Archetype of Health

Defintion: ar·che·type

ˈärkəˌtīp/

noun

 noun: archetype; plural noun: archetypes

      a very typical example of a certain person or thing.

 

"    What does it mean to be the "Archetype of Health"? The reason for this article is that most people would believe that an individual representing the Archetype of Health is that perfect person that never seems to get "sick" no matter what, or that they have no health "problems." On the surface, this could appear true, however this idea alone takes on an incorrect context of what "health" really is. Is health really never being sick, which most people connotate with never having symptoms, or your ability to naturally cope with and adapt your environment in a balanced way. Enter (2) terms: 1. Homeostasis and 2. Allostatic Load, which better represent what an Archetype of health might look like. Homeostasis is an organisms ability to properly adapt and therefore remain in balance in a particular environment. Allostatic Load ( term borrowed from Dr Jamses Chestnutt, DC) is the amount of stressors in your environment that you might have to contend with in order to maintain balance and homeostasis. Dr Chestnutt uses and analogy that I like, he likens allostatic load to the number of rocks in your backpack that you are wearing while swimming. These rocks represent stressors such as toxins, medications, injuries, mental stress, etc. The more rocks, the harder it is to tread water before you sink and die. Basically, the more stressors in life in various forms, the harder it is to remain in homeostasis and the more sick and likely we are to manifest symptoms of illness. In the example above, there are definite "symptoms" (signs) of impending death while watching a person drown. I would argue that the "archetype" of a healthy individual is not simply the one whom never elicits symptoms, rather is the one that has appropriate response to their environment and maintains balance in their overall function. Hence, that archetypal individual will still get a fever as a natural and appropriate response to infection. Problem is, all too often we believe that we have to suppress symptoms of illness rather than focus on supporting the body in a healthy response and healing on its own. We therefore end up with a model of health that represents symptom free and over medicated, all the while this pictured individual just may be one of the sickest around. Now, just to be clear, this in no way means that I don't believe in the use of Medications or antibiotics, rather I believe in supporting the individual immune system so that it functions as optimally as possible, and only when necessary will there be the intervention of Medication that alters body-chemistry in a synthetic manner. As Americans, our Archetype is symptom-free, rather than Homestatic and this image is failing us. This is why I educate my patients daily on a proper paradigm of what it means to be "healthy." The Archetype of health is the individual that works to maintain Homeostasis and reduce Allostatic Load as much as possible, thereby portraying, not the person that is never ill, but rather the individual that is seldom ill, has high energy levels and is active, and has a positive demeanor and perspective on their life.

Chiropractic for our Nation's Heroes

How do we properly "serve" those that have served us with such devotion? The United States spends more on Military and Defense than any other country, and you only need see one "person" in uniform to see a small cog in a very large machine that we call our Military complex. As a society, then shall we be defined partially by how well we take care of those that have sacrificed so much as an individual for our country as a whole? On a personal level, I respond with an adamant yes. As a Chiropractic Physician, I also resound with yes. The question, however is regarding just how well we perform this act of service to those that have served. How "well" do we, as a country, take care of those that return back home to their wives, husbands, and children in order to continue a "normal" life of happiness? I will openly recognize the overt complexity of such a topic, as unfortunately many return home broken, shot, stabbed, or otherwise both physically and/or mentally/emotionally changed or damaged. I feel it is our duty and obligation to support those returning home in every way possible! I believe Chiropractic to be an integral part of this larger puzzle.

How does Chiropractic Care fit into this discussion? I believe Chiropractic care should be more readily provided to all servicemen and servicewomen. This is based on the extreme physical nature of military service and the fact that not withstanding personal experience, there is a plethora of research on the benefits of Chiropractic Care with regards to the very same or similar stresses and injuries that are likely to occur with military service. There are numerous citations regarding both the cost-effectiveness and efficacy of Chiropractic Care, ranging from the Magna Report, multiple state worker's compensation boards, to general Low Back Pain and Pain Management studies conducted over the last few decades. As a blanket-statement, Chiropractic has been repeatedly shown to return injured individuals to work in 1/2 the time and at 1/2 the cost of many traditional Pharmacological programs when provided. Do I believe that Chiropractic Care should replace traditional forms of care? No, rather we must look at each healing art as a "tool", and for every job, there is the more appropriate tool or combination of tools in order to effectively complete the task at hand. Chiropractic is a very effective and efficient tool, and it can be applied in many ways. Unfortunately, however, it is a "tool" that is often not available enough in order to be as effective as it could be. What I am advocating for here is this: that Chiropractic as a proven effective tool, should be made more readily available to all of our military personnel. Although I applaud increasing utilization,  currently Chiropractic is only available on a limited basis to sparing Bases around the Country and world, and certainly much more limited to those in active combat zones. A number of my patients have directly told me that while in an active duty, the only form of Chiropractic care they were able to receive was from another soldier present as a reservist that just happened to be a Chiropractor. I strongly advocate for a well-rounded "Health Care Team" that is available to both active, disabled, and retired military personnel that they have access to, consisting of a combination of both traditional and proven non-traditional forms of choice. I believe that an increasingly used combination of Chiropractic and Medical care to our military would offer substantial benefits that are already being seen on a limited basis. Currently, Chiropractic seems to be in a "proving grounds" phase in the Military and VA, I believe that as we move forward over the years, that Chiropractic will see its way into Military and VA direct-provider ship roles. I feel that there is strong potential for locum-based resident/ internship roles with the co-care of young Medical and Chiropractic Doctors from various Medical and Chiropractic Schools to be integrated into military bases and VA facilities all over the world to both aide in overburdened programs as well as create a functional operating structure of co-care from the ground up.
In 15 years of practice, I have always taken care of active duty and retired Military at a "Military" rate in order to better provide care to the Chiropractic-ally under served Military community. I do this to give back to those that keep my family safe and free in appreciation, I also do this to help them get the care they need when it is not always yet available to them as a part of their existing care options. I see success with this time and time again and will continue to do so until I stop practicing. I would call for all Chiropractors to make a place for our Military in their practices on a discounted basis to say thank you and give back to them. I am certain that as we do this, we will inherently see an increasing availability of Chiropractic services within the Military itself, if only due to the self-reported successes that service men and service women are and will report back so that it becomes a more functional part of their existing options for care.  

