Knee Pain: Answers Are Often Elsewhere

Knee pain can be a great and greatly frustrating mystery. Though a clear injury is often the cause, it’s not unusual for knee pain to start with no apparent cause.

It’s common for people to go from doctor to physical therapist to trainer and back to yet another doctor attempting to find a solution. And, medication is no long term solution.

Your knee pain can result from dysfunction in virtually any area of your body and the cause is often missed by looking to and treating only the knee to solve the problem.

An Example of Finding Answers Elsewhere

I practice applied kinesiology – muscle testing as neurological exam – largely because it solved my wife’s chronic knee pain while I was still in chiropractic school. She’d had ongoing deep, aching pain in her knee with instability – feeling like it would give out when she put weight on it. It was unstable and would pop, clunk, and lock up on her walking and standing.

My wife was evaluated by a chiropractic intern who used applied kinesiology and determined that her knee problem was due to instability resulting from a weakness of a muscle that stabilized the knee.  The intern went further explaining that the muscle had a reflex relationship to the gall bladder and that she needed to use a nutritional program to improve her gall bladder function. Sounded strange, but she followed the instructions. One week of the program and all the knee pains and instability was gone. And, never came back!

This had my attention – I had to learn how to do this! After learning and practicing applied kinesiology for over 30 years I’ve observed this kind of thing again and again.

The Many Potential Causes of Knee Pain 

Clearly, knee pain can arise from the knee itself or from the pelvis, hip, or ankle and foot, neurological inhibition of muscles that support the knee, organ dysfunction that leads to reflex weakness of the muscles of the knee, or from biochemical stress that effects the control of inflammation and the repair of injured tissue (muscles, tendons, ligaments, cartilage, and connective tissue) of the knee.

Knee instability and stress commonly results from joint dysfunction of joints far from the knee. Disruption of normal mechanics of the ankle, for instance, can feed abnormal nerve signals to the brain that can result in “turning off” muscles that support the knee. In this situation, the knee pain will persist regardless of what treatment there is of the knee itself.

Solutions from Applied Kinesiology Methods

Applied kinesiology (AK) is a remarkably effective approach for discovering these potential reasons for knee problems and pain. This is especially true when manual muscle testing findings are integrated with orthopedic, neurological, and physical exams, lab findings, and imaging studies to identify the underlying cause for knee pain.

Stress, Cortisol, and You

We all talk about stress – ours and others – and we assume we know what that means. Do we?

Usually, when we talk about stress we’re talking about emotional stress, but stress is our response to anything that challenges the innate capacity of our body to regulate and maintain itself and to heal. Those things that challenge our balanced, harmonious, and healthy state are called stressors and can be physical, chemical, or mental/emotional.

When we adapt to stress we are in a state of homeostasis – self-healing and self-regulating. We become sick when we are unable to adapt to stress. This is the essence of whether you’re sick or well.

Cortisol – The Stress Hormone

With high levels of stress, the body releases a more of a hormone called cortisol to strengthen adaptation. Much – most? – of the damage from chronic stress is caused by cortisol secreted by your adrenal glands lying against your kidneys. Though in the short-term, cortisol allows you to adapt to stress, long-term high cortisol will break your body down.

Insulin is the body’s most anabolic hormone in your body and controls repair and maintenance of every part of the body. Cortisol is the most catabolic hormone in your body as its’ primary function is to break down body tissues to produce energy in response to stress.

It’s normal for your cortisol levels to be highest upon waking in the morning, to be lower later in the day, and to be lowest at night. This is the circadian cortisol rhythm.

Cortisol and the Immune System

Cortisol acts as a natural antihistamine and anti-inflammatory but also lowers immunity and resistance to infection. High cortisol levels decrease immune response, as measured by secretory IgA, in the linings of the lungs, throat, kidneys, bladder, and intestinal tract. Abnormal cortisol levels also weaken the intestinal wall, resulting in increased risk of developing ulcers, colitis, Crohn’s Disease, Irritable Bowel Syndrome, and unhealthy intestinal flora.

Cortisol and the Brain

High cortisol levels can cause atrophy of the region of the brain where memories are processed and stored (hippocampus), and this phenomenon probably accounts for the impaired memory seen in people who are chronically stressed.

Cortisol, Diabetes, Pain, Fatigue…

Abdominal fat is a common outcome of high cortisol and is a symptom of impaired insulin control (insulin resistance) and type II diabetes. Muscle and joint aches and pain often result from impaired ability to maintain muscle, cartilage, and connective tissue. The same process predisposes to osteoporosis, thinning of skin, poor wound healing, and muscle wasting. Abnormal cortisol levels are a common cause of thyroid problems.

Cortisol, Poor Sleep, Depression…

Abnormal circadian rhythm of cortisol will usually show as waking tired in the morning (high cortisol upsets the normal REM stage sleep), fatigue during the day along with craving caffeine and sugar to provide temporary relief, and difficulty getting to sleep at night. The disturbed sleep has shown to be causative of depression.

Cortisol and “Medical Mysteries”

Often patients will see doctors who are not trained to recognize this wide collection of symptoms and will diagnose the individual conditions, such as depression or osteoporosis, but not the underlying issue of don’t get of these changes can over time result in the constellation of symptoms commonly called Chronic Fatigue Syndrome or Fibromyalgia.

Doctors using applied kinesiology are uniquely trained to diagnose and solve stress and cortisol related health problems. History, physical exams, lab testing, and applied kinesiology exams demonstrate high cortisol when present and lead the best course of action to solve it. This approach guides the healthcare and selfcare that reduces stress and normalizes cortisol circadian rhythm.

Self-care for High Cortisol

Rest and Relaxation
Get enough sleep. Sleep deprivation is incredibly harmful; most of us need eight hours.
Have some unstructured time for relaxation, and make sure to find satisfaction in your work, in a hobby, or both.

