In the past, I’ve been reticent to use a chiropractor to treat injuries or other problems because I’ve heard stories about how the profession was allied with ambulance-chasing lawyers ready to sue people involved in accidents and their insurance companies, as well as the charges that chiropractic is not based the scientific method, especially when compared to the conventional Western medicine.
Over the past few months, I’ve been forced to change my mind. I noticed that several friends visited chiropractors regularly. I’ve also confirmed that Western medicine does not adequately address all health concerns. Finally, my iliopsoas spasms made me re-examine whether it was worthwhile to call in different opinions.
A new healthcare provider
During the 40-day yoga challenge at Thrive Yoga, Susan and David Bowen brought in Dr. Donald McGriff to give a talk to the group about chiropractic and general well-being. I missed the talk because I wanted to take a yoga class at the same time. But Susan and David said that they used his services so that was high praise.
On April 15, I got an appointment at McGriff Chirpractic to see if Dr. McGriff could do anything for my iliopsoas spasms. He looks more like a professional wrestler than a doctor, a burly build topped off with a shaved head. After an initial examination and a check of my medical history, he sent me off to get an MRI of my lower back. That took a little longer than expected because of scheduling conflicts, but I was back in his office on April 27 with the CD in hand. After taking a look at the MRI, Dr. McGriff came back with the news that I might have a spinal disk herniation (4-5 L vertebrae), but the MRI was not really that clear. I also seemed to have a displaced sacroiliac (SI) joint on the right side. Since I did not take notes, I can’t be sure three weeks later whether I’ve misunderstood anything. In any case, he prescribed 2-3 visits a week to his office to work his magic.
The nice thing about Dr. McGriff’s practice is that he opens at 6:00 am on three mornings a week so I schedule my visits so that I hop out of bed, get into fitness clothing and drive over for a 6:30 appointment, usually on Monday and Friday. I am out of his office in time to go back home, shower, dress, grab breakfast, and head to the Metro by my usual time. There are also office hours on Saturday.The location of his office, which is only 10 minutes from my home in Rockville, sealed the deal.
Treatment starts with 15 minutes of electro-stimulation with hot pads on my lower back. There are four electrodes sprayed with some kind of liquid to increase conductivity (The spray must come right out of the refrigerator because it is cold). Hot pads are placed over the lower back (to compensate for the cold electrodes, I guess). The electrical current goes through varying patterns of pulsing, but can be adjusted to the point where it does not cause discomfort or pain.
After chilling for 15 minutes, Dr. McGriff leads me to his examination room where he checks my alignment and then usually has me lie down on my left side and gives me a firm twist of my torso to the right. My SI joint usually pops with the adjustment. That’s usually followed by adjustments to my hips, rib cage and upper spine, and upper neck. He has a firm touch in his adjustments that gives confidence in his skills.
Once he’s done with me, I may get an additional ride on fancy equipment: a table that stretches my spine, a vibrating platform that loosens my hamstrings.
Dr. McGriff applies more than an exclusively chiropractic focus, emphasizing the value of holistic approach that includes nutrition, corrective exercises, physical therapy, fitness and life style coaching. His web site has lots of information to understand his approach, the general practice of chiropractic, and other services.
Passing the grade
Has the treatment improved my injury? That’s hard to say. My iliopsoas have not been a source of pain or discomfort recently. With a more than a month of rest and avoidance of aggravation (no yoga classes), my hips and lower back may have healed itself. I simply have not been testing their limits. On the other hand, I do feel the effects of the treatment: after a session, I feel general muscular fatigue by the end of the day, which is usually a sign that my muscles are adjusting to a realignment of my frame. I have noticed that my thighs seem to set further apart. I can sit in easy pose more comfortably and my knees fall closer to the ground naturally.
My daughter warned me that I should avoid active yoga classes or gym work on that days that I have chiropractic treatment. Dr. McGriff told Howard Rontal, my bodyworker, that it’s best if the bodywork happen the day before a chiropractic session to be the best results out of his sessions. Finally, Howard told me that I should not have acupuncture and bodywork done on the same day (within 24 hours of each) since the Oriental meridians run through the myo-fascial tissues. So there are now a whole new slew of scheduling factors that I have to take into account when planning my healthcare.
With less than a month of treatment, it’s far to soon to say that my chiropractic has worked miracles or otherwise. In the real world, it’s almost impossible to isolate the factors (chiropractic, acupuncture, rest, restorative yoga, relaxation exercises, body work, positive thing, placebo effect) so I have to go with just my gut feeling. It has not hurt me.
