A Message to “Do-It-Yourselfers”
I am a do-it-yourselfer. I try to do EVERYTHING! I don’t really think that’s the worst trait in the world. I think it’s OK to be a sort of McGuyver. I am learning, though, to sometimes just let a pro do it.
My wife and I recently purchased a house here in East Nashville that needed some work. We needed a new kitchen and we needed to update the entire main level of the house. My first instinct was to do it all myself, because I’m a pretty smart dude and I can figure it out. And I was right. If I really set my mind to it, I could design and install a whole kitchen. It would function well and probably even look decent.
After a month of pulling out old carpet, asbestos tile, and dilapidated kitchen cabinets, my wife and I made one of the best decisions we have ever made — let a pro design it, and let a pro build it. It was actually a difficult decision. Professionals are EXPENSIVE!!! AND I’M SMART!!! I CAN DO IT MYSELF!! (said the cheap-skate voices in my head).
Our designer interviewed us. I, being the visionary, told her what “we” were thinking, and she went to work. A few days later, she e-mailed me with these computerized drawings of our new kitchen. It was unbelievable! It was similar to what I had envisioned but so much better! And the colors she picked out for the entire house are just incredible!! I would have NEVER picked those colors or even known how to go about matching all these things based on how the light from a window hits a certain surface or how things look from certain vantage points where you can see several rooms at one time.
And we hired a contractor who unlike me, has built many kitchens. When I embark on any d.i.y. project, I spend more time driving to Lowes and Home Depot than I do actually working on the project! Well, my contractor knew exactly what to buy, and even carried all of the tools he needed WITH HIM (what a novel idea!).
So, I figure, it would take me at least a year to do what they accomplished in 3 months. My wife and I would live in a house with an unfinished kitchen for that long. And then, It would look like a normal, boring kitchen. And, the walls throughout the house would be boring.
BUT WE WOULD HAVE SAVED A LOT OF MONEY!!! Probably not! By the time I drove to Lowes and Home D about 5,000 times, ate out most of the time (no working kitchen), tore down and rebuilt things that didn’t fit . . . I’m sure we came out ahead financially.
So the question is, will I EVER pick out paint colors again? NO WAY!! Will I pay somebody handsome bucks to do it for me? YOU BETCHA!!
My area of expertise is the musculoskeletal system (spine and joints). So many people think that they can solve their own back problems. Example: “I don’t need no chiropractor, I can pop my own back.” OK, there, Mr. Expert! Why is your problem getting worse over time instead of better? Why do you feel the need to “pop” your back 25 times per day? Another example: “My back kills me, but it’s my mattress.” Further questioning reveals that they have been through 4 mattresses, some of them costing upward of $2,000, in the last year. OK, there, Mr. Expert!! Why does your back still hurt!! Maybe you should spend $10,000 on a mattress! Certainly THAT would solve your problem!! The truth is, an average treatment plan in our office NEVER crosses the $2,000 mark! In fact, it’s usually much less than that. Furthermore, Mr. Expert, if you leave the problem alone long enough for it to become a crisis, will it be any “cheaper” to address it then?
I can usually tell you in just a few minutes what your musculoskeletal problem is. I can usually help you with it. I know pretty quickly if it’s something I can’t help and I know where to refer you if that’s the case. I’ve worked on THOUSANDS of spines and joints! How many have you worked on?
So, don’t be afraid to hire an expert. There is a cost involved, but believe me, It’s worth it!!
Seven Years (Why I Became a Chiropractor)
Seven Years
Seven years. That’s how long I lived with lower back pain.
It started my senior year of high school in weightlifting class. I was a pretty small dude and I wanted to bulk up some. I worked very hard in that class and did bulk up a little bit, at the expense of my back.
The pain was in the left side of my rear-end and radiated to the back part of my thigh, all the way to the knee. Sitting was excruciating. Bending was very limited. Standing up after being seated was a 5-minute ordeal. I was moving like an old man and I was only in my early 20’s!
I went to a walk-in medical clinic. The doc prescribed a muscle relaxer. It didn’t help. I went back. He prescribed a narcotic pain-killer and gave me a page of back stretches to do (which I found nearly impossible to perform). The pain- killer made me feel great at least while I was on the painkiller. Maybe a little too great. I found myself well on my way to becoming a narcotic addict. I went back to the doc and asked him if I should go to a chiropractor to which he responded “absolutely not! Chiropractors paralyze people!” I took the advice of this misinformed doctor and just lived in pain.
