The Stillpoint

As usual, a great post by Joseph Mercola, DO quoting a well-written and sourced article by Russell Blaylock, MD. Please go and read all of the data he collected; I can’t emphasize enough how important it is to be educated on this topic. I’d like to highlight some of the juiciest parts here.

Once the pandemic had been declared, virologists tested the potency of this virus using a conventional method, that is, infecting ferrets with the virus.² What they found was that the H1N1 virus was no more pathogenic than the ordinary seasonal flu, even though it did penetrate slightly deeper into the lungs. It in no way matched the pathogenecity of the 1917-1918 H1N1 virus. It also did not infect other tissues, and especially important, it did not infect the brain.

Next, they wanted to test the ability of the virus to spread among the population. The results of their tests were conflicting, but the best evidence indicated that the virus did not spread to others very well. In fact, an unpublished study by the CDC found that when one member of a family contracted the H1N1 virus, other members of the family were infected only 10% of the time — a very low communicability.

So we have a virus which, at least in lab tests, is not very virulent and not very contagious. Sounds like quite the emergency, huh?

Next, Dr. Blaylock looks at the experience of Australia and New Zealand during the most recent flu season

Out of a population of 25 million people, 722 were admitted to the intensive care unit (ICU) with a confirmed diagnosis of H1N1 influenza. Overall, 856 people were admitted with a flu virus, but 11.3% were a type A flu that was not subtyped and 4.3% were seasonal flu.

They also analyzed the number of people admitted with viral pneumonia and found the following:

Number of People Admitted to the Hospital each Year with Viral Pneumonia⁵

• 57 people in 2005
• 33 people in 2006
• 69 people in 2007
• 69 people in 2008
• 37 people in 2009

They also found that the average person’s risk of ending up in the ICU was one in 35,714 or about three thousandths of one percent (0.00285%), an incredibly low risk. When they looked at actual admission to the ICU, they found that it was people aged 25 to 49 who made up the largest number admitted. Infants from birth to age 1 year had the higher admission per population, and had a high mortality rate.

But what about pregnant women. They’re at high risk, right?

There are 250,000 pregnant women in Australia and New Zealand combined. Only 66 pregnant women were admitted to the ICU, an incidence of 1 pregnant woman per 3,800 pregnant women or a risk of .03%.⁶ Put another way, a pregnant woman in these two countries can feel comfortable to know that there is a 99.97% chance that she will not get sick enough to end up in the ICU.

Pregnant Women NOT at Increased Risk, Obese Women Are!!

So, why did even 66 pregnant women end up in the ICU? As we shall see in the American study⁵, a significant number of these pregnant women were either obese or morbidly obese and most had underlying medical problems. The Australian/New Zealand study⁶ found that one of the major risk factors for pregnant women was indeed being obese and that obesity was associated with a high risk of underlying medical disorders.

OK, maybe it’s being pregnant isn’t as much of a risk factor as we thought. But what about the children?

What about the children, a special target of the fear mongering media and government agencies? This study found that 60% had underlying medical conditions and that 30% were either obese or morbidly obese.

A previous CDC study states that 2/3 of children who died had neurological disorders or respiratory diseases such as asthma.³ If we take the 60% figure, that means out of the 84 children reported to have died by October 24^th, 2009, only 34 children considered healthy in a nation of 301 million people really died, not 84. It is also instructive to note that according to CDC figures, the seasonal flu last year killed 116 children.⁹

So really it is kids who are previously sick (or obese) who are dying from the H1N1. At least we can help them if they get the flu shot.

Pediatric Flu Deaths by Year Made WORSE by Flu Vaccine

• 1999 — - 29 deaths
• 2000 — - 19 deaths
• 2001 — - 13 deaths
• 2002 — - 12 deaths
• 2003 — - 90 deaths (Year of mass vaccinations of children under age 5 years)
• 2006 — 78 deaths
• 2007 — - 88 deaths
• 2008 – 116 deaths (40.9% vaccinated at age 6 months to 23 months)

So the data shows that flu deaths increased after the initiation of vaccinations. This is incredible information, and Dr. Blaylock gives us the sources to back it up.