How Important is the "Placebo Effect" in Health Care? Proposing Questions for a Paradigm Change.

Technical Definition: 

pla·ce·bo ef·fect

noun

noun: placebo effect; plural noun: placebo effects

1. a beneficial effect, produced by a placebo drug or treatment, that cannot be attributed to the properties of the placebo itself, and must therefore be due to the patient's belief in that treatment.

   Why is the "Placebo Effect" important in Healthcare? It has to do with a very seemingly difficult part of healthcare that is largely left out of patient care, yet has provable tremendous effects on the outcome of care!  That is.........the patient's "belief" about a treatment or proposed outcome. Placebo effect is known to have around a 30% effect, give or take. What this means is that roughly 1 in 3 patients (or 30 % of the time.....or more) will respond to a treatment by simply "believing" it will work even when given a fake/ sham treatment. For Example: Drug companies will test "pill X" against a "fake or Placebo - sugar pill" and what is found is that even if a patient is given the sugar pill and not the real medication (say for High Blood Pressure) that somehow roughly 30% + of patients will respond favorably as though given the actual medication. The effect of Placebo is beginning to take a real foothold in some schools of thought in healthcare, both positive and negative as its effects are undeniable. Medical Schools such as Harvard Medical School are in the forefront of these types of studies. Individual MD's, such as Bernie Siegel, MD (ref) are also taking the positive effects of Placebo into effect in active practice. Dr. Siegel's book "Love, Medicine, and Miracles" (1986) is a very well-known text on this topic and compassion and miracles in the healthcare of his patients.

   If the concept of Placebo has been so vigorously tested that we know the belief of an individual has a 30% or better effect on the outcome of their care, then doesn't the Placebo effect in and of itself prove as strong influence on the effectiveness of care in general? If we trust enough in the Placebo Effect and we actively test against this effect on patients, then why do we not actively "use" it in helping patients get better with any care rendered? The Placebo effect is proof that we are not just machines like cars where parts can be removed and replaced without any attention to the thoughts, and emotions. To the contrary, it would seem that Placebo may be as high as 30% +/- of effective patient care in a more well-rounded Health care model. Unfortunately it is all too often taboo to address "belief systems" as a part of patient care. This leaves a major part of healthcare unaddressed all-together. Each patient comes to us with "hope, " therefore why do we not better use this hope in an effective manner to help the healing process? We would like to believe that the medication or treatment either works or doesn't in an effective and predictable manner and that the patient's thoughts, feelings, or emotions has nothing to do with it.........many patients actually hear a version of this from many of their healthcare providers even today. The fact is that patients are still too often treated like unfeeling machines when we know better scientifically. Even in fields such as Conceptual Physics, Quantum Mechanics, etc, we have a testable, yet little understood, knowing that Consciousness itself is one of our largest frontiers in all fields of science. For the most part, the only field of Healthcare that seems to attempt to regularly address this component of the individual is psychology and psychiatry. If an individual's consciousness has such a powerful effect on their entire being, much less how well they do or do not heal, then how do we focus that consciousness on the in-born power and ability for the patient to be the primary component of healing themselves. How do we make this a more effective part of effective patient care in our current healthcare system? Or do we continue to leave it out as a mere benchmark indicator for testing purposes alone?

   It is my opinion that every health care practitioner in some way encounters the Placebo effect in each of their patients whether the know it or not and whether they address it or not. What I mean here is that every patient has both an emotional involvement as well as expectations and hope regarding any procedure or treatment they may be undertaking due to some condition they "have." In this sense it becomes obvious that I believe "Placebo" exists in each treatment at some level regardless, and this is due to the fact that we are ALWAYS encountering a Patients "belief system" regarding any treatment that might be administered. 

    The question then becomes "How do we work positively with a patients expectations and hope to more effectively attain the desired outcome of improved patient health?" The first step would likely begin with simply asking what the patient's "expectations" are of any treatment. The most difficult part might then be the second part of actively using the hope and determination of each patient to structure or optimize the desired outcome. Again, Dr Siegel has an interesting approach of effectively using forms of "visualization" to actively aid in the "benefit" of therapies such as Chemo-therapy. Third, is how do we effectively create a "system" of the expectation/ hope dynamic for "different" patients? Forth, how do we then implement what will likely be a varied "system" based upon different fields of healthcare? 

   To begin with, many patients are not "neutral" to a particular treatment and have a particular and deeply help "belief" about  treatment X, Y, or Z. Therefore, if we have a way of determining those patients with certain beliefs Pro or Con ( As both can be powerful aids or detractors from the intended outcome of health), perhaps certain treatments can be "paired" with patients seeing / believing more strongly in the benefits of these treatments. Perhaps we can begin with "pairing" patients with treatments they believe in more powerfully. What then is also the potential for influencing a patients "perception" of a treatment to maximize the benefit? 

   In the end it would seem that as health care providers we are actively interacting with a patients "choice" regarding any treatment. We acknowledge this more and more across all the forms of healing. Will we be able to more specifically "structure" programs in order to more positively impact patient choices for the best possible outcome and more proactively utilize the "placebo effect?"