Archive for November 2010

To Sleep, Perchance to Dream

November 23, 2010

There are so many of you out there who have insomnia.  It is a major epidemic…a $3 billion prescription sleep medication industry.  Those of you with chronic pain, well, this is a given.  Who can sleep when everything hurts, when even the slighest movement leaves you cringing in fear of provoking a spasm?  Let me tell you something…when you do catch some sleep it is never restful, you do not dream, you do not reboot, you always want to sleep more, in the morning you can barely lift your head up off the pillow.  I don’t like the pills because they induce drowsiness but it is FAKE SLEEP.  The problems of why you don’t have real sleep are never addressed, much less resolved.  For those of you in chronic pain, well, the solution is simply, OMT.

Recently, I have discovered a good percentage of you people out there who think they are OK, healthy (or so you think) but can not sleep.  Your heads are heavy, really…literally…the melon that should be sitting atop your neck has now transformed into a bowling ball.  In the past you have had some minor aches and pains, but they were not bad enough to need a full on consultation with an MD or DO.  You just think that a little massage and occasionally going to your chiropractor to get an ‘adjustment’ will keep you in ‘good health.’  Let me pose a question.  If you are taking care of yourself…why can’t you sleep?  If that preventative cracking is good for you, again, why can’t you rest like a normal person.  That is because you are not normal…you are mechanically strained. 

Let’ s talk about Our Most Natural State…if you are exhausted out there in the wild, you can not function, you will make mistakes and become lion lunch meat.  Where in Nature does an animal need another animal to ‘crack’ its back for preventative health maintenance. 

Finally, how do I know this?  Patients who are mechanically strained from old trauma over lots of sports, those bowling ball heads turn back into melons and this coincides with better more restful sleep on fewer hours.  I have this whole family and the dad plays soccer.  I did a quickie freebie treatment for him one time and his wife tells me that he slept so well the next three nights she had not seen that kind of sound restful sleep from him since college.  In medicine there are very few absolutes.  I can say, that ALL mechanically strained patients who do not sleep well, end up sleeping better after OMT.

Please Moms, No Jumpers

November 21, 2010

Everywhere I go, I am starting to see these huge jumpers – indoor playgrounds, occasional neighborhood birthday parties…I am starting to suspect that all this bouncy activity will, in the future, have severe consequences to the bodies of young children.  How do I know?  I have been seeing children now with problems of gait and pain on walking.  Some will have “excessive pronation” or ‘flat feet.’   Most of the time, it only affects one foot.  Sometimes if both ankles roll in, one foot is usually worse than the other.  The most important question to ask is, “Why the asymmetry? Why should one be worse than the other?”  Read my prior post on Arches because what affeccts adults I also see exactly the same thing in children.  In children, as in adults the traumatized sacrum will alter the body’s ability to bear weight equally across the legs.  The most important point I want to make is this…I arrived at this conclusion after having successfully treated children before I was informed about the activity in the jumpers.  This my consistent feeling about activities of this nature – doorway bouncers for infants, bouncing children on the knee…No…don’t do it…all…bad.  Why? 

Let’s talk about our Most Natural State.  In the wild, cubs have ‘play.’  This ‘play’ helps them develop their instinctual skills to hunt, kill, feed and ultimately to survive.  What skill does bouncing on ones buttocks help children develop?  It will only lead to near term leg pains and ultimately… long term disability…yes…it is that severe and dangerous.

Doctor, Why is My Child So Clumsy?

November 16, 2010

I occasionally hear this question in various forms.  Parents bring up this subject  for discussion in several ways.  Did s/he inherit this clumsiness?  Or, s/he was ‘born’ clumsy! The answer is…sort of.  As a conventional pediatrician, this was never taught to us in medical school, in our books, or in our training programs.  I came upon this conclusion several years ago but did not put it together until a couple of weeks ago watching my babyrepeatedly knock her head.  Short answer: Head trauma.  Below is the long winded explanation…

