Monday, August 26, 2013

3 Times a Week for the rest of your life

It is obvious that this particular post is in regard to a myth that many people espouse regarding Chiropractic Care. First of all.........Yes, I still hear this from those that are poking fun, Second...........I myself actually grew up with this same fun-poking, uneducated belief system. Personally, it has been a long journey for me to become a Chiropractor being that I was raised with this attitude and considering my undergraduate studies in programs such as Pre Medicine and Physics. The point being ................comments such as this woefully come from either the uneducated or disrespectful, and the only way to help this is through proper education. I tell all my patients that I had to myself at one point in my life decided to become more open minded and realize that some of my belief-systems were plainly based more upon what I had been "taught" to believe, than what I had formulated based upon my own experience(s).
   
Going to the Chiropractor 3 times a week for the rest of your life is absolute fallacy! Important to note, is that there are (3) types of Chiropractic Care: 1. Pain-Based 2. Correction  3. Wellness. Obviously, as with any Medical treatment, a patient's "needs" must be determined in order to properly facilitate care for that particular patient. Most people understand the "Pain Model" as they "go when it hurts." More confusing to many are the Correction and Wellness Models. Yes, spinal "problems" can often be "corrected" at least to some degree depending upon the level of chronicity and destruction you have had before you begin to actually work at the problem.................as is true with anything. Although this concept can seem odd at first, this is only because most people do not think much of their spine, or their nervous system.............often it would be like asking how their kidneys are................."okay............I guess" is the answer, because they really don't know and don't give it much thought. There is a model that most people do seem to understand well when it comes to correction and wellness ( maintenance), and that is of Orthodontia and Braces for the teeth.

Analogy of Chiropractic and Orthodontia (Braces)

Orthodontia/ Dental Braces                                             Chiropractic                

 * Works to "align" teeth properly                                                  *Works to "align" spine properly
 * Uses 24 Hr "Bracing" over years to                                           *Uses "spinal adjustments" over weeks      create Measurable Change and progress                                     to Periodically years to create   
                                                                                                      Measurable Change and progress
*Frequency of Care is bracing 24/7                                               *Frequency of care may be monthly to 
                                                                                                      daily depending upon severity
*Outcomes are greater alignment of teeth, bite correction,              * Outcomes are greater alignment of
  TMJ help, headache help, to name a few                                         spinal column and therefore  
                                                                                                        decreased nervous system 
                                                                                                        interference (dysfunction)
* Maintenance care = retainer, as without its use, the teeth             * Maintenance/ Wellness care = ongoing
   have a tendency to migrate to the old position prior to                    periodic "adjustments" to spine and
   bracing/ correction efforts.                                                             nervous system to prevent migration of 
                                                                                                        spine to old position prior to 
                                                                                                        correction efforts.

The comparison chart above is intentionally brief so as to make the point without getting excessively complicated. Comparisons can also be made to that of Physical Therapy or even Personal Training. Basically, the body has a "learning curve" and to facilitate any long-term notable change, this takes time and frequency. No one goes to the gym once a week and realistically expects to win Mr Universe. No one goes to their PT for one visit expecting them to completely take care of their 30 year old frozen shoulder ailment. Ironically however, many people to want to go to the Chiropractor for one good "crack" to fix them.................well, fix what? A joint "cavitation" (pop) tends to release endorphins (therefore temporarily feeling better), however can it realistically "fix" any condition totally especially when most people have years of unattended to spinal compensations? Therefore the root of this problem is that most people don't really understand the nature of what is really causing their "PAIN," however is "pain" actually the problem, or a signal that their is a problem? Certainly when driving your car you don't place tape over that annoying red light telling you that you are nearly out of gas and realistically expect to get very much further down the road.............do you? You would only do this under the erroneous belief that the light is actually a problem and not just a warning light. Our bodies a brilliant self-healing machines, and PAIN, is nothing more than the indicator light that there is in fact a problem somewhere. On a side note..........as Americans, pain medications are the most highly prescribed class of medications and at a fairly even rate, both pain medication use and chronic disease occurrence are escalating! Is anyone really "fixing" anything on pain meds? The answer is NO! Although I take the occasional Ibuprofen as well..............I am a realist................I do it knowing that I am only temporarily numbing my body's messages that there is a problem I need to resolve..........I.E. "why" I have the headache. 

