Many people perform physical labor but unknowingly use improper lifting techniques which often lead to injury. Lifting with a proper technique is essential to avoiding injury, and a few simple ergonomic tips can help you start right away. By using these tips and utilizing chiropractic care, you can not only increase the work rate and comfort at work but also improve the quality of your life.
It’s important that you focus on keeping your spine healthy because it houses and protects the spinal cord, which is essential and acts as a highway through which your brain is linked to all the parts of your body. In simpler words, a healthy spine is essential for maintaining health.
While your spine is made up of the vertebrae, it also consists of soft tissues and discs to absorb the shock and weight. While your lower back will hold most of your weight, any injury to or stress on it can lead to discomfort and pain as you move or bend. When you’re lifting, extra stress is placed on your spine, and the added weight of the item that you’re picking puts more pressure on the lower back.
While a back injury doesn’t always result in a single instance of lifting improperly, over time, the stress and trauma can lead to serious injury.
These are some simple ergonomic lifting tips that will help you while you’re working out so that you can avoid injury.
Editor’s Note: Today’s Chiropractic LifeStyle reader and San Diego County resident, Dr. Steven Wachs submitted the following personal account of the 2007 wildfires.
As wildfires began to place many areas of San Diego County under siege last October, heroic local firefighters, CDF personnel, military serviceman and emergency services began battling what would quickly surpass the 2003 Firestorm as the most devastating wildfires in the history of California. Many experts believe that such blazes will become a regular part of life in Southern California because global warming is intensifying nature’s cycles by lengthening fire seasons and prolonging droughts in parts of the West. However, nothing can prepare you for the fires that turned San Diego County into a disaster zone during the last week of October. As wildfires raged across Southern California, we were faced with a very graphic representation of what many had been predicting since the last fires, and it affected those who live in these neighborhoods, very directly and personally, as well as the county as a whole.
As fires erupted throughout the region on Sunday evening, Oct. 21st, no one could say with certainty which neighborhoods were safe and which were in jeopardy. Many residents took the necessary precautions based on the last set of fires. Based upon previous experience, the chiropractic community knew that those battling the wildfires would need care. Fighting wildfires is an exhausting task, with firefighters working endless shifts and countless hours, the availability of chiropractic care would be a vital necessity to many.
As I drove home Sunday afternoon from a wedding in Newport Beach with my wife, the scene became eerily similar to 2003, and we feared the worst. Strong, relentless Santa Ana winds, very dry and unseasonably warm conditions, and visibility becoming an issue heightened our concerns. As day turned into night, dark smoke continued to pour in from the east as we arrived in San Diego County. The darkening sky blackened quickly, obscuring any moonlight, and there was a very real sense that impending danger was on the horizon.
By Monday morning it was evident that this firestorm was going to require a monumental effort before it would be contained. Most of the community sat glued to the TV and news websites, riveted by bits and pieces of information from different news agencies in search of something new about their neighborhoods and the people close to them. Then on Monday evening we got the phone call, a Reverse 911. We evacuated immediately, finding refuge with our neighbor’s parents’ place along the coast. The hard, dry wind continued blowing ominously from the east, and by Tuesday a haze had spread over every neighborhood, rich, poor or otherwise. The oppressive smoke carried a message to this sprawling region of around three million, even if our homes were spared there was a concern for our community. Schools, offices and businesses were closed, leaving parents and kids wondering what to do. Plays and concerts were canceled, along with organized sports. Postal service was disrupted and many banks were closed. Most freeways were strangely clear; streets in downtown San Diego were quiet; and cars packed with keepsakes and important household papers lined residential streets from Eastlake and La Mesa to La Jolla and Rancho Santa Fe as evacuees from suburbs to the north, south and east bunked with family and friends. Most everyone would soon know somebody who either lost a home or was forced to evacuate after getting a rare phone call, the Reverse 911. Within the first several days the huge Witch Creek and Harris fires, along with smaller blazes, quickly consumed about 1,300 homes and other structures and scorched about 300,000 acres, displacing half a million people potentially in their path.