Balance Your Nervous System

• General physical activity
• Intense interval exercise
• Yoga, tai chi, or chi gong
• Full abdominal breathing
• Meditation, contemplation, prayer
• Practice gratitude
• May require chiropractic care,
craniosacral therapy, acupuncture

Balance Your Blood Sugar
Eat whole, natural, unrefined foods Eat regularly

Avoid Stimulants
Avoid “energy” drinks Avoid caffeine to excess

Balance Your Zinc
Zinc decreases cortisol. If you are deficient, which is common, a small dose at lunch and dinner will help rebalance your cortisol levels.

References
Lee, K.M., Kang, D., Yoon, K., Kim, S.Y., Kim, H., Yoon, H.S., Trout, D.B. & Hurrell, J.J., 2010, A pilot study on the association between job stress and repeated measures of immunological biomarkers in female nurses, International archives of occupational and environmental health, 83(7), pp. 779-89.

Murphy, L., Denis, R., Ward, C.P. & Tartar, J.L., 2010, Academic stress differentially influences perceived stress, salivary cortisol, and immunoglobulin-A in undergraduate students, Stress (Amsterdam, Netherlands), 13(4), pp. 365-70.

Black, P.H., 2006, The inflammatory consequences of psychologic stress: relationship to insulin resistance, obesity, atherosclerosis and diabetes mellitus, type II, Medical Hypotheses, 67(4), pp. 879-91.

Mujica-Parodi, L.R., Renelique, R. & Taylor, M.K., 2009, Higher body fat percentage is associated with increased cortisol reactivity and impaired cognitive resilience in response to acute emotional stress, International journal of obesity (2005), 33(1), pp. 157-65.

Chervin, R.D., Teodorescu, M., Kushwaha, R., Deline, A.M., Brucksch, C.B., Ribbens-Grimm, C., Ruzicka, D.L., Stein, P.K., Clauw, D.J. & Crofford, L.J., 2009, Objective measures of disordered sleep in fibromyalgia, The Journal of Rheumatology, 36(9), pp. 2009-16.

Lee, M.S., Lee, M.S., Kim, H.J. & Moon, S.R., 2003, Qigong reduced blood pressure and catecholamine levels of patients with essential hypertension, The International journal of neuroscience, 113(12), pp. 1691-701.

Brandão-Neto, J., de Mendonça, B.B., Shuhama, T., Marchini, J.S., Pimenta, W.P. & Tornero, M.T., 1990, Zinc acutely and temporarily inhibits adrenal cortisol secretion in humans. A preliminary report, Biological trace element research, 24(1), pp. 83-9.

Aerobic Base Training – The Most Important Exercise You’re Missing?

Pushing weight is fun! Grinding past that nearly stopped point of a heavy deadlift. Stopping cold a big kettlebell at the top of a snatch. Feeling the bar “snap” as you catch it at the bottom of a classic rock bottom clean. Locking tight for all you’ve got at the top of a barbell jerk or snatch while every muscle in your body quivers with the effort of keeping that bar in place. Pushing that big tire through the apex of its’ arc – it just plain feels good.

Then there is the interval stuff – the 15/15s and the 30/30s that make it feel like 12 – or 40 – minutes is forever and gives you that weird hurt that makes you smile to yourself.

That’s good stuff. Then there is aerobic training. You know that aerobic stuff is right for you, but it’s so dull!

But, it makes you stronger. It makes you a better athlete. Isn’t that what it’s all about. So, do your aerobics, but SLOW DOWN! That’s right GO SLOWER and KEEP GOING!

If you’ve been training for strength, you probably have no aerobic base, and that is keeping you from being as strong as you want to be.

You need LSD! That’s not what you’re thinking; it means long slow distance training. This training will increase mitochondrial mass, mitochondrial enzymes that produce energy, and capillary bed density. All this equals more energy, endurance, stamina – you can train harder and longer. You’ll be surprised at the extra reps you can get in before failure; you’ll have more snap at the end; you’ll recover faster; and, you’ll end up stronger.

More Energy, More Health

To build an aerobic base you have to put your time in and you have to go slower. Do this right, and you can double your mitochondrial mass!1 In time. Building mitochondrial mass and enzyme adaptation is about the frequency and duration of aerobic stress, more than the intensity.2

Over time, newer capillaries will grow into the aerobically stressed tissues.3

Aerobic exercise promotes beta-oxidation of fatty acids in mitochondria for production of energy. This response decreases dependency on glucose for energy production and helps to lower cortisol levels and improve anabolic/catabolic balance. Better sleep and stronger muscles.4

How To Train Your Aerobic Base

So, how to train your aerobic base? There are a lot of formulas out there, but the simplest and most effective is the Maffetone Method, promoted by Phil Maffetone, DC.

Here’s the protocol – train at the heart rate that equals 180 minus your age.

If you take medication or are recovering from surgery, illness, or injury, subtract an extra 10.
If your health isn’t robust or you haven’t been training, subtract 5.
If you’ve regularly training for two years or more and are progressing, add 5.

How To Measure Your Results

How do you know your aerobic base is growing? You’ll feel awesome and your other training will go better. You will be able to do more work at your aerobic base training rate.

For instance, someone 50 will train at a heart rate of 130 beats per minute. Rowing a Concept II rower for 5,000 meters initially takes 24 minutes at that heart rate, but after two months takes 22 minutes, they have a higher aerobic base and can do more work while staying at the same heart rate. Another way to measure aerobic base is by pace, a faster pace over time at the same heart rate translates to a higher aerobic base. Body weight and weight training movement can be used, as well. Paced kettlebell cleans, or burpees can do the trick, for instance. Walking, hiking, rowing, treadmill, and biking are usually more ideal.

Enjoy this time aerobic base training. It will immediately help as active recovery, and over time you won’t want to go without this training once you see how fit it helps you become.