With all of this, do some people find it necessary to go to a Chiropractor 3 times a week? Yes, because that is the frequency of care necessary to work "with" their body to help them correct neurological injury or compensation patterns for long term benefit. It is inherent that if a patient chooses to work at correcting their spinal problems, that initially their visits are more frequent and as they progress and improve their visit frequency will diminish. It is also common for patients that truly understand this to periodically visit the Chiropractor for check ups prior to an obvious "problem" to help prevent "problems." This is called wellness care, just as there are wellness visits for general Medical care that are intended to benchmark your health, the same is true for your spine and nervous system..............it only makes sense. There is no hard and fast rule nor cookie-cutter mold to Chiropractic care and how your visits are structured. Honestly, we are all taught to brush our teeth from the time we get them to when they are gone. This makes sense because without them, life can be very difficult. The same is really true for any level of health..................keep it all working in the first place, take appropriate care of the big problems as they occur, but continue the wellness to avert the chronic problems you wish you could have avoided. Your nervous system and spine are literally your life-line to your entire existence, therefore why would you not take appropriate care of them? Only if you didn't know any better would you let your spine rot over 50 years to the point you need a spinal fusion. That being said, I am in a bit of a unique position with greater than average knowledge of spinal fusion methods as a Chiropractor and I help my patients with this. I have even had to go to bat for some in order to facilitate the surgery that was necessary! Yes, I am a Chiropractor and I have fought to help patients have surgery. So, before you fall out of your chair...........................it was necessary, and all Health Care providers should do what is RIGHT for our patients and not what is right for the bottom line. A good surgeon will tell you him/herself that they should be a good last option and that they want to take the least invasive approach possible in order to accomplish with they need to.

"3 times a week for the rest of your life" ha ha, next bad joke please. Take care of your body, take care of your spine. You need to know "how" to do so first. You should work with the body and keep yourself healthy as possible form birth to death in order to have a life of "quality." Spinal problems called subluxations that negatively affect the spine and how the nervous system communicates are seen in new-borns to the very aged. Different levels of care are necessary and appropriate for all levels of human existence, however health is a life long requisite. This is why I actually go to hospitals and help evaluate new borns complimentary, I see some patients once every six months, others every week........it is the level of care necessary for that particular patient. 

Yours in Health, 
Dr Moore
**we are considering our next topic to be that of "Chiropractic Cures Everything, a Misunderstood Fallacy" please email us at info@moore-lifechiropractic.com if you would like to give us feedback on this. We always appreciate and value all feedback!


Monday, February 11, 2013

Dr Oz ( and many MDs) on Chiropractic

On Friday I had a patient ask me why Chiropractic Care was on the Dr Oz show and how MDs feel about Chiropractic. The simple answer would be because "it works!" . On the other hand, these are really two very different questions and the answer is always dependent upon the perspective of the one answering as we well as asking the question.

This BLOG is because my patient was somewhat shocked at my answer.
"Chiropractic carries a strong feeling from both sides in our society, it questions very strong visceral paradigms for many, and substantiates them for others. Growing up, I had no use nor respect for Chiropractors! They weren't "real Doctors" and were basically "quacks" that got their license from a Cracker Jack box!" Can you imagine the look on her face as she stared at me? Now, how did I have that view even as a child? Well, of course, we get much of our early education and "opinions" from our parents. I explained that later in my college years I had used Chiropractic here and there growing up ( lots of headaches) but that I was pretty committed to Chemistry, Physics, Botany, and Pre Medical undergraduate programs. Being a smart patient, she asked the obvious question as to how on earth I had grown up with such negative attitudes towards Chiropractic, even began a pre-med program, yet, ended up a Chiropractor?

The answer, was in education!! I told her that at some point I had to get out of my box of "opinions" and give in to my own ignorance and decide to be open to an education. I had to realize that I was a bit dangerous..........yes, dangerous! A dangerous person being one whom is very opinionated while simultaneously very ignorant on a subject. I am pretty sure we have all met folks like this.

I gave her the example I had heard as a child wherein the neighbor had told my mother that her daughter was "cured" of asthma by getting her back "cracked" at the Chiropractor. Now,if that didn't elicit the biggest "bwahahahah haha haha" I had ever heard! Now, the neighbor was trying to help my mother with helpful information, yet this is how it was basically received, and why? Because of Education! The neighbor didn't know how to explain what she had encountered, but that it had helped. I get that, but said that "way," well, it certainly sounds "hokey."

My answer to my patient was that I had to go from hokey to scientific and do it in an open minded manner. I had to ask myself why so many went to the Chiropractor, what Chiropractic was "good for" (Conditions), and why I was finding some people went to their DC (Chiropractor) rather than their MD on the constant basis even with their kids. I said, "you see so many people, even MDs find themselves in my old boat, and if you don't get the proper information, then it is much like the tool you have never been taught to use, so you don't, and by the way, that compared to your usual tools, this one looks funny and weird, so not only do you not use the tool out of no knowledge, you also mock it out of strangeness based upon your then current paradigm."