This past year has had some huge changes for me: the deaths of my father and mother in a four month lapse, my own attempt to play out my role as the “good son,” and the progressive deterioration of my well-being as I no longer could keep up with the “protocols” that maintained my persona (exercise, yoga, meditation, self-development, etc.). I was only partially aware of how these changes were affecting me, but they became concentrated in one symptom: my peripheral neuropathy and its manifestation of numbness, phantom pain (pin pricks in my feet that kept me at night) and sleep deprivation. This symptom distracted me from seeing the deeper “dis-ease” — I feared losing my hold on life’s moorings (as seen in my parents’ deaths), on my capacity to deal with life’s daily tasks and uncertainty, and on my condition as an adult who has to take full responsibility for his life.
This fear of losing my grip translated into a systemic physical trait — I held on ever more tightly through my myofascial tissues. I was the personification of being “uptight” — stiff, constrained, and suffocating. My ligaments, fascia, tendons, muscles and other tissues were engaged to the maximum until I was strangling myself, to the point that large parts of my body was numb, unfeeling. There was a hidden lever in my head that was constantly winding me up, with minute twists to the gears, constantly engaged should some external force or internal flaw make the whole machine blow up under the pressure.
For years, I partially sensed this problem. That’s why I sought out yoga seven years ago. But this problem is so much bigger than starting an exercise regime, developing good work skills or changing eating habits because of a food allergy. That’s why I have put off writing about it here; just one entry is not going to cover it adequately.
A lighter touch
Since my diagnosis of peripheral neuropathy and the start of treatment with myofascial release therapy with Howard Rontal in August, I have begun a gradual process of releasing the tension, of letting go. My weekly therapy sessions were opportunities to explore the psycho-somatic nature of my condition and the mind-body connection. There was no promise of “curing the disease” but increasingly I saw the possibility of controlling my worst symptoms and even finding and developing a more relaxed state.
As of mid-December, my treatment with Howard has been suspended because of the Holidays and travel, so I’ve experimented with techniques that can help me self-soothe and self-heal (more on that in another blog entry). I’ve also made it back to yoga classes, put some time in at the gym and even done some jogging.
I’ve now been taking treatment from Howard Rontal for a month now, currently with a frequency of once a week for 60 minutes. As a birthday present to myself (turned 62 yesterday), I took an 90-minute session in which Howard gave me his “ligament treatment” — basically going progressively from soles to neck and stretching out all the muscles and assorted fascia, with special attention to places that were seriously compromised (in my case, hips, sacrum, lower back, neck — Howard was much more specific in naming muscles and ligaments).
A full 48 hours later, I am still feeling the impact of this body readjustment, a different kind of experience than what I had experienced in previous sessions. Rather than just relieving symptoms like numbness, tension, or pain (which I did on Tuesday), I’ve felt as if I’ve been put thorough boot camp. I’ve gone to bed feeling exhausted and sore, and woken up feeling fatigued and sore, especially in my hips, thighs, shoulders, arms, forearms. I almost felt as if I had flu symptoms — or something had gone wrong with the treatment. Obviously, something different is happening; it’s no longer just the “happy talk” of relieving tension and pain. Because of the work done on my core, I am using muscles differently, in new ways, with new lines of tensile stress. I’ve only done one Hatha yoga class (Tuesday evening) and my evening yin yoga sessions, so I’ve not be overexerting myself in a more traditional way (as if I’d gone to the gym for weight lifting for the first time in years). Rather, I am carrying myself (body frame and muscles) in a different way. So the very process of holding myself upright, walking, bending over is more physical exertion for me.
Howard told me that giving me a massage is like stroking a tree trunk: my muscles and fibers are thick, dense, hardened, inelastic, stiff, some more than others. It takes an enormous amount of energy on his part to get a response, but eventually my body does respond. There’s not a lot of give in my fibers.
I don’t look like someone wound too tightly. I’ve always been slender, un-athletic, and relatively lightly built. At around 40, I put on 25 pounds; when I quit smoking the first time, I added another 10 pounds; and by the time I finished my MS degree, I had added another 15 pounds, pushing me over 210 pounds. So I’ve bulked up over a relatively wiry, tight frame, adding layer over layer. And for the past seven years, I’ve been trying to reverse that tightness while reducing my weight, with moderate success since I can do a yoga class without looking like a complete klutz. I half joked with Howard that he’s lucky he did not have to work with me when I started yoga.