References
1 Davies, K.J., Packer, L. & Brooks, G.A., 1981, Biochemical adaptation of mitochondria, muscle, and whole-animal respiration to endurance training, Archives of biochemistry and biophysics, 209(2), pp. 539-54.

2 Harms, S.J. & Hickson, R.C., 1983, Skeletal muscle mitochondria and myoglobin, endurance, and intensity of training, Journal of applied physiology: respiratory, environmental and exercise physiology, 54(3), pp. 798-802.

3 Billat, V., Lepretre, P.M., Heugas, A.M., Laurence, M.H., Salim, D. & Koralsztein, J.P., 2003, Training and bioenergetic characteristics in elite male and female Kenyan runners, Medicine and science in sports and exercise, 35(2), pp. 297-304; discussion 305-6

4 Molfino A, Aversa Z, Muscaritoli M., Cortisol and the muscle-bone axis, Osteoporos Int. 2014 Sep;25(9):2331-2.

Genetic Testing – A Remarkably Useful Tool

Intro
There is much buzz these days about genetic testing and its’ promise to provide answers for the many complex and chronic illnesses that are often difficult to diagnose and tend to respond poorly to care.

Genetic testing can be profoundly useful as a clinical tool, given certain caveats. These tests do give us detailed information about our genetic makeup, including variants in a gene (single nucleotide polymorphisms – SNPs). The outcome of SNPs can be detrimental or beneficial.

Genotype – Your Genetic Inheritance
The sum of an individuals’ genetic makeup is their genotype. A given gene translates to an enzyme that controls a given body function. For instance, BCO1 is a gene encoding the enzyme that converts beta-carotene from vegetables into the essential nutrient vitamin A.

Phenotype
How the genotype is expressed in a person is their phenotype.
As an example of this, people who have variants – SNPs – in the BCO1 gene will tend to have a chronic deficiency of vitamin A unless they eat a lot of foods that are direct sources of the vitamin from animal fats. The deficiency itself could result in night blindness and other eye disorders, skin, hair, and nail conditions, impaired resistance to infections, hormonal deficiencies that include the thyroid, increased risk for birth defects, and an increased tendency to sinus, lung, and intestinal disorders. It is common for the underlying vitamin A deficiency to be unrecognized and the various conditions associated with it to be treated independently and often with drugs.

Epigenetics
All of the external modifiers – environment, stress, diet – that influence the genotype and determine the resultant phenotype are the epigenetic factors/variables. Clinical nutrition, for instance, can be used as an epigenetic variable to modify the phenotype.

An example here is the ALDH gene-enzyme which breaks down aldehydes. It is very common for people to have SNPs that limit this enzyme and the result is reacting to aldehyde exposure. Aldehyde sensitivity will show up as headaches, foggy-headedness, severe fatigue, and muscle aching when exposed to aldehydes from colognes, perfumes, air fresheners, formaldehyde in carpets, furniture, and drapes. Symptoms are also be triggered by fermented foods and drinks (wine, pickles, vinegar) and by mold.

For people with low ALDH because of their genetic predisposition, supplementing the essential trace mineral molybdenum which promotes the enzyme can be life-changing!

Reading The Results of Genetic Testing
Caveat emptor! (buyer beware) Most services that interpret the results of genetic testing are misleading and superficial. Consult with a doctor/nurse/counselor certified in the Opus23 database – it is the most sophisticated database for genetic curation currently.

Sick Care or Health Care?

Sick Care Or Health Care?

This is mostly what conventional medicine has to offer.

US healthcare is the most expensive in the world and rated 37th in overall level of health when compared to 191 member nations according to The World Health Organization (WHO).

In 2007, 45% of Americans were living with one or more chronic diseases and that 45% accounted for 75% of the almost $2.4 trillion spent on health care that year. If we compare ourselves to Japan, the industrialized nation with the longest life expectancy (82.07 years), we spend more than twice as much per capita on health care.

About $3 out of every $4 spent on healthcare is used to treat chronic and degenerative illnesses with many of these resulting from or being compounded by lifestyle habits. Examples of these illnesses are heart disease, stroke, lung disease, obesity, diabetes, osteoporosis, arthritis, and many digestive, inflammatory, and hormonal illnesses.

What is Health?

It is essential to help sick people get well. But, how did they get sick in the first place and what could be done to keep them from getting sick? When we get healthcare are our symptoms being helped or are we actually becoming healthy? What is health?

“Health is a state of complete physical, mental, and social well being, and not merely the absence of disease or infirmity.*”

Health has no inherent value. The benefit associated with health comes from the usefulness of possessing good health; an essential resource required for living life well.

Or as the Greek physician Heriphilos said 2,300 years ago –

‘When health is absent,
wisdom cannot reveal itself,
art cannot manifest,
strength cannot fight,
wealth becomes useless,
and intelligence cannot be applied.’

What is Effective Healthcare?

It can be argued that the essential components of effective healthcare are that it (1) optimizes function and minimizes disability and (2) maintains function and independence until end of life.

Conventional medicine is a critical part of the healthcare system – it has wonderful tools for treating severe traumas and infections and  people who are severely compromised by pathological illnesses.

For other health problems, the greater percentage of illnesses that aren’t life-threatening, but tend to be chronic and progressive – further and further limiting abilities and well being and compromising a full, rich and joyful life?

Conventional medicine isn’t usually the best option.

What to do instead? Restore function. For most people who have health problems, the key issue isn’t disease, it is dysfunction. There are parts and systems in their body that doesn’t work right.

And there is a kind of care that does just that – restore function. It is called functional medicine or functional healthcare, but I feel there is a better term for this kind of care –

Systems-driven healthcare

There are exceptions, but most conventional healthcare is driven by treating symptoms – it is symptom-driven healthcare. For most health problems that people commonly deal with it’s just not a good model (that’s a nice way of saying it doen’t work).

That’s why for most people with type II diabetes, for instance,  the progression is a slow, progressive and steady decline in health and function and a steady increase in disability.

