Archive for August 2010

My Big Fat Bunion

August 31, 2010

Ok.  I had such a good treatment week.  Go view the videos on my YouTube channel – DOCTORHOANG; amazing.  Patients who paid me cash up front were so happy with their results, achieved from inspiration by Dr. Miller – a great old time Osteopath, 80 years old and retired.  I have to keep asking why? and what is the cause?  I convinced myself that podiatrists and the profession is it necessary?  In our most natural state, would we survive anyone taking a knife/scalpel to our precious feet?  Probably not.  We would have a gimp foot forever or until a predator caught us and made a meal of us and our gimp foot.

So, I looked to myself.  My feet are not symmetrical.  I had such great results with my patient, Kris and to me it is so hilarious the dilemma he is in.  He just paid for fancy schmancy orthotics which I advised him to throw away.  Then he has his fancy schmancy Nordstrom different-fitted-sized shoes.  Then I advise him not to buy new shoes.  What is the cause of my right foot being smaller?  Is it because the leg is shorter?  Is all of this a consequence of my mild scoliosis?  Why is it that my right foot has a big fat bunion on it?  In my younger days, I had a proclivity for 3 inch clunky heels.  If I was naturally prone to bunions, how come the left foot didn’t get a bunion?  Was it because it was the normal foot?  Normal size?

I thought why does the R foot bother me as a smaller foot?  Why?  If it is the smaller foot, by a half size in a bigger shoe shouldn’t it feel better with all that room?  If it is uncomfortable, isn’t it the pathological one?  I remembered that when I was 7 years old, I was running around in our front yard chasing down a chicken.  I stubbed my great toe on a sprinkler head.  Boy, did that hurt for a while. Could that be the cause?  I did not believe it myself.  So I went to foot and that great big fat toe and treated it for a compression strain.  Well, well, well…what do you know?  Something happened and it felt better. 

The next day I put socks on and shoved them into a snug pair of shoes.  Went to a birthday party.  Afterwards, guess what?  That right foot bunion felt achy.  The next day, I thought it was my imagination but the toe and foot looked straighter, bigger, and felt better.  Rats!  I forgot to take a picuture.  I grabbed the toe again and proceeded to treat it.  This time, I had the weirdest sensation.  I felt and still feel an achiness in my left 4th and 5th finger and little in my left elbow.   Wow.  Sitting here writing this, my foot and the other little piggies are aching.  I think this foot might be getting bigger…I don’t think I’m imagining it…

I’m still going to take a picture.  I’m not sure if it will change in the next month.  Who knows.  It sure does feel better.  I thought since I missed the opportunity to take a picture, I should probably offer free treatment to the next bunion patient in exchange for pictures, and what do you know, I already found that person.  Wait for the pictures.

Quiet Time

August 30, 2010

Infants need quiet time.  With the first child it is pretty easily accomplished.  I am finding that with a second baby and an older child toddling about Quiet Time is difficult to achieve.  Why is it so important?  I have noticed that with the music and noise and heaven forbid, television on, there might just be too much stimulation.  Television is bad.  There is something unnatural about the old sets with the cathode ray tubes.  Worse now are the HD televisions.  There is a brightness that is unnatural, unholy, ungodly.

My six month old, she wants to be around her sister and wants to sit and pull to stand.  She doesn’t want to be on her belly.  She doesn’t want to try and scooch.  When she was with her sister one time this week, I saw her look at the television.  And then I saw her look away.  She looked bothered by it.  It was wrong.

That night when she woke up with teething pain and could not go back to sleep, I took out to that same spot.  The lights were dimmed.  We sat there quietly playing.  I was responding to her, facially, visually, manually supports.  She was so content.  She had memory of earlier in the day with all that noise and overstimulation, she looked to the television screen which is now dark and quiet.  Satisfied, she looks away and doesn’t look back.  A whole hour we did this.  It was wonderful.  It was exhausting but so worth it.

I interviewed a couple, parents to an autistic child.  They told me that she was scared of fire.  Most curious, trouble making youngsters have closet pyromania in them.  This light is flickering and natural and should stoke curiosity, not fear.  Then I asked about television.  The dad states that the child would often turn the television off herself!  In my talks with them I sensed tension and discord.  My suspicion is that this couple argued often in front of the child (no sibs).  With the television blaring, the arguing, she is being driven crazy by the excess stimulation.