But the elderly, they’re not at risk, right? I mean, they’re not even on the (not so) short list of people first in line to get the shot.

They also found that death from H1N1 infection correlated best with increasing age, contrary to what the media says. They concluded the study with the following statement:

“ The proportion of patients who died in the hospital in our study is no higher than that previously reported among patients with seasonal influenza A who were admitted to the ICU.” ⁶

In fact, they report that of those infected with the H1N1 variant virus who were sick enough to be admitted to the ICU, 84.5 % went home and 14.3% died and that of those admitted with seasonal flu 72.9% were discharged and 16.2% died. That is, more died from the seasonal flu.

So where does that leave us? Well, let’s set a few things straight:

• There is a new variant of the flu that is circulating around the globe, infecting millions of people
• Many of those sick people have been hospitalized, and some have died from the infection (more correctly from super-infections)
• Some of those dead include pregnant women and children, two groups in which no one wants even a single bad outcome

All those things being said, it is important that people are informed about the true risks of the flu shots. Right now we are in a very confusing time, and it is important to do your research (or use the research others have put together.)

So what can we do if we’re not interested in a injected vaccine? Well, here are some ideas which I’m using, and I think can help improve your immune system’s ability to fight off infections, including but not limited to the H1N1 flu:

• Eat a good diet, avoiding sweets and processed food. Shop around the outside of the grocery store, or visit your local farmer’s marked for fresh, local fruits and vegetables
• Moderate exercise, about 30 minutes most days of the week. But be careful of over-exercising, as recent studies have shown that over-exercising will lower your immune response
• Get your Vitamin D level checked, and supplement either through sunshine or pills until your levels are over 50 ng/ml
• Find ways to decrease stress, which can lead to activation of cortisol in the body and lower your innate immunity further
• Get regular osteopathic treatment aimed at normalizing the musculoskeletal system to allow the machinery of your body to function at their peak

To find a DO in your area, contact the AAO or the Cranial Academy.

November 5th, 2009 | Category: Osteopathy | Comments (3)

The news today is filled with stories about the Swine Flu (H1N1) pandemic which is sweeping the globe. A few important caveats before we dive into how to look at flu from an osteopathic perspective.

First, the definition of a pandemic only describes the reach or scope of the infection, not the severity. As it stands now, there are 257 confirmed cases in at least 11 countries with 8 deaths, but the only deaths have occurred in citizens of Mexico. In Mexico, the World Health Organization (WHO) stated today that there were only 7 confirmed deaths from swine flu in that country, far fewer than the 150+ which has been reported in the media. The 1 death in the United States was actually a child visiting from Mexico. Worldwide the mortality rate (percentage of people who are killed by the disease) for this particular pandemic is 3%. Compare that to the mortality rate during a normal flu season which is closer to 10%. This flu virus, though widespread, does not appear to be any more dangerous than the usual influenza we deal with every year.

How can we explain, then, the increased mortality in Mexico? One of the keys to maintaining health is to provide an appropriate environment for health. The internal environment determines how your body responds to an invading organism, in this case an influenza virus. Knowing that this particiular virus is no more virulent than the typical influenza virus we face, we can assume that the people who died in Mexico had an internal environment which was not strong enough to fight off the invasion.

What kind of things make up the internal environment? What can make it stronger?

• A good diet: avoiding sweets, making sure we eat enough protein, fruits, vegetables, and drinking enough clean water. Carbohydrates activate your cortisol system, lowering your immune system and inhibiting your ability to fight infections.
• Get a good night’s sleep: sleep is another factor in the cortisol system. A good night’s sleep is one of the most important things you can do for your health.
• Check your Vitamin D level: research is now showing what we have suspected for a while, that Vitamin D plays a key role in augmenting the innate immune response.
• Find ways to address stress: yet another activator of the cortisol system and a key in the psychoneuroimmunological response.
• Osteopathic treatment: aimed at removing restrictions and enhancing the activity of the lymphatic system helps augment the immune response by stimulating release of white blood cells into the system.