Not good.

Systems-driven healthcare can be measured.

Systems-driven healthcare is another way. If someone does their homework, a doctor practicing systems-driven healthcare can lead them to being free of type II diabetes or at least to the level of being insulin resistant rather than drug dependent. How do I know this? Because I’ve seen it reproduced for several decades with proof using the same gold-standard laboratory testing that conventional medicine – less costs and better outcomes with the individual being more in control of their health through education and coaching.

Better option.

Because systems-driven healthcare is a drug and surgery free approach to healthcare any of the essential healthcare providers (allopathic, chiropractic, naturopathic, osteopathic) can provide it. The focus of system-driven healthcare is to measure and optimize body functions. This approach  reframes healthcare from being reactive (symptom-focused) to proactive (function-focused).

Systems-driven Healthcare

  • Measures health status through measuring body functions.
  • Promotes health by restoring body functions.
  • Teaches selfcare so you can control your own health.

What Does System-driven Healthcare Look Like?

Chiropractic care retores nerve function and internal regulation.

Body function is the focus of care in system-driven healthcare because body function is the true measure of health status.

The initial phase of functional healthcare looks familiar in that the traditional tools of history, physical exams, laboratory testing, and imaging are used. Ultimately, diagnosis, though, will include both the illness and the cause or causes and both the illness and the causes will be addressed during care.

Treatment is likely to include methods that organize your nervous system through osteopathic, chiropractic, and acupuncture methods, balancing your body chemistry with clinical nutrition, including vitamins, minerals, herbs, and other supplements, and addressing the effects of physical and emotional stress.

Teaching and coaching a patient how to practice selfcare is also essential to healing.

How do I know this approach works?

  1. I’ve measured the results before and after using conventional medicines stndards and measures for successful care.
  2. See #1 – the proof is in the measure.

*World Health Organization (1998)

Three Treasures and the Origins of Acupuncture

Patients often ask me…

“Where does acupuncture come from?”

Well, we know that bian shi (sharpened stones) have been found in Mongolia that date to the Neolithic period (~7,000 BC in Asia) and archeologists believe they were used for a type of acupuncture. Fish bone needles were used in Korea as early as 3,000 BC. Around 250 BC a text on acupuncture and Chinese medicine was written, The Yellow Emperor’s Classic of Internal Medicine, and the first metal needles were developed around 100 BC.

But, all of that history doesn’t really tell us how acupuncture developed. I believe that acupuncture and Chinese herbal medicine, martial arts, and culture developed in large part because of the philosophical and spiritual ideas from taoism.

Taoism and Acupuncture

Taoism has been sometimes considered a religion, but is more properly categorized as a philosophy in that the focus of taoism is very detailed observation of the natural world and how to live in harmony with laws of nature.

It appears that acupuncture developed over a long span of time observing the most subtle details of natural laws in nature and in man and observing the effects of living an ethical philosophy, herbs, diet, physical treatments such as massage and bone setting1, exercise and breathing  – qi gong and tai chi, martial arts training and mediation.

Taoist Concepts

Tao

Tao translates as “the way.”  It’s meaning refers both to the way the universe works (natural law) and to the way to conduct ourselves in harmony with natural laws.

De

De is living a life that is intentionally focused on acting and living in harmony with the tao. This is considered virtuous conduct in Taoism.

Wu Wei

“The wise teach without telling, allow without commanding, have without possessing, care without claiming. ~Lao Tzu, Tao Te Ching, verse 2

Wu wei translates to”without action.” It is the concept that any act is most harmonious and powerful when it is in accord with the tao.

Pu

“When we live in complete integrity, we will be innocent like newborn babies. …Our bones will be pliable, yet our grip will be firm. …We’ll sing all day long without becoming hoarse because we’ll be in full harmony.” ~Lao Tzu, Tao Te Ching, verse 55

Pu translates to uncut wood/uncarved block. The principle of pu relates to a state of receptiveness and perception without prejudice, where everything is seen as it is without preconceptions or illusion. This state is considered to be our original nature.

The Three Treasures

Taoism refers to the three treasures in two ways – the three treasures of physical nature and the three treasures of emotional being.

The Three Treasures (Taoist Ethics)

“..sages dress in rags while they wear the Three Treasures deep inside their hearts.” ~Lao Tzu, Tao Te Ching, verse 70

“The first is to embrace simplicity and integrity. The second is to consume only the needs of our body and soul. The third is to allow our love and concern for others to define our essentiality.” ~Lao Tzu, Tao Te Ching, verse 19

Taoist ethics stand upon the three treasures of the tao

•love

•moderation

•humility

It is believed that all other natural human values come from these three treasures. Those who exemplify these characteristics are in harmony with tao (laws of nature).

The Three Treasures (Taoist Nature)

In taoism, there are three principles that act within the body that maintain life, action, and thought; they are also the same principles that are present and act throughout nature. These are jing, qi, and shen. Working with and refining these principles are considered central to understanding tao, practicing de, acting from wu wei, displaying the quality of pu, and exemplifying the three treasures of tao.

Jing

primordial essence, deep innate energy, reserve, constitution

Qi

vitality, circulating energy, force, breath

Shen

mind, spirit, soul

Jing is the deep reserve…

…of energy that we are born with and that we draw from to animate us and give us life. We can waste and deplete our Jing, or we can nurture and conserve it. We are born with a certain reserve of jing (primordial jing or essence).

People with a large reserve of jing are energetic, intelligent, strong, resilient, and charismatic. When we have exhausted our jing, we die.

Qi is the energy that circulates…

throughout our bodies and controls all of the processes of our cells, organs, and systems that maintains and restores us. The acupuncture meridians are some of the pathways of circulating qi.

Shen is the mind and spirit…

…and is supported by qi and represents a transmutation of qi to consciousness. This belief is behind much of the focus in taoism on developing jing and qi; they are the resources that one draws from to develop Shen through contemplation and meditation.