Now, Baby Einsteins.  There was that study that showed children exposed to Baby Einsteins talked less.  Remember all the hubbub.  All was quiet on the Disney front.  They paid $500 million for a company started by a woman with no medical, no child development background that proved to be harmful to the target group they focused on.  Come on.  These children, by watching, are constantly, turn into receptacles, constantly in receiving mode.  They do not get a chance to be in exploratory, expressive mode.  Common sense.  I also believe the fact of the light of the television does something to them. 

Children who we pediatrician suspect might have seizures, we order an EEG; an electroencephalogram.  Wires/leads are placed on the head all around.  These leads read the electrical activity of the brain.  When there are surges, it is picked up.  We have it running while they are awake and watch them as they transition into sleep.  There are some who are so sensitive, that flashing lights can trigger a seizure.  Migraine patients can get bothered by light.  Can it be possible that the flashing activity of a television screen set up and irritate the nervous system so that they are susceptible to trying to shut down, internally, all that external stimulation?

Quiet time is a necessary break from day to day stimulation.  We need to return to the old fashioned simpler time of just spending time to teach and interact with our infants and children.

Medical Mysteries

August 28, 2010

Ok. I am kinda bummed. So, about a year ago, I was polishing up my website.  I fancy myself a medical detective and hence, those lines.  People who come to me, have been through all the specialists.  I thought maybe I should remove because it sounds so corny.

Now in my tenth year of doing osteopathic work for both children and adults, I have come to the conclusion that there are no medical mysteries.  There are people who suffer unnecessarily.  Several people advised me not to remove it. 

Still, I am convinced that there are no Medical Mysteries – it is just that there is an answer, you have to have the right person help you find it.  When I solve a case, I really solve it.  Both the patient and I, we know we have reached the answer.

This week was a good week.  I had a new patient who found me because a coworker referred him.  I did not treat his coworker.  His parents drive out from another county to see me and the are getting good results.  Ray, was easy to figure out.  He is pretty much done and he left stating over and over again, “Amazing.”  I was so inspired that for the rest of the week, I decided that I want these results for all my patients.  After Ray, I was able to accomplish this for 3 other patients, 2 I videoed.  You can see them on my YouTube Channel:

Ligamentous Laxity

August 14, 2010

This is what happens to a body that gets cracked frequently.  People think that this is great.  I’m so loose.  I’m so limber.  This must be a sign of health.  No it isn’t.  Get this very clear.  The vertebral bodies that compose your spine and protect your spinal cord have scaffolding made of ligaments.  There is a long band in front and a long band in the back.  Then there are the tiny little ones in between that allow some motion from segment to segment.  When they are loose, they can no longer provide stability.  Think of an ankle that is badly sprained.  That ankle ain’t ever right again, is it?  That’s right.  It just takes one twist and one yank.  Now think about your poor unprotected back. 

There is a reason why after a car accident we have neck spasms and whiplash.  There is a reason for back spasms.  Spasming is nature’s way of telling us that there is something wrong.  We hurt and consequently we don’t move.  The spasm causes a splinting of the body and prevents further injury.  It provides stability at the time the body needs it most.  Read my past post on Crack(ing) is Bad.

Pseudotumor Cerebri

August 13, 2010

Pseudo – What?!!  Yes, this is a true medical condition.  Why do I want to talk about this?  I want to showcase to the world how they think.  Who is they?  Those of you who actually are diagnosed with this condition, already know who they are…the standard medical community.  Basically, these patients have a range of head symptoms mostly headaches; MRI is negative; when they do a lumbar puncture to look for protein, infections, etc., they find that the opening pressure is higher than normal.

In the closed tissue space of the cranium, there is just enough room from brain, blood supply going in and out and cerebrospinal fluid which cushions the brain.  Anything extra will increase pressure so that when you stick a needle in the lower back to collect CSF, it pops the meter higher.  So, if an MRI has not been done, we get concerned about a tumor.  If there is no tumor, then why is the opening pressure so high?  Hence, the name, pseudotumor.

A specialist from a “Big Name” hospital in Los Angeles, asked me what I thought.  He had a patient that he diagnosed with this condition.  He is a little poindexter in his ivory tower all these years, looks kinda like an older Ric Moranis, no offense to Mr. Moranis.  At first, I was gullible enough to believe that he was curious and really wanted to know what we would do.  Now I realize that he asked so that he could quietly, smugly, mock my distorted thinking.  I will leave it up to you, the public to decide who is more distorted.

