Subsequent visits are limited to 30 minutes unless a lab test report is needed to be discussed and in that case the visit would be 45 minutes. If the patient has a structural problem it might be a traditional Chiropractic care treatment with an evaluation of the musculo-skeletal system and a variety of therapies used depending on the patient.
Electrical muscle stimulation, hydrocollator heat packs, ultrasound, Instrument assisted soft tissue mobilization, (S.A.S.T.M), Applied Kinesiology, or natural health exercise recommendations might be utilized during the visit. If someone has a metabolic focus, then the office visit would deal with the progress of how supplements might be helping to restore their hormonal or gastrointestinal areas or what supplements might be needed to detoxify or support a specific area of the body. These are not cookbook recommendations for a condition. Again, if two people have sleep problems I might recommend different supplements for each.
There are also patients who have a need for both some structural work and metabolic work on the same visit. In this case I try to address both issues on the same visit, but sometimes there is a need to have an extended office visit.
Our Clients Came to Us For All Different Reasons...
Attention Deficit Disorder
Blood Pressure Problems
Carpal Tunnel Syndrome
Fatigue/Lack of Energy
Hand & Wrist Pain
Tingling and Numbness
They continue to come because our treatment works.
S.A.S.T.M. stands for: Sound Assisted Soft Tissue Mobilization. It was developed by David Graston a pioneer in (I.A.S.T.M.) Instrument assisted soft tissue mobilization. He developed these tools after scar tissue from knee surgery left him with chronic pain. His first instruments called the Graston Instruments were metal, and although they work well, in my opinion, were not ergonomically friendly for use by the practitioner using them.
His second incarnation of tools (S.A.S.T.M.) are easier to use and because of the polymer used in its construction allows the practitioner and patient to "feel" and "hear" the areas where there are fibrotic tissues being released. More about this technique can be learned by visiting his website, www.sastm.com
Today there are many Chiropractors, Physical Therapists, and Athletic Trainers using both sets of tools to successfully treat many acute and chronic musculoskeletal injuries such as strains and sprains, tendonitis, carpal tunnel, nerve entrapment syndromes, rotator cuff injuries, acute and chronic neck and lower back disc problems, and various other conditions. It should not come as a surprise that many of the training rooms of college and professional sports teams have these tools on hand to treat their athletes.
Traditional Chinese Medicine (T.C.M.) has long used a system called Gua Sha that is based on these same ideas. Traditionally a piece of jade or a ceramic spoon was used to "scrape away disease" of an area to relieve pain. The translation of Gua is to scrape or scratch and Sha represents the disease through "transient therapeutic petechiae" which appear as tiny red dots. After a treatment, the extravasated blood appears as red macula and fades to ecchymosis thereby improving blood circulation to the area.
Of course with each patient, an evaluation is needed to see if you would benefit from the technique.
Functional medicine is an integrative, science-based healthcare system that treats illness and promotes wellness in a different way from conventional medicine. The approach in functional medicine is to focus first on assessing the biochemically unique aspects of each patient, and to then employ an individually tailored intervention to restore balance to the patient - physiologically, psychologically and structurally. The value of the functional medicine approach is its cost effectiveness and the high rate of patient compliance with treatment. Some of the driving forces behind Functional Medicine is Jeffrey Bland President of the Institute of Functional Medicine and some labs like Genova Diagnostics, Metametrix and Diagnos-Techs, Inc.
Functional medicine addresses four primary functions in the body and seeks to bring each into balance:
Nutrition and Digestion
Detoxification and Elimination
Endocrine (hormonal) function
Functional medicine evaluates the following major symptom categories:
Mental and emotional/behavioral problems
The process of optimal aging
As an example of the value of functional medicine, consider the following. Choosing which supplements to take to maintain optimal health is a daunting task even for someone with training in natural healthcare. Functional medicine uses noninvasive, specialized laboratory tests that can show which supplements and substances are indicated to support optimal functioning of the body's many systems - systems that come under stress from the environment, lifestyle or genetics. Many of these tests are listed below.
The following information will help in understanding the difference between the Conventional Clinical Approach and the Functional Medicine approach:
Conventional Clinical Approach
Functional Medicine Approach
Focuses on the illness or disease itself - not on the underlying causes leading to it.