Upon returning home I packed up my gear and headed for the main staging area at Gillespie Field in El Cajon. Being familiar with the location this time around, I headed straight for the makeshift treatment area adjacent to the large tented food court. Upon arrival I was very pleased to be joined once again by a colleague and Los Angeles College of Chiropractic classmate, Dr. Marc Lewis. Several massage therapists were already set up and the firefighters coming off the line, as well as those just coming into town after long journeys, were lining up for treatment. As the day wore on, the demand for chiropractic treatment was nonstop. The physical and emotional demands of battling these massive wildfires took its toll on the firefighters. Many entered base camp physically and emotionally fatigued, with sore, tired muscles, suffering from numerous strained joints and mechanical dysfunction. The postural correction, improved motion, nervous system relief, and energy restoration that the chiropractic adjustments can provide was just what they needed. Never have you seen a more grateful group of patients! Whether it be the grizzled veteran commanders or the young rookies battling fires like these for the first time, the response to our care was overwhelming.
By Wednesday evening firefighters began to finally gain the upper hand with the firefighting effort in full swing. Fire crews were arriving on a continuous basis from all parts of Orange and Los Angeles counties, northern California and the Western states. We treated emergency personnel from Arizona, Colorado and as far away as Washington State, Oregon and Idaho! With the arrival of additional elite strike teams, experienced fire crews and the vast increase in air power, the spirit among everyone was greatly lifted. “There are still fires burning, and there’s still danger,” County Supervisor Ron Roberts said, “but it’s the first good day.” “We’ve turned the corner,” said Ron Lane, director of county emergency services. The region’s five major fires had burned 327,000 acres and destroyed or damaged more than 1,500 homes by Wednesday evening. Officials expected the numbers to rise as updates rolled in. About 400,000 people were still evacuated from their homes, down from a high of 560,000 on Tuesday, officials said. The largest fire, the 198,000-acre Witch Creek fire in northern San Diego County was still expected to meet up with the parallel-moving Poomacha blaze. The Rice Canyon fire had burned 9,500 acres in the Fallbrook area and was only 20 percent contained. Camp Pendleton firefighters battled several blazes, and the Poomacha fire had spread across 35,000 acres after starting on the La Jolla Indian Reservation. In southeastern San Diego County, the 75,000-acre Harris fire was moving through remote forest areas by Wednesday afternoon. Air tankers dropped fire retardant at midday to try to halt the spread farther into the backcountry. The Harris fire was still only 10 percent contained, with full containment not expected until Sunday. On Thursday, Oct. 25th President George W. Bush arrived in San Diego. He met with firefighters and toured many of the devastated areas, offering words of support and hope to those who lost their homes. Governor Arnold Schwarzenegger was a regular presence on the ground during this crisis, touring damaged areas, visiting shelters like Qualcomm Stadium, and lending encouragement to those at the base camps.
By the weekend, containment of the fires improved and the mood of the emergency personnel at Gillespie Field signaled a huge sigh of relief. The feedback from the firemen was tremendous; they could not have been any more appreciative and gracious that chiropractic care was made available to them. While many had received the benefits of chiropractic adjustments before, there were quite a few emergency personnel who received chiropractic care for the first time. Being able to provide spinal and extremity adjustments, myofascial release and stretching techniques lessened the impact of sore and tired muscles, restored vertebrae back to their proper position and alleviated nerve pressure. Thereby many, many firefighters, who were sleeping in tents and on cots or sleeping bags, were able to obtain a much more restful sleep; and many for the very first time experienced the powerful impact of specific chiropractic adjustments to restore motion, improve overall function and to alleviate pain. By Monday Oct. 29th most schools re-opened and there was talk of the recovery to follow as firefighters continued to work on fire containment, and the county got a welcome breath of fresh air as onshore air flow helped clear out some of the lingering smoke from the fires. By the next day most of the wildfires were well contained and the majority of our work had been done. It was truly remarkable to see so many of the firefighters, who had been treated for the very first time come back for a second and third time for adjustments, and so returning on a daily basis! It was a distinct privilege to serve once again alongside Lewis and several other colleagues, including Christina Sanchez, D.C., and Matthew Hubbard, D.C.