In summary, the usual precautions or actions we should all be taking to maintain health will help against this “new” flu pandemic. The majority of healthy individuals who do get the flu are going recover without significant medical intervention besides common sense.

To find a DO in your area, contact the AAO or the Cranial Academy.

April 30th, 2009 | Category: Uncategorized | Comments (1)

My good friend (and our family’s midwife) Lori Luyten is hosting a series of lectures on Holistic living. I will be speaking on Friday, February 20, 2009 at 7:00 PM. The topic will be “What is Osteopathy” and I will also be talking about how osteopathy can be applied to pregnancy.

The lecture will be at The Oaks House Birth Center in Chino. The address is 13770 Oaks Avenue, Chino, CA.

Come and learn what the difference is between an DO and MD, or a DO and DC. Learn how osteopathic medicine is unique.

See you there!

January 24th, 2009 | Category: Uncategorized | Leave a comment

With flu and cold season coming up, I thought it would be a good time to discuss how an osteopathic physician looks at infections. The standard medical approach to infections is that they are “caused” by bacteria or viruses (lets call them pathogens) and you need antibiotics or antivirals in order to recover from the infection. This viewpoint is based primarily on the work of Louis Pasteur, a French microbiologist during the mid- to late- 19th century. He established that bacteria were present in disease states. During the next 150 years, medicine has focused on these pathogens, and medical research has searched for more and more powerful drugs to kill them.

What is lost in this analysis, however, is the role of the patient in infections. Pathogens (bacteria and viruses) are around us all the time. They line the surfaces of our body, and the environments around us. Why, then, are we not constantly sick? A peer (and rival) of Pasteur, Antoine Bechamp , postulated that the role of the pathogen in disease was minimal; it is the state of the terrain (body) which determines whether pathogens will thrive and “cause” infections. In other words, a sick body will allow bacteria or viruses to grow, and the outward presentation is an infection. Treatment of the patient, if it focuses simply on killing the pathogen, will not result in a healthy body. One needs to dig further to find out why that particular patient presented with an infection.

Around the same time period in America A.T. Still was formulating his philosophy of Osteopathy, which he envisioned as a complete system of medical care which placed a prime emphasis on the patient instead of the disease. He looked specifically at the role of the musculoskeletal system in producing an environment where disease can take place. When he was asked his impression of the so-called “germ theory” of Pasteur , he stated that it was fine if people wanted to say that bacteria were present in disease, but that still doesn’t explain why a particular person is sick while another is not. He was adamant that disease was only an effect, and the presence of germs were another effect, of a problem within the body. Still focused on the musculoskeletal system, as a method of treatment, but he understood the importance of the circulatory, respiratory, and nervous systems in maintaining the body’s ability to fight off disease. Over the last 134 years science has filled in many of the gaps, and given us a clearer picture of how these systems work together to promote homeostasis (or the tendency for the body to be healthy).

Today traditional or classical osteopath are still utilizing these concepts to help patients fight disease. While we wouldn’t argue that antibiotics are necessary at times, our first approach is to help augment the body’s normal immune response. This might be through improving nutrition, using vitamins or herbs if necessary; it might involve helping to remove stress from the body, either external (work, family, etc.) or internal (strains in the musculoskeletal system, pain, etc.); it usually will involve manual treatment aimed at improving lymphatic flow (the lymphatic system is the “garbage collection system” of the body, collecting pathogens, dead cells, antigens, etc. and bringing them to the immune system for analysis). Only if those methods fail will we resort to killing pathogens with drugs, and even then we will still emphasize these other factors in disease as well.

A case study might be relevant here. This is one I published in California DO magazine in the spring of 2007. The case involved a young female patient who presented to the hospital with complaints of right back/flank pain. She had been previously treated with antibiotics for a presumed kidney infection. In the hospital she was found to have a right sided pneumonia and her urine was without infection. She was started on antibiotics, appropriately, as she had a fever and was showing signs of systemic or blood infection. This treatment, though, did not give us an indication of why she was sick, nor how to best make sure she wouldn’t get sick again. I was called to evaluate her from an osteopathic perspective.