My first run-in with a chiropractor took place at church. I had gone on a two-week tour of Israel and one of the other tourists was the wife of a chiropractor. She became like a second-mom. I started hanging out with this family after church and even went to their house for Easter dinner (in 2000). It was on that day that Dr. Don noticed that I was walking with a limp. He said “I bet you have pain in the left butt and it goes down the back of your thigh about to your knee. . .” I was flat-out impressed that someone could figure that out just by seeing me walk. He invited me to come “hang out” in his office and see what chiropractic was all about.
To my amazement, I didn’t see anybody get paralyzed! I heard no screams. In fact, people actually felt better immediately after treatment without being high on drugs!
I decided it was worth a try. On my first visit as a chiropractic patient, I was so impressed with this doctor! He did a series of orthopedic and neurological tests and a set of x-rays. He showed me exactly what was wrong and told me what it would take to get me feeling better.
After two weeks of chiropractic treatment I was a new man! I had nearly full, pain-free range of motion in my lower back. He found some things in my neck that weren’t working quite right either and got that taken care of. (I just thought it was normal to have a very stiff neck and not be able to turn my head after sitting in the car for about 30 minutes) I was sleeping better because I could turn in bed without pain.
This was also a point in my life where I really needed to make a career choice. I was a psychology major in college and was pretty sure I didn’t want to be a psychologist. I was interested in medicine, but not that impressed with how conventional medicine treated me and my condition. The logical choice, then, was to become a chiropractor. I finished up some pre-med requirements, and off to Logan University in St. Louis, where I graduated as a Doctor of Chiropractic just four years later!
I love doing what I do. Now I can tell people where they hurt just by watching them walk. Now I can alleviate most headache syndromes, help fathers and mothers regain their ability to lift their children into their arms again, get runners back in races, help students with tight necks and shoulders focus on their professors rather than on how to get comfortable . . . I could go on and on about how I’ve been able to change so many lives.
So when it comes down to it, I’m glad I had those seven years of pain. It was a great lesson. It taught me to truly sympathize with my patients. When I realized how quickly my problem could be alleviated, I was introduced to an excellent career!
The Real Deal
Chiropractic medicine has been around for just over 100 years. For most of that time, there has been no “hard scientific evidence” of its efficacy. Hard scientific evidence refers to university-based randomized controlled trials, the gold standard of determining the efficacy of any medical intervention. Most chiropractors could give a thousand examples of how they have helped patients. Most chiropractic patients could write a glowing testimonial about how chiropractic treatment “cured” their neck pain, back pain, etc. Without randomized controlled trials, however, the scientific community could easily write off this testimonial evidence as coincidence, placebo effect, quackery, voo-doo, and a host of other negative terms.
The last 10-12 years have seen many changes in this line of thinking. Hundreds of RCTs have been carried out offering volumes of information on the efficacy of spinal manipulation (the main treatment used by most chiropractors) on the treatment of a myriad of health problems. We now have hard scientific evidence that chiropractic treatment is great for some things, good for some things when combined with other therapies, inconclusive for some things, ineffective for some things, and makes some things worse — just like pharmacotherapy and surgery. We also have hard evidence that chiropractic treatment is superior to pharmacotherapy, surgery, and non-manipulative physical therapy for several conditions.
A brand-new literature review by Bronfort, et. al compiles and summarizes ten years worth of research on the efficacy of manual therapies. Manual therapies include chiropractic and osteopathic manipulation, physical therapy, and massage therapy. Here’s a link to the study: www.chiroandosteo.com/content/18/1/3
Here is the conclusion paragraph of the abstract:
Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain. The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and dysmenorrhea when compared to sham manipulation, or for Stage 1 hypertension when added to an antihypertensive diet. In children, the evidence is inconclusive regarding the effectiveness for otitis media and enuresis, and it is not effective for infantile colic and asthma when compared to sham manipulation. (Bronfort et al. Chiropractic and Osteopathy 2010, 18:3)
This is well said and very clear. It seems to be consistent with my own experiences in practice. I am pleased to have such a well-written review with a bibliography of over 300 peer-reviewed journal articles to refer to. I encourage all who are interested to follow this link and read the article for themselves.
Where are the Obese Hippies?
There is a health food store here in Nashville that I like to go to. They sell some pretty “normal” things like organic meat and veggies and such. They also sell all of the hard-core health foods like tofu, alfalfa sprouts, whole grains in bulk, every bean you can imagine. This is what some of my patients refer to as “hippie food.”
