Archive for February 2011

My Ocular Migraine I

February 22, 2011

Let’s start off with this statement…I never get headaches. Never.  Never. So for the last 2 years I have had this achiness around my left eyeball.  It wasn’t sharp stabbing pain.  Visual disruption is not associated.  Nothing to worry about.  I started noticing it after a conference in Ariozona.  I decided to drive the 6 hrs.  I don’t know why I did the driving but nevertheless, I thought it would be okay. 

The day of the conference, I was getting out of the car, leaned in, reached and grabbed my bag of books.  The load was unexpected and I felt a tweak in my neck.  During the conference, as I was paired up with wonderful doctors who have years of clinical experience, I was not quite right.  I had so much respect for these doctors but they were able to do only little with the weird pains and sensations I was dealing with.  I have to say, they were severely handicapped by the situation.  I and my strains are new to each, and I can not expect  them to figure me out completely within 10minutes.

Last year, I was in my last trimester with my second baby and I did a bad thing.  I was in a “nesting” frenzy and I got up on a ladder and yanked down old crown molding.  That wasn’t so bad so I squatted and yanked out old baseboards.  That really did something bad and the next day, boy did I feel it.  My back did not feel right but that L eyeball achiness popped up again.  I went to a friend to get treatment and he was oh so close.  I thought I might sleep like a baby tonight…Nope…I had a mini eyeball headache that night and the following night everything settled down.

Four months later, I go to another conference and I met a 5yrs new doctor.  He was an engineer in his prior career.  Then at the age of 50yrs, he quit and went to DO school.  Didn’t want to be an MD.  Quit just to do this hands on osteopathic stuff.  He was amazing.  He checked my head and felt this vector from my R head zing straight over to the L area around my eyeball!  Man, this was the only doctor who got that close to my eyeball headache.

So this thing kept going on and off for two whole years.  One day, I am driving and the eyeball is soooo…achy.  While driving I decide to try and exercise the muscles of the eye.  They felt so weak but doing the exercises did not make much of a difference.  I seriously thought to myself, “Self, should I go and get my eyes checked?  This is my good eye.  I should not ignore this.  It has been going on too long.  I thought who am I going to go to see?  My ophthomologist friend wouldn’t know, because this was extrinsic to the eye, and the tissues around the eye.  Should I go see an optometrist that I know who does vision therapy (exercises for the muscles of the eyes)?  Or should I go to my DO friend?

[ADDENDUM (7/29/11):  since this post, there have been others search ocular migraines while driving.  it suddenly occured to me that the “migraines” flare up mostly when the eyes are active, searching and focusing; what does this imply?  very simply that an “ocular migraine” is soft tissue and muscular strain of the eye.]

I did none of these things and continued to intermittently suffer with my weird “ocular migraine.”  Then one morning an epiphany happened and I ended up treating myself.  My eyeball feels great now. No achiness.  I no longer have to worry about going to another doctor, ophthomologist, optometrist and not even another DO.  I am now completely free!  My ocular migraine, it turns out, is/was a pure mechanical strain.  Here is how I figured it out…

One evening, Regan, my baby was cranky and fussy.  I decided to take her into bed with us and nurse her the whole night.  She has been teething lately and I missed us sleeping together.  Big mistake.  She flopped around and was very restless.  I was afraid that if I moved, I would wake her up.  So I layed on my right side the whole night.  The next morning I was stiff.  It was not healthy…I will finish with my cure for my ocular migraine in a future post…read on…

HMO Plagiocephaly Helmet

February 18, 2011

I wanted to share with you a recent email exchange I had with a pediatrician executive at an HMO.  As most of you know, I have been doing cranial osteopathic treatments for infants in my office for the last 7 years.  I have not been terribly aggressive about “marketing” this work.  People who search, parents who are concerned will find their way to OMT and us osteopaths.  Recently, I found out that the helmet people have been sending out droves of salespeople to ‘educate’ pediatricians about their services.  Because of this, I printed out a flyer to educate my colleagues about the mechanics of plagiocephaly.  I also had cards made and did a separate website,   I showed my work and talked to several pediatricians.  I even spoke to a pediatric neurologist and he was not a fan of the helmet and quite supportive of me.  He and a few other pediatricians said to me, ” You should talk to Dr. So-So.”  I wasn’t keen on it and did not think much of it.  Several months later, I eventually dropped it off to Dr. So-so.  The response was, “No thanks, we have a cheaper helmet.”  That says it all doesn’t it?