So what Howard did on Tuesday (and probably in a less concentrated form previously) is to start stretching out some of those sinews, freeing them to movement. Which means that instead of relying on rigidity to hold together and mobilize my body, my muscles are having to work. To use a metaphor, instead of using wooden struts to prop myself up, I am using the tensile strength of wire that has to be adjusted continuously to keep me upright. I may have felt it less before because we’ve tended to focus on a single area (feet and calves, core, shoulders and chest, neck and back). This time we were more ambitious in treatment scope.
Howard explained to me that the model for understanding the body is based on geometric principles — called Tensegrity: rather than thinking of “flesh hanging off of bones,” it’s better to think in terms of a dynamic tension in which the bones are suspended by the fascia much like a suspension bridge. The concept is fascinating, but right now I am dealing with the discomfort of the transition to being a more embodied form of plasticity from a wooden prototype.
Happy birthday to me
I see the time and money that I now am investing in this treatment as more than just pain relief or injury repair, but as a down payment on future well being in my “seniorhood.” This past year, with my parents’ deaths and all the upheaval and disruption in my personal life, I let my personal care slip and saw a dramatic drop-off in my well-being as my peripheral neuropathy and other symptoms worsened dramatically. With the myofascial release massage, I feel a renewed interest in my yoga practice.
What is really surprising is that the therapy seems to have more than transitory effect (relieving pain or loosening up muscles). You would think that “moving around muscles and ligaments” would eventually mean that they fall back in place. I suspect that if I might slip back into old patterns if I did not do yoga (or exercise or stretching) to lock in the new range of movement.
I’ve known that I had peripheral neuropathy since early 2010 when I checked in with a podiatrist about other issues. I saw my personal doctor and he took a full battery of blood tests to determine if there was anything obvious. The results ruled out any of the “bad things” (diabetes, HIV/AIDS, etc.). He did detect a vitamin D deficiency so he had me taking mega dosages of vitamin D. Because the supplement would not have immediate effect, I did not get back to him right away and then forgot about the problem.
However, this year, I’ve noted a worsening of the symptoms (pin pricks and numbness on my feet, especially the left foot) to the point that it was keeping me from falling to sleep. Symptoms seemed to flare up about 1:00 or 2:00 am. My home medicine consisted of Aleve, restorative poses on my mat, using a tennis ball to stretch the sole of my foot, and applying ice to the foot. I tried to do some of these things before going to bed. Results were inconsistent, and I would usually dose off when I was completely exhausted. Sometimes, I could pull myself together to go to work. During the day, I would not notice the pin pricks because my shoes and socks applied a uniform pressure that tended to lessen my sensitivity.
Since my father’s death in January and accelerated by my mother’s death in April, I’ve been living off reserves (don’t ask me to explain; I’m searching for a concept that doesn’t sound too “New Age-ish”). I attended yoga class in fits and starts, I did not make to the gym either, and each new beginning seemed to start from a more degraded status. Because I had to prioritize my time and energy to take of my job responsibilities and the settling of my parents’ estate, I have not been taking care of myself as well as I should.
This summer, I could feel that things were catching up with me: just run together a string of nights with just 4-5 hours sleep each, and anyone’s performance suffers; and pain medication and sleeping pills did not seem to have an effect. I finally went to my doctor again and we did another round of blood work, which revealed that I was in otherwise good health.
The next step was to see a neurologist, who confirmed the original diagnosis — the condition of idiopathic peripheral neuropathy — the “idiopathic” means that the doctors don’t know what the cause is, and the “peripheral” means that the condition is outside the central nervous system (brain and spinal cord). The neurologist did not find any impairment (grip, balance, coordination, etc.) aside from the pain, and because I can remember the pin prick sensation as far back as 12 years, it’s not something of recent onset. He then ordered up an electromyography and nerve conduction test — basically electrocuting my feet, legs and arms for two hours and measuring the speed of the peripheral nerves. The results showed that the nerve circuits in my feet and legs had a degraded capacity, but no clear cause was identified. I was given a prescription of Gabapentin (a generic drug to treat epilepsy, but also effective for neuropathic pain) and told to ramp up the dosage until it relieved my pain.