Developing shen is a very important aspect of taoism because it is through the development of shen that one understands tao, has the quality of pu, and is able to act in a way that represents the three jewels of the tao.

The Three Treasures and Your Health

According to the taoism, one cannot have a deep mental and spiritual life (shen) unless one has a strong reserve of jing and circulation of qi from which to draw.

The Three Treasures and Acupuncture

Acupuncture has effects that nourish, restore, and balance the characteristics of jing, qi, and shen in your body. This is how the taoist concepts relate to acupuncture. Using concepts and models from taoism can help us take care of ourselves by living in accord with natural laws and be healthier for it. In doing so, we protect our resources (jing), enjoy robust health and energy to use for manifesting our unique visions/goals (qi), have strong minds and pure spirits so that we can see the world around us clearly and without prejudice (pu), and can be examples of compassion, moderation, and humility (three jewels).

Footnotes

1 Bone setting my be the origin of chiropractic

2 Interestingly, the energy that flows through the acupuncture meridians can be measured with an ohmmeter, a device for measuring electrical resistance. The tool we use in the office, called Acugraph, is a sensitive ohmmeter with sophisticated software to graph and interpret the results of these measurements.

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Houston, We Have A Drug Problem (Part 1)

A story about Joe and me having lunch in Ashland, Oregon…

I was having lunch with a friend of mine this week and we were enjoying some great conversation. Joe is a talented trainer and disciplined about his health habits. We were mostly talking “shop” about training, diet and other selfcare. At one point he shared his experience getting a physical exam – his wife insisted since he was now 52 he needed an annual exam.

While waiting in an exam room, a nurse entered to review his intake forms and take weight, blood pressure and other exams. She began with “It says here that you don’t smoke, drink or take any medications?”

“That’s right.”

“Not even over the counter medicine – non-prescription medications?”

“None,” said Joe.

Doubtful, the nurse continued, ran her exams and left.

When the doctor entered, he asked, “Joe, Do you really have no prescriptions you take?

“No, why?” asked Joe.

“Well, it’s just that it is normal at your age to be taking 5 prescriptions by now!”

Think about that for a moment and digest it –

 

“It’s just that it is normal at your age to be taking 5 prescriptions by now!”

 

Why does this doc believe this crazy idea?

Because that’s what he’s told. It’s how he’s been trained to view the world. And, that beief gets reinforced because that’s what he see in his practice. According to this doc’s observation and experience that’s how the world works.

On average, patients will regularly use one prescription medication for each decade of life.

That’s common knowledge because that’s what happens in the US.

Another story about me in Honduras…

In March of 2010, my wife and I were celebrating our 30th aniversary on Roatan Island in Honduras. E’d had a wonderful time staying at a bungalow on the coast, walking on the beach, scuba diving and nights out for dinner outside with stars and ocean breezes.

But, now I was unconscious in the little health clinic on the island and the main nurse who’d been coordinating care told my wife she was “Sorry” because she felt I wasn’t coming back. I’d been unconscious for the last 18 hours and my blood pressure was near the bursting point.

Shortly afterward the clinic team started me on an antibiotic for meningitis as a last resort. And, I did come back over the next few hours.

The next morning I was released for our flight midday Sunday back home to Phioenix.  I couldn’t get around on my own because I was hallucinating so badly. My wife had to prop me up and steer me.

I was clear enough by this time that I was perfectly clear that if I hadn’t been given that IV Cephalosporin just a few hours before I would now in that moment in time be dead.

And, then I started to put the picture together…I’d contracted Listeria meningitis.

With Listeria meningitis 50% of people die. Of the 50% that live, around 80% end up with a significant permanent disability and most people are out of work for 6 months – some never work again.

I could put this picture together for the very reason I’d had the IV antibiotic and was now taking it orally.

Thanks to my wife, Kathie, we got home at midnight and I tried to sleep through the head pain and hallucinations.

First thing Monday morning I called a neuro doc friend. He scripted more Cephalosporin and Amoxycillin. Then, I called a biochemist friend for advice on the nutritional support, called a chiropractor friend and got adjusted once a day, graphed my acupuncture meridians multiple times a day and treated with acupuncture needles and did chi gong and meditation multiple times a day.

And was able to work a full day the following Monday.

Residual effects – diminished visual pattern recognition.

Where would I have been on the standard track of post-infection care? Don’t want to think about it.

I am forever grateful for the focused and dedicated care I recieved from the nurses and doctor at that modest community health clinic on Roatan Island. They saved my life. And, the strengths of conventional medicine including antibiotics also saved my life.

Those are the strengths of prescription drugs – at least certain ones – because they are truly life-saving and curative.

Prescription drugs and a confusion of aims

I will fire a patient if they don’t take medication they actually need. It’s just that most people are taking medications they don’t need and they’re sick at least in part because of it.

 

Most drugs manage symptoms – they don’t heal; they don’t cure.

 

And, essentially every drug has side effects with a great many of them serious and even life threatening!

When I started in practice over 30  years ago, it was common for people in their 70s or 80s to take a drug or two. Usually a diuretic for some water retention or hypertension, a little thyroid for some energy or a “pain pill” for arthritis. Not so unreasonable or so bad.

Now it is incredibly common for patients to come in for their initial hstory and I have to get more paper to write down all the medications becasue theee are too many to fit on my form. Now patients often have 10, even 20 prescriptions!

They will give me the “shopping list” of prescriptions and tell me they don’t feel so good. Often my reply is “I’m surprised you could get here!”

Medicine as cause of disease

 

Using multiple medications for managing symptoms of poor health

is often a cause of disease!

