Monthly Archives: October 2013

Separation in Health

The following is an excerpt from my e-book “Activate Your Inner Physician,” available at http://www.amazon.com.

Separation: The conscious mind’s attempt to maintain order by imposing artificial boundaries around aspects of mind and body. As a result we have the physical self, the emotional self, the psychological self, the spiritual self, etc. It is the opposite of movement and hence the opposite of healing. Pain and suffering are by-products of separation.

Our health care system is based on two falsehoods: that we will never die and that we’re entitled to a pain-free existence. When you create a model that denies two of the most fundamental truths of human existence, how can that not create separation of the highest order? And, if separation is what causes pain to be necessary in the first place, it follows that our accepted model of health actually sets the stage for pain and suffering.

We get funneled into various specialists who will treat the physical problem and one who will counsel you on the emotional and psychological issues, once again reinforcing in our minds that these are two unrelated problems. The linking of physical and emotional-psychological symptoms is often left up to the individual because very few practitioners will tell you that liver inflammation and repressed grief need to be treated as one event.

The multitude of diagnostic tests and procedures that grows daily is another reflection of this fractured perspective. A lab tech at the hospital is evaluating your blood glucose level while another tech across town at a private lab is testing the pH level of your urine. Talk about separation—your bodily fluids aren’t even in the same building!

One of the original Old English meanings of health is “whole.” The deep desire of the body-mind is to return to wholeness, and pain is the price for recognizing that we’re not whole. If health is meant to describe a whole experience, why can’t we talk about it without classifying it as “good” health or “poor” health, or applying a diagnosis to a feeling or a mental state?

Our conditioning to regard our minds and bodies as separate entities sets us up to become fodder for the health care machine. For example, our body has little opportunity to show us that it can heal an infection on its own, because we cannot hear the word infection without hearing the word “antibiotics” in the same breath. The mind will hold the infection in place until the actual physical proof of the antibiotic is presented to it in the form of a pill or an injection.

A good example of how separation permeates our language around health is how we regard a cancer diagnosis. The person is described as “battling cancer.” By definition, there has to be a winner and a loser in a battle. If the patient adopts this perspective, she has already compromised herself with this declaration of war, which is the equivalent to stating, “I am not my body and my body is the enemy.” How is she supposed to have compassion for an enemy that’s trying to kill her? Then she chooses a practitioner (her general in the battle against her disease), draws her line in the sand and goes to war against herself to eradicate the clues to her humanity.

If the patient survives and wins the battle, who or what exactly lost the battle? The standard answer would be, “Well, the cancer lost, of course!” On the contrary, the loser was more likely a deeper part of that person seeking attention–such as unexpressed regret or grief–and the only way to make itself known was through something as extreme as a life-threatening disease. It had otherwise run out of options. Since the mind will never equate cancer with our humanity this connection often goes unexamined. So, we congratulate the victor on avoiding yet another close call with self-recognition.

A woman’s breast cancer doesn’t heal because thousands of people are doing a 5K walk, which is just a gussied-up version of going to war. Who else marches but an army? Again, it’s an expression of separation. The only enemy to confront is in the mirror. Her healing, if it occurs, is a very private and unique event that cannot be marketed or branded, and if we want to help then we stay as neutral as possible about the disease.

Have You Been Saddled with a Garbage Can Diagnosis? Part II

This is the second part in a series that focuses on “garbage can diagnoses” (see Part I for a more detailed description of what constitutes a GCD.)

TMJ: (properly known as temporomandibular joint disorder) “My doctor/dentist says I have TMJ.” Gawd, I wish I had a dollar (nickel adjusted for inflation) for every time I’ve heard this one. Of course, they never follow up this statement with how it’s being treated, because most practitioners don’t know what to do with this condition besides give you a mouth guard. Great, now I can play hockey without losing my teeth, but my jaw still hurts. This GCD could include everything from jaw clicking, locking, joint pain, and nighttime clenching and grinding.

The importance of the jaw in overall health can’t be overstated. Because of the intense concentration of nerve receptors in the jaw that monitor proprioception–the body’s ability to sense where it is in space–proper alignment of the jaw is essential in maintaining balance and a decent center of gravity.

More importantly, the TMJ is one of the linchpins of the skeletal system (along with the sternum and pubic joint), meaning that if it’s out of alignment it can easily take out your whole skeleton. This can cause chronic muscle and joint conditions to flare up, inner ear problems, chronic headaches, sensitive teeth, ringing in the ears, and make you more prone to injury because of compromised balance. What causes the TMJ to be out of alignment? Intense dental work, serious injuries such as car accidents, giving birth, and gum or tooth infections are some of the most common causes.