Conclusion: After a three-week blitz, Western medicine has determined that whatever the cause, the only option is to treat the symptoms by helping me manage the pain and to monitor my condition to see if it got worse. I could probably consult some more specialists or look for some obscure disease (does Dr. House receive patients from DC?). I’ve consulted with my acupuncturist and he said that he could help with the pain and, perhaps, slow the neuropathy, but did not hold out much hope for reversing it. I am going to have to take ownership of my pain and body, and learn to manage both, which is a trial-and-error process.
I was even more struck by what Fishman writes in the Foreword of the special issue:
There are few therapies that boast about their side effects. Both medicine and surgery are undertaken because there is a favorable cost-benefit or risk-benefit ratio. The 2 (sic) are placed on opposite sides of the balance of good judgment. In yoga, the side-effects, irrelevant to the actual reasons for its initial adoption, may turn out to be more to the practitioner’s advantage than the primary therapeutic effect! Almost any style of yoga brings with it reduced blood pressure, less obesity, and less back pain, improved range of motion, safe strengthening, reduced asthma and reduced anxiety, better recovery after surgery and chemotherapy and almost stunningly low cost.
The last two days I’ve been handicapped by having a bloody nose. It started late on Monday evening after a shower, and kept me from getting a good night’s sleep. The next day, I seemed to be doing OK, except when I started to do bastrika breath, my left nostril started to bleed again so I cut short my pranayama practice. These episodes have been controlled fairly easily, but I plan t consult a physician about this problem.
I’ve tried to trace my bloody nose to a change in diet, supplements or medication but have not found a good culprit to blame. Since I’ve revived my pranayama practice over the past week, that may be the cause because the vigorous air stream may dry out and irritate my nasal passage. In the past, I’ve probably gone over the edge in pushing and pulling air, but this time around, I’ve been staying more controlled.
I’ve never had a problem with nose bleeds until this year. I had one in April at work, but that seemed to be connected to the use of an antihistamine nasal spray for allergy season. I no longer use it.
You have five months to clear your schedule of the DC Mind-Body Week, which is to take place on October 13-16. An initial dab of information is available at the website, with developing news also flowing out through the LinkIn page. Among the organizers are my friend, Rachel Permuth-Levine, Dr. Deborah Norris and Thrive Yoga, among others.
Herbert Benson will be the keynote speaker at the event. He is Director Emeritus of the Benson-Henry Institute (BHI), and Mind/Body Medical Institute Associate Professor of Medicine, Harvard Medical School. He has defined the relaxation response and explored how it affected health and well-being.
More news about location, speakers, demonstrations and other details will emerge as we get nearer the event. Rachel has organized similar events in the past.
Not much to add. My mother is close to the end. She’s no longer speaking, eating, even swallowing water. She is gradually leaving behind her body, like a discarded exoskeleton.
The people at Montgomery Hospice have been extraordinary in giving my mother, my family and me support and solace in this time of suffering. Casey House has created a welcoming, sheltered space where I’ve been able to find peace while accompanying my mother through this passage. I’ve frequently come home to rest and immediately gone back to the hospice because it offers a more mindful environment at this time. At home, I just get swept up into busy-ness in front of my computer.
Mindfulness techniques are appearing everywhere, with incredible data showing the health benefits of developing a meditation practice. Meditation is proven to be a reliable practice for managing the stress response. Since stress has been linked with most forms of chronic illness, this may account for how meditation is so therapeutic.
Health Promotion LIVE has an audio recording of a recent webinar Mindfulness in Medicine and Healing with Dr. Deborah Norris, who is the Executive Director of Science for Health Energy, Inc. and Founder of The Mindfulness Center in Bethesda. Norris packs a lot of scientific information into the open remarks (20 minutes) and webinar playback shows the PowerPoint presentation (Deborrah, you need some graphic relief: too much white, small, text on blue background; gets some photos). An excellent summation of the most recent research findings and their impact on healing and medicine. In the second half, there’s an interesting exchange among several panelists and several participants who tuned into the webinar.
The Mindfulness Center is a “wellness center providing Meditation, Yoga, Massage, Acupuncture, Tai Chi, Aerobics, Nia Dance, and other Mind-Body programs to bring mindfulness to all dimensions of life,” Deborrah’s site says. The webinar confirmed in my mind that The Mindfulness Center is an invaluable resource to have in the DC area. It opened up recently so it’s good to see that it’s finding its following (I assume from the crowded schedule of classes and workshops).