 

It is estimated that prescription related drug deaths are around 125,000 annually in the US.1

Kidney dialysis and related treatment for end stage kidney disease used up 8% ($30 billion) of the 2010 Medicare budget.2  Why are most of the folks on dialysis there? Chronic hypertension and diabetes are the most common. Hidden in those illnesses is chronic and multiple drug use and kidney disease due to same associated with other diseases. Most of the incidences of the people suffering these diseases are being managed for their symptoms with drugs that incrementally making them sicker –

 

When some good counsel on diet and exercise and maybe some targeted nutrition

to address genetic predisposition to certain illnesses could have headed off a pile of tragedies.

 

Solution for both type II diabetes and hypertension? Less junk, more veggies and move! A couple of months of getting serious about taking care of that can transform people. It’s rarely complicated and the proof is transparent and easy to measure/prove.

Why does this continue? Docs and nurses are good people. They just want to help – to make a difference. They’re doing what they believe is right.

Who convinced them?

The pharmaceutical industry is designed primarily for profit. And, the drug business has gamed the system from medical school, to research and to hospitals and clinics to make drugs the “only option.”3 Why does the high end of normal for cholesterol and blood pressure keep going down? Follow the money – it makes for more long-term customers for BP and diabetes drugs.

Why? There’s way more money to be made off the prescription pad than from counselling and coaching a patient to practice selfcare. The drug business is doing great!

However, in my experience, most medication is a poor excuse for good doctoring.

And back to Joe and me having lunch…

Joe and I had some more conversation about selfcare and lifelong health.

For me, I had antibiotics when I had my wisdom teeth removed at 17 and the antibiotics for meningitis in 2010. Full disclosure – I did use Benadryl for a week around 2000 during a bad bout of Spring hay fever. It didn’t work so I had to focus on the solution and some selfcare for the actual problem solved it after a few weeks. Other than that? No medications – over the counter or prescription.

And, at 61, I’m doing pretty good. No aches or pains, headaches or digestive problems. Sleep good. Blood pressure good. Labs good. I’m not as fit as I’d like, but nothing that holds me up. A couple of days a week I like to put on a 30lb pack and hike up the steep trails around Ashland.

In a couple of days I’ll be ski mountaineering on Mt. Shasta.

I certainly don’t feel Im missing anything or that I have a prescription drug deficiency. I’d say I’m all the healthier without any of it!

These outcomes aren’t random. They are reproducible. There are things I don’t know, but I know this because I’ve seen the same outcomes in thousands of people over the years. We can live in the way that makes the best version of ourselves.

References

1 Starfield B, 2000, Medical Errors – A Leading Cause of Death, JAMA Vol 284, No 4.

2010 Annual Data Report United States Renal Data System

3 “The Truth About the Drug Companies: How They Deceive Us and What to Do About It”, Marcia Angela, MD, past editor in chief of The New England Journal of Medicine

Yin, Yang, The Great Integrity and You

A blog about yin and yang? Isn’t this website about my health? Exactly.

Understanding and knowing how to use the principles of yin and yang will give you tremendous leverage over your health and well-being.

The concept of yin and yang is the foundation of traditional Chinese medicine. Recently, I have been lecturing to doctors around the country on the concept and how it relates to every doctor’s practice when observing and serving patients. Indeed, restoring harmony to yin and yang is the essence of healing and health.

Origins of Yin/Yang

The concepts around yin/yang developed around the 4th or 5th century BC and are associated with observing the laws and dynamics in nature as presented in the Tao Te Ching and attributed to Lao Tzu.1 Often taoism is called a religion, but is more correctly a philosophy oriented around abserving and living in harmony with the laws of nature.

Here is a passage elucidating yin/yang from the Tao Te Ching –

The Great Integrity expresses one.

The nautilus displays harmony of yin and yang.

One manifests as two.

Two is transformed into three.

And three generates all

the myriad entities of the universe.

Every entity always returns

to yin after engaging yang.

The fusion of these two opposites

births the Vital Energy

that sustains the harmony of life.

~ Tao Te Ching, Chapter 42

It’s All Yin & Yang

In nature all phenomena are an interplay between the characteristics called yin and yang. This dance between the principles of yin and yang helps us understand the big things – the big pictures in nature – and how the parts relate to the whole. The principle helps us understand the very small things – like particles and charges and elements and their natures and behaviors.

Keeping in mind the principles and behaviors of yin and yang helps us understand how we relate to and are interdependent with nature. To be in harmony with yin and yang we are by extension in harmony with the elements, the time, the place, day, week, month, season, and year, our thinking and feeling, our movement and rest, our breathing, drinking, and eating and in harmony with those around us.

Harmony of Yin & Yang

To be in harmony within ourselves and with our environment and others is to be in harmony with our body and mind – healthy and content.

Being in harmony with yin and yang is to have balance between things – not too hot or too cold, too tight or too loose, too bright or too dark, too high or too low…

Your nervous system has this harmony of yin and yang. A nerve is optimally healthy when it gets just the right amount of tone and stimulation. Too much or too little tone or stimulation of a nerve over time will cause it to degrade – transneuronal degeneration.

So, too your body chemistry. There has to be balance between the principles – between yin and yang. There has to be harmony between reduction and oxidation, anabolism and catabolism, polarization and depolarization, sympathetic and parasympathetic…

And, also, your mind and spirit – shen in traditional Chinese medicine. There must be a balance of focus and relaxation, speaking and being silent, moving and being still, going outward and being reflective…

Yin and yang – a binary model for matter, energy and biology.

Healing and Yin & Yang

When I do my work to understand and serve others toward their harmony and healing, I need to consider their balance and harmony of yin and yang. From this perspective, every phenomena in a human is neuron depolarization is a binary phenomenon, all cell membrane transport, all nerve action (depolarization and repolarization), cell oxidation and reduction, production and utililzation of every cell, every enzymatic reaction…all of these things are a dynamic between binary states – between yin and yang.

This is essentially the matrix model for energy, matter and biology. At some level, all things are binary – yin and yang.