When I asked about previous traumas, she initially denied anything significant. On examination, I found that the right lower ribcage was depressed and did not move when she took a breath. The right diaphragm (the muscle which separates your abdomen from your chest and causes you to breath ) was also restricted and didn’t move very well when she breathed. On further questioning she remembered that she had been involved in a car accident several months ago, and the seat belt had tightened against the right side of her rib cage, causing a bruise.

Now the situation was becoming clearer. She had had a trauma which impaired her ability to take a deep breath. This had set up a situation where bacteria, which are normally present in the lung, were able to overgrow and lead to an infection. The infection in the lung irritated her diaphragm, causing the flank pain she had initially presented with. The antibiotics would have killed off the bacteria in her lung and “treated” the infection, but without treating the musculoskeletal system the predisposing situation would continue to be present, and she was at risk for further infections. Taking a whole body approach allowed us to help her return to a greater state of health.

It is clear that antibiotics are occasionally required to treat infections, especially when the natural defenses are so diminished that the patient is at risk of overwhelming infection. Our goal, as osteopathic physicians,is to get deeper into the problem. If possible, we want to treat when the infection is early enough to augment the natural responses and avoid medications. Even in situations where medications are required, the osteopathic philosophy requires that we treat the precipitating cause, wherever the location, and allow the natural health we all possess to thrive.

October 10th, 2008 | Category: Osteopathy | Comments (1)

I promised a few weeks ago a post on labor and delivery, so here goes:

The first thing to remember is that the osteopathic approach sees the body as being capable of self-maintenance and repair. It is in that light that we look at the woman in labor, not in a medical light.

The Osteopath sees pregnancy as a natural process (as we see all disease) which needs to be assisted, not managed. The end result of that process is labor and delivery. There is no difference which would automatically necessitate medical management just because the process is now ending.

The assistance of labor actually begins during pregnancy. Regular osteopathic treatments help the body adjust to the changes that are taking place, and prepare the body for labor. Specifically this includes making sure the pelvis is balanced, and the sacrum is free to move forward and back so that the baby’s head can pass through. But there are other important considerations. Labor and delivery is a very tiring process which can last more than 24 hours. The body needs to conserve energy and utilize it as efficiently as possible in order to make it through safely. Any other somatic dysfunctions which are present will take energy away from the situation at hand and make the body less efficient. For this reason it is helpful to have the whole body checked out and treated prior to delivery.

The initiation of labor is something the body does on its own, when the baby is fully developed and ready to enter the world. Modern medicine has no idea how to determine if the baby is ready to be delivered, yet they routinely “induce” labor for a multitude of reasons. Premature babies are at risk for a multitude of problems, most commonly respiratory distress, but also infections, heart defects, and developmental delay. Prematurity is usually defined as being born at less than 36 weeks, but any child delivered before the uterus spontaneously begins contractions is at risk for being premature. If you had a cake recipe that said to bake for 40 minutes, would you take it out at 38 or 39 minutes?

Once labor has begun, the best thing for women is to be as ambulatory as possible. This allows for natural spread of the pelvic bones (called the pelvic inlet) and allows the baby to “engage” or move head-first into the lower pelvis. For a woman who is having “back labor” caused by the baby’s head pressing against the sacrum, being upright may allow the baby to rotate to a more appropriate, less painful position. Osteopathic treatement aimed at the sacrum, pelvis, and especially the sacro-iliac joints (between the sacrum and the pelvis) may allow for more motion of the pelvis and sacrum and encourage proper positioning of the baby for descent through the birth canal.

As labor progresses the pain of contractions increases. During this difficult time, strong pressure over the low back may help reduce pain. A small study by RA Guthrie showed that inhibition of the back muscles can give 80-100% relief in 65% of patients. Most women will get relief from spending time in the water, preferably in a tub which allows almost complete submersion.

The final stage of labor, called transition, is the most intense, with contractions sometimes overlapping, and the pain is at its peak. During this time a skilled birth-assistant will be addressing the emotional and psychological well-being of the woman more than the physical aspects. Women need gentle support and constant reassuring that they can make it past this difficult time, and that each contraction is getting closer to the birth of their baby. Through confident coaching, the woman is now into the delivery phase.