I could make many more analogies, however my own story is a great one here, and very true. I had instructors at Chiropractic School that were MD's that at the time probably understood Chiropractic better than I did as a Chiropractic Student. The point being, that often information depends upon one's opinion from their paradigms.

So.................Dr Oz and general MDs on Chiropractic? Honestly Chiropractic hasn't really changed much since it's inception in 1895. Sure, some of us use different "tools" of our particular trade, however the biggest difference from DC's going to jail for practicing Medicine without a license in the 40's to it's now it being purported as a great treatment for low back pain on a Medical show, is social education and acceptability. The occurrence of "alternative" treatments being positively spoken of on a Medically-oriented show is a very positive thing for our society. This is because in terms of patient treatment, options are always a great thing! There is no "one size fits all" model for Healthcare. Patients need options and the freedom of choice to engage those options. Most importantly, patients need to be truly "aware" of their options.

So, to my patient, I have said that what you are seeing is an increase of awareness to many things that are non-medical and that it is this that is most responsible for the inclusion  more than the "advancement" of most "alternative" fields of healthcare. That in the end, both my Medical Friends and myself are great at what we do, we are both well intended to the maximum benefit of all of our patients and their well-being. Both sides see fantastic success as well as failure in treating our patients, unfortunately this is why it is called "practice" in some ways. Very important, is that Medical and Chiropractic are very different "Paradigms" and that the "science" is there for both. The determining factor is what the patient's "needs" are. Perhaps my adjustments won't help a patient that is too far gone and needs surgery? Perhaps surgery isn't appropriate for a spine that could be "adjusted." We all need to better understand the application of differing paradigms and therefore treatment modalities. Chiropractic Works! That's the answer, it's mostly a matter of understanding "how" it works, and an acceptance that it does work societally. The current science IS there on this, just ask your MD Neurophysiologist. This is why Chiropractic was on Dr OZ.

In our office I can tell you education is ALWAYS key. Ask any patient and they will agree that this is our focus. Every patient must understand "what" Chiropractic is in order to determine if it the "right" tool. Personally, I have argued vehemently for different patients to both avoid and have surgery. (imagine the response I get upon calling the surgeons office and then line itemizing the reasons why a patient needs surgery based upon the MRI's I am looking at? Not usually expected from the Chiropractor)

The point is that proper care should always be what is rendered! Every situation is different, you don't call the Police, when your house is on fire, and you don't call the fire department when all you need to do is fix the door frame.

Lastly, I would point out what seems obvious, however is periodically ignored for some reason in our mindset as the "mincing of words."
*Patients are people with a condition, they are not their condition!
*All of us rely upon the body's own natural ability to heal itself! All Adjustments, Medications, Surgeries, and even Chemo-Therapy are given as no more than a modality of treatment to a body that that in the end will either accept or reject that treatment as either right or wrong for its particular needs.
 *We all supply our treatment and then sit back and see what with body will do with it.
*Healing therefore, depends upon the patient! Medicine Works! Chiropractic Works! If properly applied, it all works.



Wednesday, January 16, 2013

Affordable Healthcare OR Affordable Insurance??

Let's propose something thought-provoking with regards to the "Affordable Healthcare Act" for just a moment!

To begin with, this is not a simple "for" or "against" universal healthcare blog, rather it is regarding the "concepts" of what it might mean to have real healthcare coverage.

Please understand, that if there hypothetically were aliens in space watching  humanity, and how we "care" for each other, well..............there would be some frowns. We need a system that ensures better "care" for everyone. Everyone needs to take part in a system that in turn "helps everyone." The great part is that our society is actually at a point where we are at least attempting true "altruism." And this is of course, is a huge leap forward socially speaking. It may not be perfect, however it is a start.

Now, in terms of my focus. Does the proposed plan really affect "healthcare" and thereby the "health" of our American society? We are all faced with having to gain "Health Insurance" whether we really want it or not, this will help to defer the costs among the larger whole of "covered" persons............lower costs, and some potential governmental credits = lower healthcare premiums, right? Yes, this can potentially mean lower Healthcare Premiums, but does that necessarily mean Better or lower Healthcare costs? Therefore, does Healthcare Insurance really necessarily equate to better health? Now, although I believe it a good idea to have insurance particularly for the potential catastrophic situation, we must realize that Health insurance is really "Sickness and Disease Insurance." Although we are finding more plans that will cover more of what they consider to be "preventative" services, lets face it, you can't just go asking for most healthcare services, such as Bone Scan, MRI, etc. without having first been diagnosed with a condition.  Basically, you already have to have a problem in most cases to then be able to treat the "condition." Therefore, most people only go to their Medical Provider when something is already wrong, and this is usually delt with by masking the symptoms ( not necessarily the problem itself) with some sort of Medication. Most people end up at their Medical provider between once and 4 times each year. This is the type of care we are attempting to "make more affordable." Is this really "Healthcare" though? Does this make one more healthy or decrease their risk of further debilitating disorders or even death itself. Interesting that the Cochrane Collaboration (www.cochrane.org) data shows that wellness visits to Medical Providers had almost no effect on the early detection and treatment of most illness nor a reduction in the mortality risk of patients. Now, this doesn't mean that Medical care isn't necessary, however perhaps the "type of care" and "frequency" of visits could be real indicators.