So why is this important? Because understanding, using and developing mastery of this model gives you more leverage over your health and your life.

How do yin and yang relate to one another in terms of the very small and the very large? How do the models of the East and West translate between one another and relate to one another? How can we observe yin and yang objectively? In other words, how can we objectively measure yin and yang?

There are ways to be very objective about yin and yang. The principles seem abstract and, yet, the expression of these principles is very tangible. What is your blood pressure? The balance of your blood pressure is an expression of yin and yang and there must be harmony – balance – between yin and yang for you to be healthy.

How can you measure your yin and yang? How can you be a catalyst for restoring harmony to yin and yang?

Next, we will cover the principle of the three treasures, the model for measuring your balance and harmony of yin and yang and how to use these things to become more whole, robust and well.

References

1 My favorite translation of the Tao Te Ching is by Ralph Alan Dale.

 

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Your Body-Mind & Nasal Breathing

Nasal Cycle Revisited

The nasal cycle is a normal and natural alternating shift in the amount of air rushing through each nostril – a tidal increase and decrease in volume. The presence of the nasal cycle maintains and regulates hormones, neurotransmitters, digestion, detoxification, cardiovascluar system, immune and inflammatory responses, sleep and wakefulness and their circadian rhythms, alertness, focus, memory, emotions, and even consciousness.

How To Increase Nasal Cycle Benefits

All of the benefits of the nasal cycle are reinforced and promoted (up-regulated) by a yoga breathing method – nadi shodhan pranayama – commonly known as alternate nostril breathing (ANB). The effects of practicing ANB are so readily observable that it has inspired a lot of interest from researchers and clinicians and there has been a lot of research looking into the effects of ANB on various measures of health.

Much of the research has focused on the tonic effect of alternate nostril breathing on increasing parasympathetic nervous system tone which regulates internal body functions globally.1,2

Impaired parasympathetic (PS) tone is extremely common for most people and has significant detrimental effects on health and increased PS tone results in significantly improved body functions for most people.3

Typical benefits from increasing PS tone include a slightly tonic effect on the mind (mood, focus), relaxing effect on the body as a whole (muscle relaxation, lower respiration rate, lower blood pressure, skin warming (vasodilation)) and improved internal regulation (digestion, elimination, hormones, detoxification, sleep quality, circadian rhythms).

Particularly interesting is that inspiration through the right nostril alone increases tone of the stimulating (sympathetic) branch of the autonomic nervous system and inspiration through the left nostril alone increases the relaxing (PS) branch and this is exactly the effect attributed to ANB from traditional yoga writing.4

My Direct Experience

Alternate nostril breathing was incredibly effective in helping me heal from ulcerative colitis as a teen. That experience and research led me to have patients use ANB to support their healing and health from the begiining of my practice. About 20 years ago I did an in-clinic study of various relaxation, meditation, biofeedback and relaxation techniques for their effects on heart rate variability – a standard method used in research to measure PS tone. There were 100 subjects in the study and the alternate nostril breathing clearly came out the winner for both reliability of response and degree of shift in PS tone increase.

Because of my observation over a 45 year period, alternate nostril breathing is my “go to” method for increasing PS tone and improving body functions.

To fully appreciate how important all of this is for you,

consider that nearly every non-traumatic illness that we can suffer from

needs increased parasympathetic tone to promote healing

and alternate nostril breathing is the most reliable

thing you can do increase your parasympathetic tone.

How To Do It – Alternate Nostril Breathing

Practicing this breathing method is done by inhaling through the right nostril, exhaling through the left nostril, inhaling through the left nostril and exhaling through the right nostril. This represents one full cycle of alternate nostril breathing (ANB). Breath in deeply letting your “belly” expand and breath out fully. Breath with an even pace in and out – metronomic breathing.

Occlude the nostril opposite the “active” nostril which is inspiring/expiring air with your finger(s). An efficent and restful approach to occluding each nostril is to rest the finger tips/pads of your second and third finger between your eyebrows. Your thumb will be able to easily occlude one nostril as needed and your fourth and fifth fingers the other.

Results are enhanced by paying close attention to the pattern and process of your breathing. Doing this is practicing mindfulness of your alternate nostril breathing. Think only of what you are doing.

Some practice may be required before seeing beneficial effects.With practice, more relaxing and, interestingly, tonic effects will be experienced. This conforms my personal and clinical observation and research.5

How Much and How Often

Most people suffer from being in a constantly stressed state. Most of us have been trained to be in an ever-present hypervigilant state. It all makes us sick, keeps us sick or limits the level of health we could otherwise enjoy. Using ANB regularly – making it a habit – is a remarkably effective tool to restore, protect and enhance your health.

Typically, people notice a distinct sense of relaxation after 3-4 cycles of alternate nostril breathing. This is good and the benefits will be more profound when practicing for 10-20 minutes.

Each time you practice ANB you are reinforcing the relaxed state you experience from practice. Repetition reinforces the relaxed (PS) state.

When using alternate nostril breathing to overcome illness or build your health to a higher level, use ANB for longer periods and more frequently. And, as you get better, you can use ANB to support and optimize your health – once or twice a day and for 5-20 minutes depending on how you feel. Over time you will know what is optimal for you. You may need ANB less when you have less stress and you may find more helps you when under more stress.

Please experiment with this alternate nostril breathing and I am sure – based on 45 years of observation and research – you will find it makes your life better and brighter.

References

1 Sinha, A.N., Deepak, D. & Gusain, V.S., 2013, Assessment of the effects of pranayama/alternate nostril breathing on the parasympathetic nervous system in young adults, Journal of clinical and diagnostic research : JCDR, 7(5), pp. 821-3.

2 Telles, S., Sharma, S.K. & Balkrishna, A., 2014, Blood pressure and heart rate variability during yoga-based alternate nostril breathing practice and breath awareness, Med Sci Monit Basic Res, 20, pp. 184-93.