Chronic pelvic pain: I could build a practice based on this GCD alone. I’ve listed this right after TMJ because the pubic joint and the jaw joint are inextricably linked. When the TMJ is not aligned properly, then the pubic joint also misaligns itself in order to balance the skeleton out as much as possible, and keep the body upright in space. And, the reverse is also true–if the pubic joint is misaligned, the TMJ follows suit. I’ve seen this relationship to be true 100% of the time.

A misaligned pubic joint can result from many factors, but a few common ones are: pregnancy and childbirth, acute injury such as car accident, abdominal or pelvic surgery, bladder or reproductive system infection or inflammation, dental work, and bodice-ripping sex.

A chronically misaligned pubic joint can cause a whole host of problems, such as: migrating pelvic pain involving the hips, tailbone (sacrum), genitals, and sometimes the groin or front of the hips; chronic urinary system infections; chronic vaginal or prostate infections; frequent groin muscle strains; and knee joint instability.

Do you see a chiropractor, physical therapist, or osteopath, but he/she just can’t seem to get your pelvis and hips to hold their adjustments? Quite likely they either don’t know how to recognize a misaligned pubic joint or they don’t know how to adjust it. If your pubic joint is misaligned and your therapist adjusts your hips or sacrum without adjusting the pubic joint first, then any other adjustments will not hold for very long. The third possibility, of course, is that your therapist simply doesn’t want to go there. At one clinic where I worked I was known as “the pubic joint guy,” which was something of a dubious distinction. But hey, everyone needs a niche, right? And this is one that badly needed to be filled.

If you take anything away from this series, it would be the critical importance of the jaw and pubic joint in both musculoskeletal and systemic health. It’s frequently missed because it’s rarely a consideration in the medical model, and it was also given scant emphasis in my chiropractic education.

Leg Length Inequality: This is more commonly known has having a short leg. The two most blatant symptoms are talking like a pirate and involuntarily walking in circles.

There are two types of short leg, anatomical or functional. An anatomical short leg means that the bones of one leg, either the femur or tibia, are literally shorter than the other side. A functional short leg is caused by structural imbalance in the pelvis, which results in one leg appearing to be shorter because of dysfunctional muscle patterns that are attempting to right things.

In 12 years of practice I can count on one hand the number of people I encountered with an anatomical short leg. It is extremely rare. Generally, it’s either due to a congenital condition such as a malformed hip joint on one side, or a nasty hip/leg fracture that healed in a less than ideal manner. Functional short legs, however, are more common than dirt. Just from your personal history you’d likely know if you had such a congenital condition and certainly would’ve remembered a bad fracture that didn’t heal properly.

I can’t say this more emphatically: If you don’t have an anatomical short leg and your therapist wants to prescribe a heel lift for you then they simply do not know how to adjust your pelvis to even out your legs, in which case you need a new practitioner, or they need to prove the need for a heel lift by virtue of full skeleton x-rays. If you’re given a heel lift for the “short” leg only and you don’t have an anatomical short leg, it can screw you up for life. If the therapist tries to convince you that a heel lift is not a big deal, then run, don’t walk, out of that office.

Because a functional short leg is a compensation for an imbalance in the pelvis, using a heel lift does nothing to correct this imbalance and in fact encourages one’s body to accept this imbalance as normal. This will create even more layers of muscular dysfunction over time, and can even cause secondary problems in the neck, upper back, and shoulders.

Carpal Tunnel Syndrome: This is the GCD for which I’ve encountered the most failed surgeries simply because it is so easy to misdiagnose. The actual carpal tunnel is a bony trough in the wrist that is bordered by two of the carpal bones. A variety of tendons, nerves, and blood vessels pass through this area. Generally, you have to really beat the crap out of your hands for a very long time in very repetitive ways for the actual carpal tunnel to be the source of the symptoms of numbness, tingling, pain, muscle weakness, and muscle wasting.

More often than not, however, the symptoms leading to this diagnosis do not originate in the carpal tunnel. Hence, the number of unnecessary and unsuccessful CTS surgeries. More commonly the symptoms originate from the upper back, neck, shoulder joint, collarbone, elbow, and the muscles, nerves, and disks in these areas. Even inflammation of muscles in the forearms can mimic CTS. A major problem with being diagnosed with CTS is that if you don’t improve with conservative treatment such as rest, splinting, and stretching, then you’re likely on a track for surgery.

It goes without saying that you need a second or even third opinion if you receive a CTS diagnosis, before you go down the road of a treatment plan designed around it.

 

 

Have You Been Saddled with a Garbage Can Diagnosis?