Unfortunately, medicine is a business and is very much like anything else in life.  You get what you pay for.

Doctor, Why Do My Legs Feel Heavy?

February 16, 2011

I have heard this many, many times.  Those legs feel like tree trunks.  It is so much work lifting them to walk, go up stairs, much less even run.  Another patient described them as “walking through molasses.”  Why?  You problably have had a whole lot of problems in that poor pelvis.  I have seen this in past falls to the buttocks, bad multiple car accidents, rear end collisions, and many years after hip replacement surgeries.  If you have a problem with your elephant legs, then you are, in non-technical terms, really messed up.  People with pelvic problems also have hip problems, feet pain, neck pain, back pain and headaches.  

I have this patient who was jogging and got hit by a car; his brain started to swell on the way to the hospital, he became belligerent so the EMTs had to restrain him.  He was in the ICU they were watching and if the swelling continued, they would drill a hole through his skull to release the pressure (if not he could die within minutes); he was eventually stabilized and went home 2wks later.  After he came home, his personality changed, he was volatile and started to become afraid of being alone with his 1 year old daughter (emotional, not feeling good); he was afraid of hurting his own daughter.  I saw him twice.  After the first visit he exclaimed to his wife, “I don’t know what she did, but she’s welcome to feel me up anytime!”   He did not come back after the second visit because the medical bills were piling up.  Two years later, he comes back.  My shoulder is very painful, my legs feel heavy, my breathing is tight, running is not enjoyable anymore.  I told him, “Your shoulder pain is coming from your hip.”  He replied that I saw a problem with his hip 2 years ago.  He was perplexed.  I said, “Ron, you are mere flesh and blood. 2 years ago, you go into a fight with steel and concrete.  You lost.  I am not a miracle worker.”  It is now 6 visits, this second time around.  The breathing is easier, the shoulder is better, the legs are lighter, the whole body is lighter.  He comes in now every 2 or 3 weeks when he feels his body tighten up.  Soon he will be out once a month and he and i will be eventually done.

Yes, there is a treatment. Yes, there is a cure.  I have done it many times.  I even have patients test raise each leg. I do a treatment and right there and then, I have them recheck as proof that I know what I’m doing.  It is beautiful.  In these last 6 months, since August 2010, I have used this quickie technique to show patients how strained tissues can instantaneously change.  I grab a hold of strained tissues and actively reduce strain.  Wow.  It is a lot of work on my fingers.  It has only been this last week that I discovered what our osteopathic teachers have been talking about all along.  Hey, you guys out there, my patients and readers, all three of you who know that I am way gentle, yes…this is even more subtle than what I have been currently doing.  I have been doing osteopathic manipulative treatments for the last 11years and I finally, just this week realized how to do more precision, even less force work to achieve more dramatic change.  What is this huge epiphany?  It is difficult to explain in just a few sentences; a paragraph may not do it justice.  This is knowledge that belongs to the DOs. It is a seriously long and hard haul.  Most people go to DO school, pay $250,000 for the education, study for 11 years (4 years college, 4 years medical school, minimum 3 yrs training) and work in the CMS just to pay it back. Who has the time to wax philosophical? and much less write anything down to pass on to the next generation?