If the opening pressure for CSF is high and if there isn’t a tumor pushing that fluid out the needle, then there must be something.  What?  Well, our Poindexter, they, of the ivory tower stop the thought process right there and label it “idiopathic” meaning cause unknown  (some meds can cause this, but not lots, not common).  Unknown cause.  Therefore unknown treatment.  Now, get this.  This increased CSF pressure causes headache.  So, the little guy wants to have his patient come to him once a month so he can stick a needle in her back and take out CSF.  Band-Aid.

Here is my rationale…If CSF pressure is high, maybe there is too much CSF.  Why would there be too much CSF?  You are either overproducing or under resorbing. In the osteopathic philosophy, mechanical strain acquired from trauma or residual birth process could affect circulation, drainage (of blood, lymph, CSF) and resorption.  MDs think that the cranium is static.  We, traditional DOs, believe that it is dynamic, that there is a mechanism for motion and drainage.  It is the natural state.  When there is trauma or strain, the cranium does, sputter and stagnate – then what happens?  Pressure builds up -Tah Dah! Crank that mechanism up, reduce and resolve the strains and bingo the system stirs and fluids drain and pressure decreases.

Our little poindexter decides that it is impractical, not to mention that the parents might not like it.  What does he do?  Nothing.  So the patient is left on her own to suffer.  That is how they think!  They know it all.  So if they can’t do anything, no one else has the answer either.  Scary.  I feel sorry for all you patients out there diagnosed with Pseudotumor Cerebri.  Everybody else ?  Be scared.  Be wary.

Glad to be a D.O.

August 8, 2010

Yep.  I am in my right place.  I was such a nerd in school.  Loved biology and human development.  Of course the predominant medical system is the statistical biochemical model.  So when I knew I was going to be a pediatrician, not going to need this, babies don’t have back and musculoskeletal problems.  Boy, was I wrong.  Man! If anything, chronic problems of infants and children, tend not to be biochemical.  Hello?!!  If anything, the primary problems tend to be mechanical.   The sad thing is they do hurt, they do have chronic medical problems.  The only problem is that they don’t know how to communicate their distress and pain.  That is for us to figure out.

So I found my way back to being a real D.O. about 10 years ago.  Boy, am I glad I landed in the right place.  Since then, I really don’t trust everything the ‘experts’ say anymore.  I now subject what people say through a crucible of healthy reserve and if it doesn’t pass the smell test, then well, I discard it.   Read my future post on “Pseudotumor” wherein I share with you how they think.   I just think we have more common ‘horse’ sense.  Unfortunately, if you are reading this and you agree with me, then you have been burned by the system.

Now in practice for 10years in my own office, some really neat things are happening.  Adults are referring me to their adult friends and families for osteopathic manipulative treatments.  But last year was the year of two people separately, who don’t know each other, being told to see me.  Cool.  This year, is the year of “friend of a friend.’  My goal now is to continue developing my skills so that I can get more results and faster.  I am excited for the next 30 years.

Crack(ing) is Bad

August 8, 2010

In the immortal words of Whitney Houston…”Crack is whack.”  Why do I so firmly make this statement?  Clinical experience.

When I first started finding my way back to traditional osteopathic work, I had no opinions on the cracking business.  After all, we are taught that in our basic manipulative medicine courses.  I just didn’t like it.  It wasn’t until I started seeing some things that I could not explain that I started to shape my understanding… 

There was a 16year old girl who came to my office for After Hours Care complaining of an elliptical patch of numbness on her left arm.  Numbness.  That is neurological.  Nerves feed a distribution of skin that is distinctive and stretched out in linear patches (called a dermatome); kind of stretched out like when someone has the shingles.  Her patch was cut off in the middle of a linear  patch.  I continue to examine her.  No weakness, no fever, no pain, no spasms.  It came on suddenly.  Was she traumatized?  Did she do something unusual recently?  Yesterday, she was on roller coaster, the kind where you sit and your legs dangle in the air and you are strapped down with a shoulder harness.  After she got off, the numbness started.  I checked her and her muscle tone in her arms and legs were quite high.  I was confused. I asked her if she worked out.  No.  Did she do any sports or cheer?  No.  Dumbfounded, I ask again.  Dead end.  So I rephrased my question.  I asked the mother, “Is there anything in her medical history that can explain what I am finding with her muscles and all this increased tone?  Mom answered that she was very healthy and that she USED to have a scoliosis.  What?!!? What did she mean?  She took her to a chiropractor and he ‘treated her and ‘cured’ her. Uhhh…that was it.  I treated her arm, osteopathically and the numbness went away.  Since then, I started seeing more cases…