We are creatures of bilateral symmetry.  This means that the right side is a mirror image of the left and vice versa.  Usually, in our Most Natural State, unimpeded and untraumatized, we develop with a balanced form.  The next question to ask is, well, which and what types of unnatural states would cause our symmetry to be disrupted?  Let’s take the legs.  If you break a leg, the growth in th broken leg is disrupted while it repairs in the cast for 6 weeks.  I must also mention the possibility of your ortho casting the underside too thick, which would add inches to ‘length’ on that side for the period of casting.  Other orthos may use a boot.  If you have ever seen people hobbling around on the fancy-schmancy boots, take a close look at their hips.  The pelvis is off balance and the side of the broken leg is higher.  When the pelvis tilts, it causes…hello…a compensatory scoliosis…hello.  So, one little trauma and the subsequent attempt to treat it causes major structural shifts that neither the patient nor the doctor are aware of…hmmm…makes one think, huh?  Let’s talk about the arms.  You say, Doctor H., “In what case would you ever see one arm longer than the other?”  Well, again a fracture would do it; especially at the elbow.   The elbow is notoriously difficult to repair.  It almost always heals angulated and that will cause a shortened length.  Serious tennis athletes who slam out serves of close to a hundred miles an hour…all that repetitive force will stimulate a lengthing of that arm.  So what does this all have to do with clumsiness?

Our balance, equilibrium, our perception of our self in space, all these mechanisms are housed within our ear canals.  The temporal bones to us Traditional Osteopathic Physicians move in synchrony and there is balance.  The first trauma that can disrupt this balance is called..birth.  In the birthing process, after the head is engaged, it is then compressed.  As the baby’s compressed head traverses the birth canal, it has to spiral (followed by the full length of the body).  Somewhere along this path, one side gets more compressed than the other, see my prior post Plagiocephaly and Other Malformed Infant Heads.  As nursing commences, engaging all the muscles of the face and mouth, the infant head, over time decompresses.  Some babies continue to be molded, i.e., stuck.  If one ear is more stuck than the other, you get an imbalance.  Self and our perception is distorted in these patients.  In some ways clumsiness can be ‘inherited’ because the child’s head is prone to compression in the back if a parent has that tendency.

How do I know this?  I do equilibrium testing before and after treatment.  Adult patients get better.  They walk straighter with their eyes closed.  I’ve done equilibrium testing so many times that I’ve stopped.  Patients feel better, their heads are less congested, they report that they sleep better; this is proof enough for me.  In infants, their heads look more rounded, symmetrical and balanced.

In older children, from repeated trauma to the body, buttocks and head, these kids are definitely out of whack.  Trauma begets trauma.  It is a vicious cycle.  An accident causes trauma.  Thereafter, balance is affected leading to more accidents and injuries.  Athletes know this all too well.  One ankle sprain will lead repeatedly to re-spraining. 

So what can we parents do about this?  Early on, get the child treated with OMT.  Infants and children should only be touched by osteopathic physician and not anyone else.  I had an infant come to me late because mom had taken the child to a ‘craniosacral therapist’ and  a chiropractor.  The baby still had problems nursing and latching.  On the first visit, after I treated, mom could tell right away that the latching and nursing was improved.  When I treat an infant, parents notice within the same visit results.  Do not settle for less.  Keep in mind that you get what you pay for.  For children, it takes longer to see results because their young bodies usually pile up traumatic strain before they clinically present.

For Olga

November 5, 2010

I want to share this story Olga.  It is for you.  Six years ago, I was introducing myself to the community as a pediatrician and went to do a pediatric talk.  This family had already chosen their pediatrician and I always tell people that you want a doctor who is philosophically on the same page as you (doctors are a dime a dozen, but finding the right one for you might be difficult).  One day they show up to my office.  The baby has a rash on her bottom for 3wks.  It has worsen despite all these creams applied to the buttocks.  They lose faith in their pediatrician and remembered me.  On the exam, I notice that there are a few early spots on her face and figure her out.  I gave them directions on how to care for the skin.  In their frantic attempt to kill this rash, they have tried all manner of OTC diaper creams.  They went to the doctor for prescriptions.  Well now, this irritated skin is chemically traumatized and the ability to heal has been impaired.  I see this very frequently – Do, do, do.  I had to give them the  “Let’s Back Off Talk.”  I reccommended that they switch formula to a fancy schmancy expensive formula.  I explained that there was something unusual about her head and that we should observe it.  Everything clears up and plays out as I had explained.  Months later she has a cold.  She had been so healthy.  What happened?  What changed?  What did you do, mom?  The formula was getting too expensive and mom went back to the cheaper formula.  This happened several times and I could always spot it a before she went in the exam room.  Mom finally got it and finally stuck with the expensive formula.  As we watched the baby grow, her head started to get lopsided.  We had ‘The Talk.’  I presented the two options for the plagiocephaly (Read my prior post on Plagiocephaly and Other Malformed Infant Heads).  They did not trust me (even after all the issues with the skin and formula) and opted for the helmut.  I did not like it, but it was their choice, their informed consent.  I was going to see how this would play out.  I would still be here for the consequences.