Focuses on suboptimal functioning of the body's systems as the underlying cause of illness and disease.
Focuses on how the patient compares to the "average."
Focuses on the biochemical individuality of the patient.
Treatment focuses on suppressing the signs and symptoms of an illness, not on eliminating its causes.
Treatment focuses on correcting the functional imbalances that can cause illness.
Views the organ systems and functions as isolated and acting alone.
Considers the interconnectedness of the organ systems and functions.
Considers genetic triggers and mediators (hormones) of body function
Conventional Laboratory Testing
Functional Laboratory Testing
Lab tests focus on pathology - the disease. Tests are not useful until disease is present.
Lab tests focus on suboptimal functioning. Tests are useful before disease can be identified.
Lab results identify "what" symptoms are occurring.
Lab results identify "why" symptoms are occurring.
Lab results identify a single cause.
Lab results identify the interrelationships among the causes.
Symptoms are separated from one another.
Symptoms are viewed in relationship to one another.
Lab results are compared to the "average" for the population.
Lab results are compared to what is "normal" for the individual.
Lab results are numerical data only.
Lab results are graphical data together with numerical values.
Lab results are used only as a clinical tool.
Lab results are used as a clinical tool and to educate the patient.
The results, which show "what," are not link to the therapeutic treatment.
The results, which show "why," act as a guideline for therapeutic treatment.
Chiropractic is a system of natural healthcare that believes in the body's innate ability to heal itself. Chiropractic was discovered in 1895 by D.D. Palmer. Palmer was a self-educated man who by most accounts was a genius. He worked as a healer and came to the conclusion that misaligned vertebrae and joints can cause subtle pressure on the nerves which, in turn, could cause "dis-ease" in the body. The misalignment was named subluxation. Palmer reasoned that the nervous system - the brain, spinal cord and spinal nerves - transmits information that provides the body with the innate intelligence to keep it healthy. Today, Gray's Anatomy, a standard text used by medical and chiropractic students, corroborates this understanding by defining the nervous system as "the control system of the human body."
Although joint manipulation has been recorded by cultures around the world for thousands of years, D.D. Palmer's observation was remarkably insightful - that a specific correction of a specific subluxation would address a specific health problem. Palmer developed scientific records and a terminology to support his work and wrote books so that others could learn it. He termed the correction of subluxations adjustments and his new science Chiropractic, which means "done by hand."
Over the years, Palmer developed a reputation as a healer for his ability to help people with chiropractic when there was no other road for the patient to take. His son, B.J. Palmer, continued his research and was the main force behind starting a school to train others in this magnificent healing technique. Today, there are over 50,000 chiropractors worldwide and chiropractic is the second largest healing profession in the world. In the United States, there are two national chiropractic organizations. Dr. Goldstein is a member of the American Chiropractic Association because he believes this organization will be the most progressive in protecting the chiropractic profession's interests in the future.
There are two main philosophies that have developed in chiropractic - the ideas of the father, D.D. Palmer, and the ideas of the son, B.J. Palmer. D.D. Palmer believed that "dis-ease" could be the result of improper nerve pressure, improper thoughts or toxic or chemical insult to the body. B.J. Palmer felt that all "dis-ease" was the result of improper nerve pressure alone. To this day, many chiropractors follow one of these two philosophies. Although this difference in belief system has caused the chiropractic profession some internal problems and how it is perceived by the general public, there is common ground between the two. The Vertebral Subluxation Complex (VSC) is a modern term that researchers use to describe what occurs physiologically and neurologically to the spinal motor unit when a vertebrae is displaced. The VSC is recognized by both schools of thought. Researchers are now attempting to show that there is a link between subluxation and dis-ease within the body.
Many chiropractic detractors had previously denied the very existence of subluxations until recently. Now, it is a well accepted notion that a vertebrae can subluxate. The philosophical argument about the neurological implications of the subluxation is being researched and will in my opinion show a definite link between subluxated spinal segments and compromised organic function. The vast majority of chiropractors agree that the VSC exists and contributes to pain and "dis-ease." Furthermore, although there are various techniques to correct the VSC, the vast majority of chiropractors agree that it is treated most effectively without drugs and surgery.
Research: The Vertebral Subluxation Complex
Basically, there are five components to the vertebral subluxation complex (VSC) that many researchers, including those from the medical community, commonly accept as consequences of D.D. Palmer's original observations.