I had a woman come in crying.  She is desperate and not sure if I could help her.  She was an engineer.  She was in a car accident  and had whiplash.  She could not move her neck.  Went to a chiropractor and was cracked in her neck and back, several times a week for their usual treatment period, maybe 4wks.  Her pain does not abate and she gives up.  She is still hurting and one day she is sitting at a restaurant resting her chin on her hand.  A waitress walks by and bangs into her table.  The supporting hand slips, her head rotates/twists quickly to one side.  Now, for the last 2 months she is dizzy on a daily basis.  She has to take a break from work.  She consults specialists, neurologist, orthopedic surgeons, radiologists.  No one can help her.  She went to an osteopath teacher I know and only gave her only one visit.  She cries to me, “Now I understand why my neck was in spasm.  It was supposed to spasm -so that it could stabilize my head and neck! Look at me now.” and she does this wobbly bobble-head motion.  My question is the person who hurt her, she gave all that time, visits and her money; and in searching for an answer, she only gives us, real doctors, one to two visits. 

I was flying back from a conference. I happened to sit next to an orthopedic surgeon who gave it up.  I shared this story with him.  This woman suffering exclaimed, “A chiropractor did this to me!”  We (osteopathic physicians) know. Neurologist know.  Neuroradiologists know.  You guys (ortho surgeons) know.  [Even my medical assistant receptionist who went to school to be an xray tech knows].  They hurt people.  Why don’t you guys stand up and say something?  His response.  “It’s a business. They send us patients.”  Wow.

Patients, in general,  when they have things done to them, it changes their body.  They hurt.  They spasm.  It is the body’s signal say, Hey, something is wrong here.  Stop doing.  Rest.  But we don’t listen to our body.  So desperate to relieve the pain, they unkowingly allow others to crack (chiros), pound and rub (massage) and yank (PT).  All this additional trauma, electrically disconnects the nervous system and weeks, months, and years later they still are not right.  Read my post on this, “Don’t Tenderize that Meat.”

I had another woman who had abdominal pain 8 months after delivery.  Of course she ran to her chiro.  I bet you there was plenty of cracking.  Of course he could not help her and told her to go to her doctor (???!!!)  don’t they claim to be doctors?  So she went to MDs and they did everything under the sun – specialists, blood work, tests, scans.  Nothing.  I don’t blame the MDs.  They just don’t look at all the other stuff we look at; but at least they don’t do too much else that hurts people additionally (most of the time).  Read my future posts on Medical Mysteries.  She comes in and she is a musculoskeletal mess.  Needless to say, she is getting partial relief.  I suspect only partial because of all the other crap that has been done to her or she has allowed to be done to her.  It will take more time and visits to undo.

Prior to all this, before the pregnancy, she thinks she is fine.  She thinks she is healthy.  She exercises. She does pilates.  This wonderful chiro who helps her with preventative health? BS, who doesn’t do a lot ( but some) cracking but mostly massage (this so and so technique, blah, blah, blah), so why does she have problems sleeping?  Of course she has problems sleeping because her head is heavy and dense and blood does not drain well because it is been cracked so many times.She will have serious problems later.  But then if cracking is good and is healthy and ‘disease prevention’ why does she need to keep going back?  If this is such wonderful ‘prevention’ why does this woman still have problems?  Read my past blog about Our Most Natural State.  If she existed out there on the plains of Africa, this woman would be a meal for the lions because she would be too tired/fatigued to run away from them.  That is not health.  The  final question to pose is, If she is so healthy, why was the pregnancy and delievery less than ideal?  Then, afterwards, she has this weird musculoskeletal pain that no one except and osteopath has figured out.  Too many things wrong here…Don’t pass the smell test.

If you have a healthy fear and skepticism of us in medicine, but you don’t know what to do for your problem, do nothing at all or do the most benign things.  I like acupuncture – the relief is temporary, but you don’t have additional trauma.  I like reflexology – no additional trauma.  Gentle massage is okay.  Read my future posts on ‘Pseudotumor’ and Medical Mysteries.  Don’t trust anyone unless they can explain to you in a way that makes sense and prove it.