Days 4-7 1/3 Of The Way!

Sunday, January 22nd, 2012 At 2:48 pm

Myth: To avoid heart disease, we should use margarine instead of butter.

Truth: Margarine eaters have twice the rate of heart disease as butter eaters.

- Source: (Nutrition Week 3/22/91 21:12)

We are now a third of the way there.

I have been away from my computer for the last few days, but I am still on track.  I was very fatigued on Thursday and Friday, but have recovered quite well.

Today, you should have more energy.  The lack of protein can make you feel sluggish, so some organic whey in your shake is acceptable.

Remember, we may ad 3-oz of cold water non-farmed fish or organic chicken 2-4 times a day on Wednesday (I myself can’t wait for some salmon!!).

Exercise!

Remember to work out and perform 30 minutes of cardio a day. We want to boost our metabolism.  For those doing the Purification Challenge, please know that our gym is at your disposal. Also, the Standard Process Website has some useful information. See links below:

• http://capitolrehabofwinchester.com/blog/
• http://www.standardprocess.com/display/psppurification.spi

Recipe of the Day

Guacamole

Ingredients

• 2 organic avocados – peeled and mashed
• 1 clove minced garlic
• 1 tablespoon finely chopped onion
• ½ chopped tomato (use less if diabetic)
• Salt
• 1 tablespoon lemon juice

Directions

1. Mix all together thoroughly and put avocado seed back into bowl to prevent turning brown.
2. Tip: although you can’t have tortilla chips (always a favorite with this dip), you can enjoy a nice crudité with your guacamole by slicing up some raw vegetables (or using them whole if you prefer). Whole cherry tomatoes, sliced carrots and celery are always favorites.

Day 3 Purification Challenge: “I Pray I Become the Man My Dog Thinks I Am”

Wednesday, January 18th, 2012 At 3:11 pm

 

Sometimes a promise to yourself is easily broken.  You have no one to disappoint, but yourself.  Since you are OK with that all is forgiven.  Great things are accomplished when done for the greater good.  Great things have been accomplished for Family, God, and Country.  Me, I’m going to workout every day for my Dog.

Day 3 is almost over.  My Lab is very happy with the program.  She has gone for a long walk/run three days in a row.  She is very happy to get out and pleased with me.  But then again, Jasmine is always pleased with me.  She is always happy to see me and believes everything I do is with uncompromising integrity.  When I said to her,” I will take you out everyday during this 21 Day Purification Challenge,” she had no doubt.  Well, my goal is to not let her down. 

I have had some recent requests for recipes. So here they are:

Butternut Squash Soup

Ingredients

1 (2 to 3 pound) butternut squash, peeled and seeded
2 tablespoons Flax or Olive Oil
1 Clove Garlic
1 medium onion, chopped
4 cups chicken stock
1 Cup water
Salt and freshly ground black pepper

Directions
Cut squash into 1-inch chunks. In large heat oil. Add onion and garlic cook until translucent, about 8 minutes. Add squash and stock. Bring to a simmer and cook until squash is tender, about 15 to 20 minutes. Remove squash chunks with slotted spoon and place in a blender and puree. Return blended squash to pot. Stir and season with salt, and pepper. Serve.

Divine Eggplant

Ingredients

3 tablespoons of Sesame oil/ Olive Oil
1 onion
1 medium size Eggplant
3/4 cup of unfiltered apple juice
1/4 cup of Tamari/Apple Cider Vinegar

Directions

Slice onion anyway you want.
Saute in oil until golden.
Slice eggplant into 2 by 1/2 slices, add to onions.
Saute for about 10 minutes.
Add apple juice.
Simmer until apple juice is reduced to about half the amount — about 10 minutes.
Remove from stove and add Tamari to taste.
Serve over brown rice.

Serves: TWO

Patience Day 42

Thursday, August 25th, 2011 At 2:50 pm

When I graduated some 15 years ago (Did I say 15 years? Ouch!), I was ready to save the world, or at least Washington, DC and Northern VA, from all the aches and pains that plagued them.  I pictured healthy, active, Stepford-like communities of people all grateful for the contributions of Capitol Rehab.  As a Chiropractor I did not want to limit myself to necks and backs.  We were taught how to treat extremities, well before it was Chic, we understood the relationship between your spine and extremities.  For example, if you had knee pain, look to the low back, and if you had shoulder pain, look to the neck. 

I immediately brought additional practitioners into my practice out of respect for what they had to offer and my quest for a well balanced approach to care.  Physical Therapists and Massage Therapists were part of the Capitol Rehab team and we recently  added the expertise of Athletic Trainers, who have masters degrees and are not personal trainers, but experts in orthopedic acute care and exercise.