3 Thayer, J.F. & Sternberg, E., 2006, Beyond heart rate variability: vagal regulation of allostatic systems, Annals of the New York Academy of Sciences, 1088, pp. 361-72.

4 Bhavanani, A.B., Ramanathan, M., Balaji, R. & Pushpa, D., 2014, Differential effects of uninostril and alternate nostril pranayamas on cardiovascular parameters and reaction time, International journal of yoga, 7(1), pp. 60-5.

5 Subramanian, R.K., P R, D. & P, S., 2016, Alternate Nostril Breathing at Different Rates and its Influence on Heart Rate Variability in Non Practitioners of Yoga, Journal of clinical and diagnostic research : JCDR, 10(1), pp. CM01-2.

Brain Function and Nasal Breathing

Every 2 1/2 hours – almost magically – the volume of air running through the nasal cavity shifts with air volume decreasing on one side and increasing on the other. In accord with this change, the stimulation to and activity of the brain decreases on one side and increases on the other.

The effect crosses over – is contralateral – and as the right nostril takes in more air than the left nostril, the left side of the brain receives more stimulation and is more active. Simultaneously, the left nostril will be taking in less air and the right side of the brain will be getting less stimulation and be less active.

Now, we will cover how this effects the brain and it’s functions.

Neural Oscillation

Activity of every neuron is electrical in nature and the simultaneous activity of groups of nerves in the brain results in neural oscillations that can be measured by EEG.

So, EEG measures these oscillations and the relationships between brain states and mental and physical activity. Measured brain neural oscillations are called brainwaves.

Brainwave Frequency Patterns & Brain States

Delta – up to 4 hz – slow, high amplitude wave most concentrated in the frontal (conscious) area of the brain (frontal intermittent rhythmic delta); may be related to contemplation

Theta – 4-7hz – associated with elaxed, meditative, and creative states

Alpha – 7-14hz – shows up when relaxed with eyes closed

Beta – 15-30hz – associated with active thinking and concentration; higher range frequencies in Beta are associated with anxiety

Gamma – 30-100hz – this wave pattern appears with intense demand on both cognitive and motor functions simultaneously

Body-Neural Oscillation & Body-Mind States

Brain waves and their associated brain states are influenced by sight, sound, smell and touch. Also, brainwaves tend to synchronize to the frequency of these external stimuli, a phenomenon called entrainment.

Ultimately, all these external stimuli influence neural oscillations/brain waves and regulate brain activities that effect a mental and body functions.

Body-Limbic Oscillation

The part of the brain particularly important for this conversation is the limbic system. The limbic system (paleomammalian cortex) regulates brain functions including emotion, behavior, motivation, long-term memory, and olfaction and virtually every body function through control of the pituitary and the autonomic nervous system.

All sensory stimuli end up in the limbic system and have influence, but our focus in this conversation is the influence of nasal cycle, brain-body functions and your health.

Olfactory-Limbic Oscillation

The sensory stimuli triggered by air rushing across mucous membranes and the olfactory – smell sensing – nerves in the nasal cavity are projected to a part of the brain called the limbic system. This sensory stimulus to the limbic system results in olfactory-limbic oscillation and coordination of the various limbic areas and functions.1

Is this important?

Stimulating nerves in the nasal cavity results in improved EEG patterns in the limbic system and increases heart rate variability, a measure of how well the nervous system regulates and coordinates body function, resilience and well being.2,3

Moreover, olfactory-limbic oscillation modulates a part of the limbic system called the hippocampus that regulates emotion and fear responses.4 It also regulates areas of the limbic system that link and coordinate with higher conscious cortical functions.5 These processes relate directly to our awareness, focus, memory, mood and executive functions – discipline, impulse control and problem solving.

Rhythmic lateralizing of brain activity and the autonomic nervous system appears essential for regulating the rhythmic cycles of hormones, REM and non-REM sleep, neurotransmitters and other processes. Absence of this cyclical lateralization causes chronic stress, dysfunction and illness and one-sided forced nostril breathing may be a means to improve brain and body function.6

But, enough for now. Part three will teach you how to use what we know about the nasal cycle to dramatically improve your health.

References

1  Tsanov, M., Chah, E., Reilly, R. & O’Mara, S.M., 2014, Respiratory cycle entrainment of septal neurons mediates the fast coupling of sniffing rate and hippocampal theta rhythm, The European journal of neuroscience, 39(6), pp. 957-74.

2  Zelano, C., Jiang, H., Zhou, G., Arora, N., Schuele, S., Rosenow, J. & Gottfried, J.A., 2016, Nasal Respiration Entrains Human Limbic Oscillations and Modulates Cognitive Function, The Journal of neuroscience : the official journal of the Society for Neuroscience, 36(49), pp. 12448-67.

3  Li, T.Q., Wang, Y., Hallin, R. & Juto, J.E., 2016, Resting-state fMRI study of acute migraine treatment with kinetic oscillation stimulation in nasal cavity, NeuroImage. Clinical, 12, pp. 451-9.

4 Yanovsky, Y., Ciatipis, M., Draguhn, A., Tort, A.B. & Brankačk, J., 2014, Slow oscillations in the mouse hippocampus entrained by nasal respiration, The Journal of neuroscience : the official journal of the Society for Neuroscience, 34(17), pp. 5949-64.

5 Heck, D.H., McAfee, S.S., Liu, Y., Babajani-Feremi, A., Rezaie, R., Freeman, W.J., Wheless, J.W., Papanicolaou, A.C., Ruszinkó, M., Sokolov, Y. & Kozma, R., 2016, Breathing as a Fundamental Rhythm of Brain Function, Frontiers in neural circuits, 10, p. 115.

6  Shannahoff-Khalsa, D., 1991, Lateralized rhythms of the central and autonomic nervous systems, International journal of psychophysiology : official journal of the International Organization of Psychophysiology, 11(3), pp. 225-51.