After transition begins the pushing stage. For many women this is a relief, as it is a change from the difficulty of transition. The pushing stage can last from 30 minutes to 4 hours. During this time two important issues develop: First, the woman needs to stay hydrated, as she may be working for a while; Second, the woman needs to assume the most beneficial possible position for pushing. This will differ from woman to woman, and may change during the pushing stage for a given woman as the baby moves down the birth canal. Squatting, kneeling, either in the water or on the bed, are all positions that utilize gravity to assist with pushes. Laying on one’s back, also known as the lithotomy position, is the least beneficial position (except for maybe doing a headstand!), and is made even worse with forced flexion of the knees towards the head.

The reason the lithotomy position is least advantageous for pushing has to do with the shape of the pelvis. If you were to lay on your back, the pelvic outlet actually curves slightly upward (towards the front). If you bring your head up, as in most hospital beds, you curve the pelvis even more forwards. Finally, pushing the knees up towards the head induces even more forwards curve. All of this together makes the pelvic outlet smaller, and the baby has to do more work to pass through. This is one common cause for “prolonged pushing.” From an osteopathic perspective, as long as the woman is progressing and the pushes are effective, they should continue. If they become ineffective, the doctor needs to assess the situation to see if there may be a more advantageous position for pushing. It is not uncommon for women to change positions multiple times during the pushing stage.

Once the head is crowning, one or two more pushes are all that are required for birth. Episiotomies are largely unnecessary, and can lead to deeper tears of the perineum. Early cord clamping is not natural, and so should be discouraged. In fact, the most osteopathic approach would be to do very little for the mom and baby at that point, leaving them to bond skin-to-skin and even nurse. Of course, appropriate steps should be taken to make sure that neither is in danger.

I hope that this overview has given you an appreciation of a natural approach to childbirth. Unfortunately in America it is very difficult to have this type of birth attended by a physician, even an osteopathic one. This has to do with the rules and regulations set out by professional colleges (ACOG), insurance companies, and hospitals afraid of non-intervention. Your best bet is to look for a supportive physician or certified professional midwife who can help you on your journey. For more information on midwives, contact Midwives Alliance of North America.

September 28th, 2008 | Category: Osteopathy | Comments (1)

Many people are confused about the difference between an Osteopath who practices cranial osteopathy and a cranio-sacral therapist. The assumption is that they are the same thing, or at least have the same training.

Cranio-sacral therapists are often physical therapists or massage therapists who decide to take additional training in cranio-sacral therapy (CST). Before we go further I would like to compare the history of CST with Osteopathy in the Cranial Field (OCF).

In the early 1900s an osteopath named William Garner Sutherland began a private study of the motions of the bones of the cranium. He had been struck by an idea as a student that the bones of the head were beveled as if to indicate motion. He spent the next 20 years or so trying to prove himself wrong. Through a detailed examination of the anatomy of the skull, followed by a series of experiments on his own head and on his patients, he became convinced that there was a subtle motion of the head which could be palpated with experience; and that distortions of the joints between the bones of the skull would create problems in the machine of the body just as distortions of the joints of the body create problems. His treatments were gentle, almost imperceptible movements aimed at restoring free motion of the skull. Dr. Sutherland went on to spend the last 30 years of his life teaching others to carry on his work, and now OCF is taught in all osteopathic medical schools, and tested on the national licensing exams. There are two organizations dedicated to research, application, and teaching of the cranial concept, the Cranial Academy and the Sutherland Cranial Teaching Foundation.

Dr. John Upledger was a practicing Osteopath in Michigan when he attended his first OCF course. He began practicing, and researching, the motion of the cranial bones. He later decided to rename his technique CST and begin to teach it to anyone who applied for his courses. Because he is not teaching to physicians, Dr. Upledger does not teach diagnosis, nor do his students learn how to apply specific approaches to specific diseases. They are taught that intention is the key to a safe treatment but due to their lack of osteopathic training they are not able to handle the possible side-effects of their treatments, especially if they are not specific to the problem.