With my will to save the world and an elite team of experts I set off on my quest.   Just like all long journeys there were some bumps in the road.  There were two things they did not teach us in school.  First, how to run a business.  With the changes in our health care system, decreases in reimbursements and increases in co-pays, it is not as easy to run a medical facility, but that I will leave for another time. 

Secondly, they never taught us patience.  Patience to cope with the fact you can’t help everyone, for they have to want to be helped and they have to be compliant with care.  Patience to realize that, just as Rome was not built in a day, injuries even with the best of care do not heal overnight.  ”Patience” with my “patients” and recovery was learned over time, although,  I need to re-visit that lesson regularly.

The lesson of patience was more like a hypothesis is to science.  A hypothesis is your best guess to a problem or your answer to a question.  Once you arrive at the hypothesis it must be  proven over time by multiple experiments to become a law.    My lesson of patience would only be learned over time.  My experience with thousands of patients over the years have been my experiments.  The final experiment was my status as a patient.  The procedures I followed during this experiment was as follows:

First:  I must break my arm.  That seemed easy enough.  I also knew how long it should take to heal as I outlined in my previous Blog www.capitolrehabofwinchester.com/blog/2011/07/the-first-96-hours-one-word-ouch/  .  For some reason these ”Laws of Physiology” did not apply to me.  They did not apply to me because:

•  I am ”The Director of Capitol Rehab”
• I have too much to do. 
• I have access to a full service rehab clinic.
• (The most important)  I am a guy.   

So after a week of Acute care and taking it easy, I figured I could start lifting weights again.  Within 4 weeks I figured I would be back at work and back to my full exercise routine.  Boy was I misguided.  What did happen is I had to do each step of therapy just as I recommend to each of my patients.  I further realized I actually had to come to my treatment sessions and take the advice of my Therapist to recover without compensation.  My most important lesson was being a  “Guy” was not an asset, but a liability.

I now know first hand the importance of the “Rehab Sequence”.  So Here it is:

• Treat Acute Symptoms: Day 1- 4 weeks.  RICE.  Rest, Ice, Compress, Elevate.  During this phase Electrical Stim, Ultrasound, light massage, and medicine is very beneficial.  We need to get the swelling out of there ASAP.  
• Address Joint Function: Day 1-8 weeks.  Chiropractic adjustments, Physical Therapist manual therapy, as well as pain free stretches and exercises can help with this.  Two points.  There is some acceptable pain and not acceptable pain.  My whole elbow hurt during all of my exercises, but I had to work through it.  One in particular, pronation, hurt alot.  This one was putting undue pressure on the fracture and I had to discontinue it.  Only your Chiropractor, Physical Therapist or ATC should tell you what is acceptable and what is not.  Second, compensation to your injury must be addressed.  I had to have my neck and back adjusted for my elbow to fully recover.  By having a restricted Cervical and Thoracic spine my elbow was under undue stress.  
• Address Muscle Function. Week 1-8 weeks.  Myofasial Release, massage, and any manual therapy helps promote proper healing and decreases the amount of scar tissue.  This is also the time to exercise the injured area.  Light and passive at first,  more strength later.  Don’t rush it, doing too much too soon is almost as bad as doing too little.  Too little is the biggest mistake people and Doctors make.  It will allow for possible long term disabilities.  I also learned to importance of Russian stimulation when necessary.  My bicep was wasting away and no matter what I did, I could not get it to work properly.  This was because it was inhibited (neurologically shut down due to swelling)  I applied Russian Stimulation to it and it worked.  This is a strong estim that is applied after the acute phase.  If a muscle stays “inhibited” it could lead to injury down the road.
• Address Neurological Function:  This is a little more complicated to explain, but your Therapist will know. Essentially, after an injury, our body compensates.  Certain muscles shut down, some become overactive (tight), we lose our sense of balance, and it creates muscle imbalances that we call dysrythmias.  If not addressed through the goofy exercises we apply such as standing on one foot, wall angels or the upper body cycle (if you are a patient you may know some of these well), it can lead to problems weeks, months, or even years later.  How many times have you heard of someone complain of low back pain after they hurt their knee?  Probably because their compensations were never addressed.
• Strength Training/Cardio. Weeks 4-8 and forever. The last thing that should be addressed is strength.  It is the weight training, the running, the biking, the aerobic class etc.  If these things are done too soon or in lieu of all the stuff above, your are guaranteed to have ongoing issues and chronic problems.  It drives me crazy when a patient is told  to rest/immobilize for 4 weeks and go back to normal activities because the pain is better.  So seek out therapy that addresses all of these things to prevent long term injury.