For those of you searching for answers, how can I help direct your search?  Since this blog was first posted, so many, many of you people out there have searched for answers and I suspect you got little for your efforts at those other (MD) web sites; yes even the ones that are really reputable and that are by institutions of medicine that I like. They look at the tensions as localized and ‘easily’ remedied by gross external applications of force. The answer we propose is that the tensions above and below should be…balanced.  The answer for you is Osteopathy…

Read my prior posts about osteopathic, health, our (traditional osteopathic physicians) and search for a DO licensed to practice medicine in your state.  Absolutely do not let anyone crack your back or neck, yank your legs or hips.  I will tell you that hands on osteopathic treatment styles can vary between different DOs; I liken it to the martial arts, some people are very subtle, some people are out there fru-fru energy stuff; I am more hands on cranking mechanical…I like to prove before and after within minutes in a visit because my goal is for you to trust.  Call and ask about experience and comfort with treating mechanically.  We charge for our time to get results so that you…do not need to come back.

7/29/11 ADDENDUM:  since i first wrote this post there have been 2300 searches on this topic.  you people out there are searching for help…i know what your problem is and can cure those legs…there was also one comment that this post did not provide any real answers to this question…unfortunately, it took me this long to figure this out and to try to explain to lay people what their problem is and how to fix it themselves would be impossible; in fact i have 2 local colleagues that have more experience and  different treatment styles and even they don’t know about this; so this is essentially my own discovery…today, i test explained this idea to one of these 2 colleagues; at first she did not seem too impressed – yes, my legs are about 10% lighter only after 10mins, so what?  big deal…. it took about 20minutes when the changes worked themselves up into her neck, face and jaw that i saw a twinkle of respect…so come to California for your cure or if you can afford it fly me in for a consultation…in the meanwhile, i will continue to discuss this topic with my colleagues and teachers; perhaps we can develop a course or training program so that you can find a trained osteopathic physician to address this issue specifically; you guys out there need to demand it of us DOs; sign up for my this blog; i check on the traffic, when there is enough demand, a critical mass is reached, hey, how about crashing this site with volume? maybe it will drive and impel us to do more.

1/4/2012  ADDENDUM:  since i first posted this blog, there have been 6300 views.  so many of you out there…i don’t know what to tell you…i am working on trying to get interest so that MDs and DOs can be inspired to learn this.  to get really good treating hands, it takes about a minimum of 7 years, i don’t know if physicians in general, want to spend more time and money to learn something that will free you up and not keep you coming back; especially if they are satisfied, churning the repeat volume…we shall see…i will keep you posted…

9/13/13 ADDENDUM: I just completed my new beverly hills website, it is cleaner with lots of new spectacular photos at Go to the video gallery and you will see what this is you. I am sorry, but I believe that very few osteopaths in the world can get these changes so instantaneously.

Vaccines, Part II

February 11, 2011

This week a skeptical parent wanted the low down on whether doctors (we pediatricians) made money on “pushing vaccines.”  The short answer would be ‘no.’  He was thinking in terms of kickbacks, which are illegal.  He thought that doctors got some money, in the form of a check, directly from pharmaceutical companies fo giving vaccines.   Trust me, the lawyers and the gov’ment are all over our case, breathing down our necks; that never happens.  Here is how it really works…

First, lets talk about govment interference, i.e., mandates.  Federal law requires that all children in the US get vaccines regardless of economic or legal status.  The reccommended vaccines are determined by an “Advisory Committee” made up of pediatricians and vaccine researchers (who researches vaccines? people who are paid to research).  Is there true independence?   What is the governments’ financial interest?  No, pharmaceutical companies do not cut checks out to government entities (not that I know of, it’s just not how it works); they do cut checks to spokespeople, people who represent them.  It is the other way around…the federal government is the largest purchaser with deep pockets (and its own press to print paper money) that pharmaceuticals try to sell to the government at a premium when it is “proven” safe and efficacious.  The federal governements interest is not to protect you the individual;  The government looks out for the large populations of immigrants that are at risk, poor to no prenatal care, living in crowded conditions that can potential spread an outbreak.