I have put together a table which outlines some of the differences between OCF and CST. I would recommend that if you have a problem for which you think cranial treatment might be indicated, search out a good Osteopath in your area. You can look here or here for a qualified physician.

September 6th, 2008 | Category: Osteopathy | Comments (1)

I’ve put together a table which compares osteopathic treatment with chiropractic. My goal is not to denigrate or insult chiropractors, but instead to objectively compare training, scope of practice, and treatment philosophies. I would ask that any comments be respectful and instructional in nature, rather than negative.

August 29th, 2008 | Category: Osteopathy | Comments (9)

Just before July 4th I had the opportunity to talk  with a reporter from Pasadena Weekly regarding Osteopathic medicine, specifically insurance coverage and patient’s access to care. If you remember, at that time Congress had decided not to vote on a bill which would have prevented physician’s Medicare reimbursement from being cut 10.6%. At the time, physicians around the country were debating whether to continue to take Medicare patients. It was in that context that I spoke to Liz Hedrick, and the result is “Which Doctor?”

August 14th, 2008 | Category: Osteopathy | Leave a comment

Inspired by a comment that came along yesterday, I thought I’d put together some thoughts on the osteopathic approach to pregnancy. I’ll write on labor and delivery later.

Osteopathy and Pregnancy

Pregnancy is an exciting time for expectant moms, and also a time of great change, both physically and emotionally. Osteopathic physicians (DOs) are uniquely qualified to intervene and assist in this wonderful time. In fact, a study in the Journal of the American Osteopathic Association in 2003 showed that women who received Osteopathic care during their pregnancy had lower rates of cesarean section delivery, preterm delivery, umbilical cord prolapse, and meconium stained amniotic fluid compared with women who did not receive Osteopathic care.

As the baby grows, the uterus expands around it. This causes the center of gravity to shift, and the mother-to-be has to adjust her posture to accommodate. In an ideal situation the body would adapt to the changes it is subjected to, and the pregnancy would be uneventful. Unfortunately, most of us have pre-existing imbalances in the skeletal system, which Osteopaths call Somatic Dysfunction. These imbalances prevent the body from making the appropriate changes, and pain is the result. The job of the Osteopath is to find these Somatic Dysfunctions and, through a series of gentle techniques, remove them, thereby allowing the body to respond and change with the ever expanding uterus.

Unlike other practices, there are no pre-defined “techniques” or movements in Osteopathy. The Osteopath uses his or her hands to examine all parts of the musculoskeletal system looking for Somatic Dysfunction. Evidence of Somatic Dysfunction could be changes in the texture of the skin or underlying muscles, asymmetric positioning of the joints of the spine or appendages, restricted responses to active or passive motion testing, or tenderness in specific anatomical locations. Any one or all of these findings might be present, and their presence is an indication for Osteopathic treatment.

Other symptoms of pregnancy which are amenable to Osteopathic treatment include pelvic, back or neck pain; swelling of the extremities; varicosities (enlarged veins) in the legs or vulvar area; hemorrhoids; and mastitis or milk duct blockage. Often women will continue to have back pain long after their children are born. This is because the lax ligaments which allow the pelvis to expand and the baby to pass through can become strained if the joints are not positioned correctly before they tighten again. Osteopathic treatment post-partum, therefore, can help prevent chronic back pain after pregnancy. Women who have inductions of labor have a more forceful and often more difficult labor and may have more Somatic Dysfunction following birth. Women who have C-sections not only have to contend with the changes related to pregnancy and labor but also major surgery. There are many studies showing the benefits of Osteopathic manipulation following surgery to prevent respiratory infections, constipation, and reduce pain medicine use.

Osteopathic physicians are not only qualified to provide the appropriate manipulative treatment but are also fully licensed doctors, meaning that they can diagnose and treat many of the medical complications which can arise during pregnancy.

To find a DO in your area who practices Osteopathic manipulation, contact the American Academy of Osteopathy or the Cranial Academy.

August 13th, 2008 | Category: Osteopathy | Comments (4)