Blackbeard’s Death Ocracoke 1718/ My Elbow Day 34

Wednesday, August 17th, 2011 At 11:14 pm

On November 17th 1718, Lieutenant Robert Maynard, of the Royal Navy,  set sail from the James River with a crew of 30 men on the hired sloop Ranger, to find the notorious pirate Blackbeard (AKA Edward Teach) somewhere off the coast of the Outer Banks of North Carolina.  Alongside another sloop named Jane with an additional 25 men, Maynard found the pirates anchored on the inner side of Ocracoke Island on November 21st 1718.

On that same night aboard the pirate ship Adventure, Blackbeard and his crew of only 19 were drinking in his cabin, anticipating what Maynard’s first move would be.  Reportedly, one of the crew asked Blackbeard, ” If ye die on the morrow, does your wife, Mary, know where ye buried the treasure?”  Blackbeard replied,” Damn ye, my friend, nobody but me and the Devil knows where it is hid and the longest liver will get it all.”

Maynard decided to attack on the morning of the 22nd in anticipation of a more favorable tide.  As the two sloops approached Blackbeard’s Adventure, Blackbeard’s superior knowledge of the waters and devastating attack disabled the Jane killing the Captain, midshipman Hyde, along with six others, and wounding 10.  Badly hit, but still in pursuit the Ranger, captained by Maynard, was able to disable the rigging of the Adventure forcing it ashore. Seeing only a few crew members standing on Deck alongside Maynard, Blackbeard decided to board the ship with ten men to end the battle, as he has done many times before.  To Blackbeard’s surprise, the crafty Maynard had ordered most of the crew below deck, and as they emerged, the pirate crew were engaged by a superior force.  The following account of the  ensuing battle was reported on the colonies only newspaper the “Boston News Letter”

“Maynard and Teach themselves begun the fight with their swords, Maynard making a thrust, the point of his sword against Teach’s cartridge box, and bent it to the hilt. Teach broke the guard of it, and wounded Maynard’s fingers but did not disable him, whereupon he jumped back and threw away his sword and fired his pistol which wounded Teach. Demelt struck in between them with his sword and cut Teach’s face pretty much; in the interim both companies engaged in Maynard’s sloop, one of Maynard’s men being a Highlander, engaged Teach with his broad sword, who gave Teach a cut on the neck, Teach saying well done lad; the Highlander replied, If it be not well done, I’ll do it better. With that he gave him a second stroke, which cut off his head, laying it flat on his shoulder”.

Blackbeard was killed, and the battle ended.  The most feared and respected Pirate, was reportedly shot five times and stabbed more than twenty before he was decapitated and died. Legends of Blackbeard spread after his death like wildfire.  There was even a report that after he was thrown overboard, his headless body swam 3 times around the ship.

This is part of the most accepted version of the death of Blackbeard.  There is some debate over who Blackbeard really was,  his relationship with the British government and Governors of Virginia and North Carolina, and his status as a pirate upon his death.  But all accounts confirm a formidable man and adversary. 

As I pondered this story on my recent trip to the outer banks of North Carolina and Ocracoke Island, a few things struck me.  First, it took them a full five days to sail down the James River and the coast of North Carolina to reach Ocracoke.  Perhaps it was due to the need for investigation along their quest to find the elusive Blackbeard, or they were in no rush to be killed and decided to stop for some of the amazing seafood along the Outer Banks.  But I will no longer complain about the beach traffic we have to deal with every time we head up route 12.  Instead I will imagine the fearful anticipation Maynard and his crew had to endure for those five days knowing they were about to face certain death.

Secondly, by most accounts, Blackbeard was shot 5 times and stabbed over 20 times, yet still fought Maynard to his death.  Now, maybe in the heat of battle I would find some inner strength to fight on for the greater good.  Just as in the case of the 120 lb mother who, with superhuman strength, was able to lift a 3500 lb car off of her trapped son,  I could put aside my pain and with the strength of Achilles in the Iliad of Homer, battle on.  But sitting around, as I watched my wife pack and unpack the RV as others looked on, made me feel a little inept and a little guilty.  If  Blackbeard can endure being mortally wounded, yet still swim around the ship in a defiant victory lap, I could chip in a little.  But due to my dedication to my patients, the need to heal my broken elbow so I could return to work, and following Doctors orders, I popped open a Stella and continued to read about the history of Ocracoke Island.