Lets  talk about the compensation source, who pays whom for what when your child gets one vaccine.  Say you have a PPO insurance.  You take your child in and get 1 vaccine.  You pay a $20 copay.  Maybe you don’t pay anything at all, upfront.  But, where did that vaccine come from?  Poof, out of thin air?  No.  The pediatrician (me) has to stock it in my refrigerator.  Where did I get it?  I had to purchase from a vaccine manufacturer at any price which they choose to set.  Then they don’t send it one at a time.  I have to buy it in bulk, between $200 to $600 for a box of 10 of one type of vaccine.  Look at the vaccine schedule, I have to stock one of every possible vaccine at the appropriate recommended vaccination period.  Before I even see your kid, I have to outlay, out of my own pocket, to stock the refrigerator a couple thousand.  So, your $20 copay, does that really help me offset my upfront costs?  I did not give the vaccine yet, so I can not even get you or the insurance company to prepay.  When your child gets the vaccine and you leave, then we can bill the insurance company.  If the office is pretty streamlined with electronic billing and the biller posts that charges that day (which usually never happens), theoretically we might get a payment in 2 wks.  In the real world, even with inhouse billing, it usually doesn’t go out for a week or two.  Also, based on contracts and payment, legally, the payer is allowed 90 days to pay.  In any sector of society, where does a professional providing a service have to wait to get reimbursed for costs related to providing that service?  Now, that is the supposed to be the good insurance. 

Suppose you have an HMO.  Same scenario, kind of.  With volume buying power within the network/HMO, sometimes the pharmaceuticals will cut a deal for volume purchases and they are not allowed to gouge us doctors (should we be thankful?).  As in any business (construction, interior design, landscaping), when we buy a wholesale item legally (and even ethically) we cannot and should not mark it up exorbitantly.  Most decent reputable people do not do mark ups of more than 10% and insurances don’t reimburse for more than that.  In fact a trend is for them to pay even less than the cost price.  [ Aside: do you know why chain pharmacies are popping up around every corner; they are flush with cash to buy real estate because…you guessed it…their markups are astronomical; think Walmart…if they can make a profit, selling people without insurance generics for $4, that means that their cost for that generic is…probably…under $2-3.  Not huge profit per unit, but in terms of volume, fairly decent.  Think of credit card companies right now.  They borrow money from the government pretty much for free, in this horrible economic environment.  They turn it around and your interest rate has now skyrocketed to 20-25%; that is called loansharking, but it is perfectly legal].

Let’s now talk about the poor who have no insurance.  They can go to a community health center and get all the vaccines without paying a copay, no questions asked.   I don’t begrudge this for the poor at all.  I just think that it is so sad, is the government really looking out for them?  With insidious marketing campaigns for formula, the uninformed think that formula is great, and it is free, from WIC.  And the women who work for the state government programs, they can’t educate other women about the benefits of breastfeeding?  The assumption is that the at risk population does not breastfeed.  Community health centers get their shipments of vaccines for free.  They are charged with vaccinating and protecting the public.  So if you want free vaccines, take your kid in, but you will be subjected to the vaccination rules/schedule.   If you go to a private office that accepts Medi-Cal, then that pediatrician did not have to buy those vaccines out of pocket.  Unfortunately, again, once you accept government monies, you have to follow govmt rules.  Any office that offers free vaccines, free physicals (for the poor) must abide by that vaccine schedule; they are regularly audited.  To make things much simpler, any office that takes a mix of payors, PPOs, HMOs and Medi-Cal all mingled together are more likely to uniformly apply the vaccination schedule rigorously.  There is no time to figure out those at risk to need vaccination and quite frankly, most offices are too busy to care to cater to anyone.

I hope this sheds some light for those of you who are skeptical of the motivations for pediatricians who “push” vaccines.  In my office, my feeling is that I lose when I give a vaccine and I also lose when I don’t.  Its a wash.  What happens in those other offices?  Wait for upcoming posts…