A year and $3,000 later the helmut is done and the child’s head looks symmetrical and normal.  Months later, she gets sick with colds and congestion.  The frequency of these viral infections increases.  Eventually, the mom asks the all important question.  Why does she keep getting sick?  Finally, I check her head.  I am horrified!  I feel the strain of the helmut pulling her head one way.  I feel the original lop-sided head pull the other way, one on top of the other!  I treat her and both correct somewhat.  She gets better and mom notices that the head treatments break her tendency towards getting congested and catching frequent infections.  Over time, she gets better and only comes in occasionally for head treatments. 

After these years, she is finally free.  She does not get sick anymore.  Even though he saw for himself that I was the real deal, her dad wasn’t quite sure about me and this osteopathic stuff, but his back hurts.  I think he finally made an appointment out of sheer desperation.  Over time, he slowly gets better.  He is an engineer and my explanations for his back issues make sense.  He also has proof that I know what I’m talking about because over time, he gets better and does not need to come back as much.  He then refers his mother.  Now his wife wants to experience OMT. 

There are several points to this story:  1.  sometimes we need to back off.  2. with OMT, over time, you need it and us, less and less – that is true return of health. 3. i really do know what i am doing.  just trust that the body wants to heal.  you just need it give it enough time.  do not offend it.  it does not need more trauma forced upon it.

Ethical Dilemma

November 4, 2010

I find myself in an ethical dilemma.  I use this blog to share my cases and what I am seeing out there in the medical consuming public.  It is not primarily a place to rant and rave about a specific profession or problem.  Ideally, this blog serves to share with people how I came about some of these conclusions based on my medical training/background and most importantly clinical experience.  By now, after all these posts, I hope that you have gathered that I am a minimalist in my medical philosophy and in life, generally (primarily because of my immigrant background).  I find there just is much too much  of having things done to the body.  Once things have been done, it is hard to go back.  After an initial injury, the sane, minimalist immigrant approach is to leave it alone, let it calm down and….go back to work, or in Our Most Natural State, forage for survival.  Here in the US, because of the vast medical consumption possibilities, it is very rare that I get a patient who is a pure unadulterated mechanical strain.  It does happen occasionally and these people find OMT to be “amazing” and my hands “miraculous” after just one visit.  But most of the time, I get these “go-go-go” personalities who “research” and believe nonsense about how this or that can help.  They are in pain from some past mechanical trauma and they think that massaging, chiropractic, PT yanking, ultrasound, deep tissue pummeling of their muscles, beating them into submission is going to resolve anything?  Or even worse believing that  injecting, cutting, inserting a battery/external electrical source (nerve stimulator) will help?  People! wake up!  With just these words, please visualize what these other people propose to do to you.  In your debilitated pain state do those ‘treatment modalities’ not sound more…..traumatic?  That is why OMT is so powerful.  It is gentle simply because the mechanically traumatized and strained body wants precise removal of that traumatic force.  It looks so easy.  Let me tell that it is not.  It took me a long time to comprehend the beauty of Osteopathy and this is 11 years after graduating as a pediatrician.  Please beware.  There plenty of fakers and wannabes out there who think they can do it because it looks so simple.  Ha-ha joke is on them.  They think they can take a stinky little weekend course here and there from a less than successful sellout DO (ie, inferior in skill/talent) and claim to offer you OMT (only a DO can legally render OMT).