This is the variance from normal within the biomechanics of joint function. Six major classifications of spinal kinesiopathology are observed throughout orthopedic literature: (1) hypomobility; (2) hypermobility; (3) compensation reaction; (4) loss of joint play; (5) change in axis; and (6) positional dyskinesia.
(1) Compressive lesion: direct compression of the nerve root
(2) Facilitated segment: indirect compression of the nerve root
(1) Hyperactivity: muscle spasm (contractive myofibrositis)
(2) Hypoactivity: loss of muscle tone (atrophy myofibrositis)
Inflammation, edema, and swelling. Frequently subclinical in non-acute situations.
Biochemical and bioelectrical. This process describes what is known as subluxation degeneration. The regeneration of new bone tissue as a direct result of gravitational misalignment. Bone spurs or osteophytes would describe this process in simpler language.
There is a growing body of research investigating chiropracticâ€™s effectiveness in the treatment of musculoskeletal problems as well as organic problems such as headaches and premenstrual tension. These links can bring you to sources with the most up to date information in these and other areas of chiropractic research:
Auriculotherapy was developed by Dr. Paul Nogier, a neurologist, in the 1950's. He became interested in the study when several of his sciatic patients related how they had been helped by a middle eastern woman. They reported that their suffering ended after she put a hot needle into their ears. Nogier began his quest to understand more of this system.
Since then, researchers such as Terry Oleson, PhD from UCLA, and Dr. Jay Holder in Miami, FL have expanded Nogier's work. Oleson, using radioisotope techniques, showed how these ear points could be located and identified their relationship to areas of the body. The acupuncture meridians do not innervate the ear. Originally, Chinese medicine evolved to include a form of auriculotherapy that used needles placed in the ear to treat opiate addictions as well as other problems, Nogier became aware, however, that auricular points differ from acupuncture points: Auricular points can move; acupuncture points are stationary. To detect the movable points, Nogier used elaborate cameras with filters but it was time consuming. Today, a noninvasive microstimulation device is used to not only detect the points but to deliver a microcurrent that effectively treats the points faster and more accurately than would be possible with a needle. The microcurrent feels like a slight prick with a needle. Although some mild discomfort is possible, most patients find it just barely noticeable and tolerable.
Uses of Auriculotherapy
The five addictions: smoking, food, gambling, sex, and work
Jay Holder, DC, MD, PhD, Medical Director of the Exodus Treatment Center in Miami Beach, FL, conducted research in 1990 using auriculotherapy in combination with the standard 12-step program for addition recovery. The results were dramatic. Using 66 participants, Dr. Holder demonstrated that patients receiving auriculotherapy treatments without medications were ten times more likely to complete a thirty day residential treatment than patients who did not receive auriculotherapy. More recently, Dr. Holder has done research to see if using chiropractic and amino acid supplements will increase the overall success rate of treatment with first time drug offenders. The success rate of his program was so impressive that it helped give Miami national recognition for a decreased crime rate. Dr. Holder has met with Attorney General Janet Reno and drug czar McCaffrey to discuss the success of his programs. It is hoped that the government will recommend that 12-step programs include auriculotherapy, chiropractic and nutritional supplementation as the standard treatment for drug offenders.
The Brain Reward Deficiency Syndrome
All vertebrates produce neurotransmitters, chemical messengers in the brain such as serotonin, that make us feel good and give us a sense of well-being. In all addictive behavior, there is a deficiency of these neurotransmitters and, thus, a deficiency of feel-good chemicals. The drug or compulsive behavior is sought to bring up the feelings of well-being that nonaddictive people have naturally. Other neurotransmitters, such as endorphins, when not present in sufficient amounts will lead to chronic pain syndromes. The addictive behavior will then produce an increase in these chemicals and lessen the chronic pain.
Addiction is a multifactorial disease having psychosocial, spiritual, genetic and metabolic components. It is important to realize that once an addict, always an addict. In dealing with addictions, the goal is to remove the behavior through a natural process of encouraging patient compliance with the 12-step program and to restore the balance of neurotransmitters that will allow the person to feel good about him/herself.