As far as my status, I am now 5 weeks into what will most likely be a 7 to 8 week healing process.  I have been a compliant patient, except for my 2-week hiatus from therapy learning the lore of Blackbeard the Pirate.  I now have a first hand appreciation for what it is that we do at Capitol Rehab, and the importance applying the correct therapy at the correct time.  The well-rounded, balanced approach is of paramount importance.  From acute care, to the final stages of healing (called the remodeling phase) there are things you must demand from your Doctor and Therapist.  On Monday, I will break down the importance of the following from my experince as a practitioner and now as a patient:

• Manual Therapy- What is it and why is it so important.
• Modalities such as IFC (estim), ultrasound, and the often unused Russian Stim- When they should be applied and why.
• Exercise- When is it bad and when is it good.

So, check back next Monday!

My Epiphany- The Making of a Pearl-Days 8-11

Monday, July 25th, 2011 At 9:29 pm

Did you know, before the time of cultured pearls, natural pearls, also known as “the Queen of Gems”,  were so rare, they were reserved for only the very rich and powerful.  It has been reported that the value of just one natural pearl earring was enough to finance a Roman military campaign.  Even today, with the abundance of pearls from farming or “cultured” pearls, a natural pearl necklace can fetch hundreds of thousands of dollars.  This information alone was not an epiphany, nor was it at all new.  But thanks to Father Dobbins’ sermon this weekend, I learned a little more about what it takes to make a pearl.  This information changed my outlook on my injury, and to some degree, my life.

The creation of a pearl is actually an immune response from a mollusk.  These particular species of oyster, mussel, or clam secrete a fluid around an irritant, such as a piece of sand.  This defense mechanism of secretion forms layer upon layer around the irritant until a lustrous pearl is formed.  This irritant, or wound, is similar to my fractured elbow and torn ligaments; and the secretion, is similar to the inflammation.  A beautiful and rare pearl is formed from an irratant.

This simple story, told by a man I greatly respect, had particular meaning for me that day.  The wound I received, and the difficulty it has caused, has turned into a blessing.  Things that I took for granted, such as being able to brush my teeth, eat my food, and play with my children, have been either taken away or made more difficult.  I realize how lucky I am and how much I loved doing those things.

I also had a re-affirmation of what I do for a living.  I love being a Chiropractor and helping people recover from their injuries.  It is easy to get caught up in the day-to-day monotony of paperwork, insurance companies, and other mundane tasks.  At that moment I realized that the mundane tasks are a small price to pay for all the things I enjoy, but have taken for granted.  I look forward to my return.

So what has transpired since last Thursday?  I received three more treatments.  Dr. Ricci adjusted my neck and mid-back to reduce the restriction I had been experiencing.  The adjustments have helped my neck pain and that rib pain tremendously.  My neck pain is currently at a 0/10.  My range of motion in my neck and mid-back is back to normal.  I still have some stiffness around the rib-cage but the sharp pains are gone.  I also had a 1 hour massage on my neck, back and arm.  The combination of better spinal mobility, along with the benefits of massage for circulation and muscle function, have directly improved my elbow.  To see this relationship you must understand what the adjustment of the spine is and what it does for extremity injuries.

According to the World Chiropractic Alliance,

The Goal of the Adjustment:

The goal of a chiropractic adjustment is to correct the spinal subluxations detected during the examination. To do that, the doctor applies pressure to the bone and “unlocks” it from its improper position. The bone will then be free to align itself correctly.

Unfortunately, the muscles connected to subluxated vertebrae get used to their positions and have a tendency to pull the bone back out of place. It may take several adjustments before the adjustment “holds,” and the bone settles into its proper alignment.

So when my neck and mid back were adjusted, it allows for normal range of motion.  This allows for better posture and movement for all the muscles that travel from my back to my shoulder.  This in turn allows for better movement of my shoulder and arm, thus taking stress off of the healing bones, muscles and tendons.

In my career I have seen neck and back adjustment relieve pain in the arms, wrists, knees and ankles of my patients due to this direct relationship.  My bone and soft tissue still have to heal.  But I am allowing them to heal at maximum capacity because I am treating the whole body rather than just the injury itself. I have also increased my vitamin C and water intake.

As for the elbow, it still hurts, and is still very weak.  The swelling is almost completely gone, and my range of motion is still slightly restricted.  All things considered, it has only been 11 days out of the 6-8 weeks it generally takes for these things.  My aggressive therapy seems to be paying off.  I have done Ultrasound, Electrical Stimulation, and both passive and active exercise on the injured side.  I have also increased my exercise on my uninjured arm as there is a small neurological stimulation to the affected side.

Pain: 2/10 spikes 7/10

Swelling: Mild

Prognosis: Good

Next time I will discuss how a good therapist must address more than just exercise and the benefits of myofascial therapy.