Another reason I like going to this store is I like watching the “hippies” who shop there. I’m talking real hippies, here. Just wearing tie dyed clothes, long hair and sunglasses doesn’t cut it. Real hippies try in every way to buck the system of Capitalism. One major aspect of the Capitalist society is corporate agriculture. Mass-produced, high fat, salty, overprocessed, genetically altered foods are a large part of corporate agriculture because these foods are easy to produce and have a long shelf life.
The “real” Hippies just don’t go for this. For the most part, their diet consists of food grown locally on small farms. Food grown locally on small farms is not cheap. And last time I checked, very few Hippies are rich. If nothing else, the cost factor limits how much they eat. Plus, local small farms don’t produce trans-fats (that involves a chemistry lab), overly fatty meats, and preservative-loaded sweets full of high-fructose corn syrup. Therefore, there is a huge lack of OBESE HIPPIES!!
I’m not totally against corporate agriculture. I’m not an anti-capitalist. I am a proponent of full disclosure of the ingredients of the foods we eat. I am a proponent of doing real research on these ingredients and finding out the health risks/benefits of them. I am a huge proponent of using common sense with food!! Eat some veggies!! If it’s full of chemicals, you probably shouldn’t eat it!! Consume only the amount of energy (food) that you will use. If you sit at a computer all day, you probably don’t need four pounds of food per day to meet your metabolic needs.
Enjoy a Snickers bar sometimes. Drink a Coke with it. For the most part, however just eat some lentils and hummus!
Why Logan College of Chiropractic is a GREAT School
I had a patient come in for an evaluation. She was dissatisfied with her current chiropractor, who persuaded her to pay close to $3000 up front for 80 visits, “a year’s worth” of treatment in his office. (That will be discussed in a whole new blog — entitled “Why most people think Chiropractors are Quacks”) As I was examining her, she asked where I went to Chiropractic College, and I replied “Logan, in St. Louis.” She then told me that the other doctor told her that he went to Logan, but it’s a terrible school because it’s “too medical.”
Let me explain this for those of you who aren’t intimately familiar with chiropractic. Some chiropractic colleges teach mostly “chiropractic philosophy,” and teach as little as possible about the human body, disease, and such. They don’t like research because that is too much like the “medical model” of health care. They don’t want to know how to do a full physical exam on a patient, because they don’t diagnose “medical problems,” they only diagnose “vertebral subluxations.” They don’t “treat back pain,” they only adjust the spine, and so on.
Well, the truth is this. Most people who go to a chiropractor have some kind of back pain. And guess what . . . there are MANY different causes of back pain, not just vertebral subluxations.
This week, a patient that I hadn’t seen in awhile came in with a new complaint. She had severe pain in her neck and right arm. I examined her. When I examine a patient, I do neurological, orthopedic, and chiropractic testing. With this patient, I didn’t even get to the chiropractic component of the exam because my neurological tests told me that this patient was dealing with something that I do not treat in my office, and that’s metastatic lung cancer. She had no reflexes in the right upper limb. Skin sensation was decreased in some parts of the limb, and increased in other parts. The slightest pressure placed on the lower neck was very painful. She was holding her right arm against her chest with her left arm because it was very weak. Her health history revealed a 40+ year history of smoking at least a pack per day.
Almost immediately, I could hear Dr. Kettner, Dr. Geubert, Dr. Kuhn, Dr. Bub, Dr. Huber, Dr. Mannello, and others . . . their voices are permanently lodged in my head, reminding me of things to look for, what certain symptoms and signs might point to, other tests that may be applicable in helping to DIAGNOSE THE LESION!! This time I remembered Dr. Kettner and Dr. Geubert talking ad nauseum about Pancoast Syndrome, which is related to a metastatic tumor in the upper part of a lung. That was my diagnosis, and I sent her to the ER for immediate CT scans and bone scan. Sure enough, that was the correct diagnosis, (unfortunately, in this case). In fact, the ER doctor called me — she was impressed that I could diagnose that without ANY imaging, just history and physical exam. The patient called me from her hospital room a day later and thanked me for catching the tumor and sending her to the ER, because it gives her a chance to “get things in order” (unfortunately, the cancer had spread throughout her body, and she will probably not be with us for much longer).
So, Logan is a GREAT school. They teach you all of the things you NEED TO KNOW so that your diagnostic skills will be on par with (and sometimes better than) the practitioners in main-stream medicine. Chiropractic philosophy is important too, but a DOCTOR of chiropractic has the responsibility of knowing when the problem is NOT just another vertebral subluxation.