The Neurology of Auriculotherapy
Dr. Paul Nogier noted that the ear is one of the few anatomical structures that is composed of tissue from each of the three tissue types in the developing embryo. He believed the ectodermal tissue(superficial), mesodermal tissue(middle) and endodermal tissue (deep) of the ear could be stimulated to affect the organs and systems that also formed from these same tissues. With over 120 points in the ear, this corresponds to just about everything one could imagine.
Acupuncture research sheds light on the underlying effects of stimulating auricular points. The ear is innervated by four cranial nerves and by the second, third and fourth cervical ganglion nerves. Direct evidence that stimulation of acupuncture points produces endorphins has been verified by Sjolund and Eriksson (1976) and by Abbate et al (1980). Assaying plasma B-endorphin concentrations in subjects undergoing surgery, they observed a significant increase in B-endorphins after acupuncture stimulation when combined with nitrous oxide inhalation, whereas control subjects given nitrous oxide without acupuncture showed no such elevation of endorphins.
The use of auriculotherapy is blossoming in Asia, and now that the World Health Organization declared it to be a viable medical therapy in 1989, it is likely to gain in popularity here in North America, as well.
The use of auriculotherapy for nicotine addiction can be used effectively if done with a motivated patient. Many successful cases have been reported after only one or two treatments.
Disclaimer - Auriculotherapy is not meant to be, nor claims to be, a treatment for all diseases. A proper evaluation and diagnosis is needed to determine if auriculotherapy would be the most appropriate treatment.
Applied Kinesiology | Muscle Testing
Applied kinesiology is a form of diagnosis that uses muscle testing as a primary feedback mechanism to examine how a person's body is functioning. When properly applied, the outcome of an applied kinesiology diagnosis will determine the best form of therapy for the patient. Applied kinesiology draws together the core elements of many complementary therapies and thus provides an interdisciplinary approach to health care or a "total person" concept of health.
How does applied kinesiology work? In general, the applied kinesiologist finds a muscle that tests "weak" and then attempts to determine why that muscle is not functioning properly. The practitioner will then evaluate and apply the therapy that best eliminates the muscle weakness and helps the patient. Therapies used can include specific joint manipulation or mobilization commonly practiced by chiropractors, various myofascial therapies, cranial techniques, meridian therapy, various reflex procedures, clinical nutrition and dietary management . Any one of these therapies alone or in combination will usually restore strength to the previously weak muscle. In some cases, the practitioner may test for environmental or food sensitivities by taking a strong muscle and determining what makes it weak thereby working the system in "reverse." This information may show what substances are weakening the individual's immune system. It may also have bearing on the recurrence of the Vertebral Subluxation Complex (VSC) and thereby reduce the frequency of office visits.
The Triad of Health and Applied Kinesiology
Applied kinesiology uses the concept that a person's health can be described by the balance of three major health categories - chemical factors, mental factors and structural factors. This is called the Triad of Health. The Triad is represented by an equilateral triangle with structural factors as its base, and chemical factors and mental factors as the upright sides. When a person experiences poor health, it is due to an imbalance in one or more of these three factors.
The Triad of Health is interactive: All sides must be evaluated for the underlying cause of a problem. A health problem on one side of the triad can affect the other sides. For example, a chemical imbalance may cause structural symptoms. Applied kinesiology enables the practitioner to evaluate the Triad's balance and direct therapy toward the imbalanced side or sides. An example can be seen in the case of a patient who has both chronic neck pain and chronic sinus problems. This patient may show weakness in the muscles in the front or back of the neck - the neck flexors or extensors. According to applied kinesiology teachings, these muscles are associated with the sinuses. Identifying and eliminating chemical sensitivities and environmental factors that may be irritating the sinuses can play a role in diminishing sinus congestion. Consequently, the neck muscles may be stronger when retested and there may be reduced neck pain.
Applied kinesiology is used in addition to standard diagnostic techniques, such as x-rays, to help determine the cause of health problems. The proper course of treatment will only be indicated by combining Applied Kinesiology with an adequate case history, thorough examination and laboratory findings.
Donna Amundson L.C.S.W.