Once the damage is done, please just back off.  The body needs time to recover.  Once it recovers, then with osteopathic treatment it has a chance to heal.

My dilemma is should I keep my mouth shut?  I keep seeing the same thing, over and over again.  People need to be warned about the damage that other people can unwittingly force upon already debilitated bodies.

Legs Out!

November 3, 2010

Children always sit with their knees angulated because it is easier.  It looks deceptively stabilizing.  I visit my pediatrician friend and her kids did the same thing.  Because they are young and still developing, the sitting that way, with the feet out to the sides, they can potentially cause the head of the femur to internally rotate and develop that way.  When a child walks and ‘toes in’ (also called pigeon toes) we do an examination to see whether the cause is at the ankles, knees or hips.  This is a bad habit that needs to be broken and I never imagined how difficult it is for mommies to constantly remind their child to sit the proper way.  Here is my secret.  Feef free to share it, but always attribute your source.  My 2year old since her first visit to the park at 18months has always, consistently, heard the same instructions from me on how to go down the slide.  Up, Up, Up (the steps).  Sit down, legs out, Down you go!  They always need consistency – for learning and for language.

Now when she sits in the bath or out in the living room playing,  Kathleen, legs out and she does it.  The great thing about this age is she will do it.  Easy as pie.

Rosy Cheeks in Infants and Children

November 2, 2010

Most people think that a chubby rosy cheeked baby is ideal.  No it is not.  Not good .  Not normal.  We are in California.  It does not get that cold here for children to be ruddy or flushed for going from outside cold temps to a warm indoor environment.  I am trying to guess what other questions mommies out there are asking/wondering about their child that have not been adequately addressed by their pediatrician.  Do you remember those first days when you brought your beautiful baby home?  Baby started life red.  The full term newborn has pretty thin skin.   That redness is blood suffusing the underlying skin.  As the infant gets older, the face still looks plethoric.  As the baby cries or fusses and scrunches up the face, you notice that your baby get red very easily.  Why is that you say?  In going through the birth canal, the whole infant cranium is compressed -the skull plates, brain matter and blood vessels.   Ideally, in the wild and in Our Most Natural State, the infant nurses immediately after birth and expansion occurs.  Blood flow into the head is active and propulsed via contractions of the heart.  Blood flow out is passive via the draining veins.  If there is back pressure from compression there will be congestion.  Superficial veins will bulge blue.  Blood suffusing the skin will not drain well.

In infants that have expanded and or been treated, their cheeks are usually clear.  One day everything looks okay.  In the next, you see a flushing bright red centrally on the cheek.  You think back and ask yourself, what was different in the last couple of days?  Why is my baby’s cheek red all of a sudden?  I see this all the time…and it coincides with the child’s exposure to cow’s milk directly or even indirectly through the breastmilk.  This is inflammation.  (this inflammatory process is also a harbinger of colds and illnesses as the immune system needs to ramp up to fight an infection). This is pre-eczema.  I can spot it a mile awway.  In some cases, it starts off very mild with only a few discrete bumps that you can not see but only feel.  After repeated exposure, they get bigger and bring friends, then erupt.  The skin continues to change, get red, and cracks.  The cracking causes dryness, which leads to itching, which leads to redness.  Pretty soon there are splotchy red patches. In some cases of extreme compression, the infant is colicky within 3 weeks and the rashy cheeks are not far behind; it does get there faster if momma doesn’t breastfeed.  Momma usually is not to blame  even though most of the time the guilt and blame of not being being able to breastfeed is borne by mom as ‘stress.’  I must admit that I suffered that myself (read my prior post There is Something Wrong With My Baby).  You can even see these splotchy faces on my previous blog Plagiocephaly and Other Malformed Infant Heads and the before and after photos (on the Website) where the skin clears up.

So to test this out, you eliminate the exposure, get rid of the milk.  If you are washing the baby with soap (i find Johnson & Johnson to be very offensive) stop it altogether.  Within 3-4 days the skin returns to normal.  Then once it is absolutely clear, reintroduce the dairy and you will see the skin change.  Easy as pie.