What about further considering the visit frequency to certain providers? First of all, which type pf provider? A Triage and sickness specialist? Or a Correction and wellness specialist? How many people could have avoided that spinal fusion surgery or organ transplant, etc. that was the result of cumulative effects over time? What if a Wellness Specialist were to see a patient potentially 10 times a year, what if more? Would one not agree that with more constant supervision, comes the greater chance of earlier detection and treatment? What if that wellness specialist were actually rendering smaller treatments and tweaks to a patients health along the way? Would those large problems they were to potentially face not now mitigated and potentially kept from getting bigger at all due to more constant small treatment and supervision?

The current way most Americans handle their health is much like getting the oil change on their care only once a year or when it starts to scream and shudder. What if you had a auto protection policy that covered unlimited maintenance, how often would we each take our car in? Some, may try every week, some monthly, some, it would make no difference to because they're going to wait for it to scream catastrophe anyway. Could we argue that the person taking their car in more frequently for check ups and/ or small tweaks is more likely to have their care run better (healthier) and likely last longer with fewer great issues? I think common sense says yes. Therefore, I would infer that our healthcare for our bodies is much like this automobile example. With that, the problem isn't so much making the current model "more affordable," but rather making a model that actually is preventative and effective, more "affordable."

What is more important, making insurance premiums that only allow for the same periodic "sick" care model more affordable, or facilitating a maintenance model for prevention as well as earlier detection more affordable? Again, if we compare this to our automobile model, it may look something like this:
(Example for "non-catastrophic" model of general use and maintenance)
Automobile Insurance Plan Choice 1                                 Automobile Insurance Plan Choice 2
Deductible:                          $500                                           Deductible:                   None
Co Payments per visit:         $20                                             Co Payments per visit:  None
Monthly Premiums:             $400                                            Monthly Premiums:       None
*$600 per month without Governmental assistance
Visit Limit:                           10 per year                                 Visit Limit:                     50 (or unlimited)
                                                                                                                                                         
Total Personal Annual Expense using all visits available:                                               
                                          $5,500                                          Annual Flat Rate:        $4,000

In the above example we would generally find that those "car enthusiasts" would be more likely to take real advantage of a perpetual maintenance program for the car(s) they love, whereas some who don't particularly think much about their car, wouldn't take much thought of this. What about those in the middle though? Those that didn't understand or perhaps didn't know maintenance programs were important much less available and how to understand their use? Well, education is the key, as with all things. No one, can use a tool they have never encountered or been taught how to use! 

At first this seems unrealistic, however do plans like this exist? ABSOLUTELY!!! One only need know what to look for and where to look.

Our cars are important and I would propose that if enough people knew of plans like the ones above, then at the right price to have enough access to car maintenance, more people would certainly take advantage of them. This is the very same with our health. We tend to take advantage of the fact we think we are healthy and don't do much until something is obviously wrong. Kind of like waiting so long you need new tires rather than taking care of them the entire time. Well, we can't get New bodies, nor can we ever repair them, once damaged heavily enough, to the former 100 % functional status.

After all of my analogy to cars here, there seems to be one thing clear with current healthcare reform. The current proposals are reform of pricing of the current sickness model only.  Yes, this can make this type of care more affordable to those without even this, I get it, and yes, this is an important "aspect" of healthcare. However, what about affordable continual access to providers for less than catastrophic care and/ or maintenance?

I would propose the thought of a system of "Affordable" premiums, yes, but also affordable ongoing direct provider access and thereby improved maintenance.

This subject has the potential for great depth and breadth. This particular blog is designed not for that, however to stimulate "thought" on the matter. As well, to stimulate the reader to engage the idea that there are systems out there that actually function much like the proposed examples. That there are systems of maintenance that can often cost less than your health care premiums alone. As always, we welcome your input and questions, and hope that you find this subject thought-provoking and informative.