerve and blood supply, then almost any healing can occur." Full credit is given to Dr. Richard MacDonald, DO, for presenting this maxim from his long Osteopathic teaching career when I assisted him in his Functional Anatomy courses in 1989 & 1990.3
Let's return to the notion of 90% afferent vagal fibers and 10% vagal motor fibers. Stimulating the afferent filaments is being proposed as a method to assist the central nervous system in re-engaging its full attention to coordinating physiological function inclusive of a more alert and responsive immune system.
The next proposal is that reducing the compressive forces upon the vagus nerves motor fibers is also a part of this re-engagement of normal vagal function. Based on my clinical experience with clients, the most frequent places in anatomy where this compressive force is most plausibly obstructed is where the vagus nerve exits the cranium through the jugular foramen and in the superior sympathetic ganglion immediately lateral to C1, C2 and C3 where there exists an intimate relationship between the sympathetic fibers and the parasympathetic vagal fibers.
The successful long history of upper cervical adjustments by osteopathic and chiropractic physicians in addressing a plethora of somatic and visceral dysfunctions bear testimony to the importance of these anatomical relationships. Then, when one adds myofascial stretching to the fibers of the esophagus and to the stretching of the pleural, pericardial and peritoneal sacs, this is how the proposed stimulation of vagal fibers as they descend into the abdomen is effected. I share these observations and ideas, not because of my certainty that they are absolute facts, but because I desire to stimulate other practitioners in our field to join with me and explore whether these ideas can be reflected in our choices of skill sets and techniques which collectively comprise our profession. Thus, producing more effective results for our respective clients. In doing so, anatomy is our common language.
It has long been my instinct that our profession can make a number of significant contributions to how healing may be realized. It is my prayer that this concept of "Freeing The Heart" may simply be one of many more to come.
Author's Note: Additional credit to John Upldeger, DO, developer of CranioSacral Therapy, for his healing paradigm of lowering sympathetic tone and assisting parasympathetic outflow; to Dr. Jean Pierre Barral, DO, for his premise about the importance of re-establishing normal pressure differentials between the body's three great cavities in its role toward enhancing normal circulatory efficiency; to Lansing Barrett Gresham, founder of Integrated Awareness® for his postulation that since the visceral organs are functioning well before the skeletal muscles are capable of moving the body in a coordinated fashion, that the tensional patterns of the visceral suspensory ligaments play a major role in the eventual range of motion for most of the body's joint structures; and finally to Frank Lowen, LMT, for his contributions as I have an indelible memory of his fascial stretching between the thorax and the abdomen in 1991 in West Palm Beach that I know was part of the inspiration to develop these techniques.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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