495 Union Ave. Suite 1B
Middlesex NJ 08846-1962
E.W.O.T.(exercise with oxygen therapy)
Of all the health recommendations one could make, the best might be to recommend adequate oxygenation to our bodies. Although there are free divers who can survive 10 minutes underwater without oxygen, most of us would have trouble staying alive after 3 minutes without oxygen. Luckily, our ambient atmosphere is about 21% oxygen and it is readily available to us whenever we need it. We seem to get an adequate amount too because if we check our blood through a pulse oximeter, we will see that for most of us it regularly reads that our blood is 95-99% saturated with oxygen.
Despite what the pulse oximeter reading on the left shows is an adequate amount of oxygen in the red blood cells, what it fails to measure is the amount of oxygen in the blood plasma. This key distinction is the basis for oxygen therapies such as hyperbaric oxygen chambers and a newer therapy called E.W.O.T. (exercise with oxygen therapy).
Hyperbaric oxygen is the use of 100% oxygen delivered in a pressurized chamber. It has long been used for oxygen deprivation with divers suffering from “the bends” and to treat difficult to heal wounds. More recently it has been proven to help many other problems such as recovery from intense exercise and excess lactic acid, neurological symptoms from strokes, and other neurological diseases where the brain has been injured or deteriorated. Dr. Paul Hartch has been involved with hyperbaric oxygen chambers for over two decades and recently wrote a book named “The Oxygen Revolution” in which he details it usefulness. Hyperbaric oxygen works but it is also time consuming and expensive for treatments. A newer technique has been developed from the research of Dr. Manfred von Ardenne of Germany. Dr. von Ardenne was a student of Otto Warberg who received the 1931 Nobel Prize for proving that cancer can only grow in an oxygen-starved environment and that cancer cells are metabolically anaerobic. Dr. von Ardenne called his therapy, “Oxygen Multi Step Therapy”, and it consisted of an 18-day, 36-hour process of increasing oxygen to the body to make it more alkaline, saturating cells with more oxygen, changing them to a healthier aerobic metabolic state where they could detoxify and function better. With the modern development of an oxygen concentrator, ambient air can be filtered so that oxygen can be concentrated into a bag and delivered to a person with a hose and mask while they are exercising. This is called E.W.O.T. and a therapeutic session can now be achieved in 15 minutes which is a vast improvement over the process developed by von Ardenne.
More on E.W.O.T.
Pictured is an E.W.O.T. system by Maxx O2. The large bag holds 900 liters of concentrated (93%) oxygen and depending on your level of fitness while exercising you could potentially absorb all 900 liters of oxygen in 15 minutes which is the equivalent of almost two days’ worth of normal breathing. The exercise (for example, an exercise bike) increases the heart rate so you can pick up more available oxygen.
The generation of CO2 (carbon dioxide), is an important signal to absorb more oxygen. All of this is completely safe. There is no increase of free radicals from the use of E.W.O.T. Working out at a light or moderate level is all that is needed for benefit. The unit pictured also shows a smaller bag. This bag has 14% oxygen reservoir for adaptive contrast training. Adaptive contrast is enabled by a switch to go from high oxygen, to lower oxygen for a short period of time, such as 20 seconds every 5 minutes. This low oxygen sequence adapts your body to lower oxygen concentrations so that when you put the high oxygen back on, it literally floods your body with oxygen. During the short bursts of adaptive contrast training, it simulates training at a 9000-foot elevation. The time spent in this low oxygen state can stimulate autophagy. This is a state where your body eliminates or recycles old worn out parts of itself. Essentially, this is a way of stimulating detoxification of ourselves.
The Benefits of E.W.O.T. Training and its advantages over Hyperbaric Oxygen chambers
As with hyperbaric oxygen chambers E.W.O.T. can provide relief from chronic illness, it reduces inflammation, pain and fatigue, it increases energy and mental clarity.
Additionally, it has benefits over hyperbaric chambers in that it can strengthen the cardiovascular system, boost VO2 max, takes 15 minutes vs one hour in a hyperbaric oxygen chamber, and has far less risk such as rupturing the eardrum, or causing damage to the lungs, sinuses, or eyes. The cost is far less too.
Another benefit is the use of oxygen for killing pathogens. Bacteria, viruses, yeast and other pathogens such as Lyme disease can hide out and cause stress to our immune system. Applying this technique can kill these micro-organisms and help your immune system.
Olympic swimmers such as Dana Torres, and Michael Phelps along with many other professional football and basketball players have been successfully using E.W.O.T. in their training and recovery strategies.