Have You Been Saddled With a Garbage Can Diagnosis? Part I

As a chiropractor I was often the last resort for someone whose experience with previous health care practitioners was less than satisfying. Kinda goes with the territory when working in a fringe profession. So, neither one of us had anything to lose. I would either be the latest source of that person’s dashed hopes or I’d be able to bring a fresh set of eyes and find something the doctors missed.

One of the shortcomings of the medical model is its reliance on diagnosis. A doctor often lives or dies with it, and so will the patient. This jump to identify and label can actually impede a healing process because it can severely restrict the condition’s freedom to reveal itself. Instead of witnessing what’s going on in front of us, we impose a diagnosis that is generated by the intellect and its relentless obsession to categorize, explain, and rationalize.

The establishment of a diagnosis is treated as a victory of sorts, as if to say, “now we know what we’re dealing with.” When our intellect feels like it has reached a resolution of sorts, then it will often abort all further investigation and fall into the default protocol associated with that particular diagnosis. All it does is relieve our poor assaulted psyches of the anxiety of uncertainty. Well, certainty is often our worst enemy.

Also, the next step after diagnosis is to suppress whatever has just been named. So, say goodbye to finding root causes if the goal is simply to push everything back below the surface and turn off the body’s distress signals. In the rush to identify and suppress, the clues to the condition’s source are trampled.

This is especially true of a so-called “garbage can diagnosis.” It’s a label that is slapped onto a symptom or group of symptoms because the practitioner doesn’t feel that the principle of do no harm extends to a willingness to say “I don’t know.” As health care practitioners, we sometimes trick ourselves into thinking that we have someone’s best interests in mind when all we’re doing is covering our ass as a professional.

GCD’s are superficial umbrella terms used to classify symptoms that can have a wide variety of possible origins. A GCD is a prime example of using language to obscure rather than clarify, something American culture has elevated to an art form in more arenas than we can count. For example, the diagnosis of sciatica might be applied to a condition whose root cause might be any of the following: muscle spasm, lumbar disk bulge or herniation, infection, fibula misalignment, or repressed grief.

GCD’s also worm their way into everyday language, which accentuates their superficial nature. The words “TMJ,” “impingement syndrome,” “chronic fatigue syndrome,” “fibromyalgia,” “tendonitis,” and “bursitis,” glibly trip off our tongue like we’re talking about the latest hijinks of some Hollywood beefcake.

A good indication that you’ve been slipped a GCD is that you don’t significantly improve with the treatment protocol that accompanies the diagnosis. The condition ends up being managed rather than resolved because the diagnosis is a cop-out in the first place, and thus can leave a person in health care purgatory for years. It can cause even more pain and stress for the patient just because someone thought they needed to give a name to something.

I’m only going to cover some of the most common ones I’ve encountered, and I’ll be making generalizations that are based on my own experience.

Fibromyalgia: This is the mother of all GCD’s. There was surely dancing in the streets in the medical community when this diagnosis finally hit the streets. No longer did GP’s have to wince at seeing these folks in the waiting room, and have the joy of telling them after a 30-minute phantom evaluation that “it’s all in your head.”

Conditions like these of global pain or chronic fatigue often remain mysteries because their origin is precisely in that area that most practitioners and patients don’t want to go–repressed emotions. This doesn’t mean that the physical pain is not real; it most certainly is as real as the pain from an acute ankle sprain. The difference, though, is that the pain is being generated by the body to inform the person that unless these emotions get some expression, the pain will persist.

One of the dangers of this diagnosis is that if the person is resolved to remain in the dark about their repressed emotions, now they’re free to use the diagnosis as official confirmation that there’s something wrong with them. So, the diagnosis becomes ammunition for behaviors and beliefs that further alienate the person from her/his true feelings. This is a GCD that can perpetuate a particularly brutal cycle of suppression, particularly if extended use of antidepressants is also part of the treatment protocol.

Pneumonitis, costochondritis, angina, thoracic outlet syndrome, dyspnea: I’ve lumped these together because I’ve seen them all applied to what turned out to be rib misalignments, which are quite common. This is sad, because rib misalignments are one of the simplest corrections to make, and generally provide a quick resolution to the problem. When ribs aren’t properly aligned, it can cause intense, knife-like pain, particularly with deep breaths and particular movements, such as twisting of the upper body. Other possible symptoms are numbness and tingling in the arm and hand, or poor circulation to the arm.

Ribs can be misaligned both in the front where they join the sternum, producing a pain which can mimic heart-related symptoms, or in the back where they join the spine. The cause is generally an acute injury, such as a fall or car accident, repetitive stress, or a period of intense coughing and/or sneezing.

Stay tuned! Part II of this blog post will include old favorites like TMJ, carpal tunnel syndrome, leg length inequality, plantar fasciitis, scoliosis, tension headaches, and chronic low back pain.