It was truly an honor to be able to contribute in a small way to this large effort. This opportunity to provide care to those heroes who sacrifice so much and take the risks they do, has truly reminded me once again why I am so proud to be a part of the chiropractic profession. Once again the chiropractic profession answered the call, by being on the front lines right away, providing relief and essential care to those who put themselves in harm’s way.
Dr. Steven M. Wachs, D.C., of Chula Vista, Calif. is a Certified Chiropractic Sports Physician (CCSP), Qualified Medical Evaluator (QME) and Independent Medical Examiner (IME).
If there’s one thing I have learned in practice, it’s this: Don’t be fooled by not checking the feet. Remember that as a profession, we understand the axial kinematic chain. Joints down below can definitely have an effect on joints up above, either positively or negatively. I have found in the past when I’ve skipped over the feet thinking they had no bearing, I have had to go back later and evaluate them since there was a relationship to the patient’s complaint. For many of us, the feet are not the first place that we think about looking, especially if a patient comes in complaining about hip or lower back pain. “Why would you bother checking the feet when someone isn’t complaining about pain in the feet?” Not only are you asking me this question, but the patients ask it of me as well.
For most of the patients that walk through your door, the reason you should be checking their feet lies in the concept of excessive foot pronation. Eight out of 10 people pronate excessively when they are performing any type of weight bearing activity. Eighty percent of all people coming into our office, from children to the elderly, have feet that roll inward due to some degree of arch collapse. This is a common theme with runners.
Think about the power of that previous statement. This means that regardless of where a chiropractor practices in the world or what techniques they use to remove subluxations or misalignments, 80 percent of the people will have excessive pronation. The kicker is, the patients usually don’t even realize it. Here’s ?another interesting fact: often, the chiropractor doesn’t realize there is excessive foot pronation either. The altered biomechanics that result can lead to pain in the feet, ankles, knees, hips, lower back or higher.
Foot pronation is a normal occurrence when the foot flattens out during the gait cycle. At the subtalar joint, we should observe a healthy amount of foot/ankle inversion, dorsiflexion and abduction. In fact, foot pronation is necessary in order to have normal foot biomechanics. What we are looking at now is the problem of excessive foot pronation; where the foot is dropping or flattening out too much.
Now we have a situation where the foot rolls in so much that the connective tissue and the three arches on the bottom of the foot cannot provide the proper support. When the three arches of the feet begin to collapse due to any number of reasons, we can start to observe the effects of over-pronation as signs and symptoms in the patient.
Excessive foot pronation affects both feet, one usually worse than the other. Since our feet are not as springy and resilient as they were previously, the connective tissue on the underside of the foot (mainly the plantar fascia) becomes stretched permanently. Elastic tissues now become more plastic and deformed. Shock transmission is increased each time the heel strikes the ground because the foot is less biomechanically stable. Thus the foot is not able to absorb the ground shock and it moves into the ankle and up the kinematic chain with more force.
Over-pronation begins at the feet and spreads northward like the domino effect. If you stand up and roll your feet inward as far as you can, it recreates what happens to people who are experiencing excessive foot pronation. You can actually follow along with your own body to find out what happens.
As the arches fall toward the ground and become flatter, more stress is placed on the medial ankles. The tibia and femur bones inwardly or medially rotate, placing stress on the medial knee. The patellae also move medially as a result of the physical forces, thus affecting the Q angle negatively. The femoral head is pulled laterally, placing a lot of pressure on that particular joint. The pelvic effects are equally as significant. There is dropping of the pelvis and posterior movement of the ilium bones. Excessive pronation continues its march up the spine by affecting the thoracic area and shoulder levels. It even affects the pull of the muscles of the neck and skull.
So what is the significance of excessive pronation for your practice? It can be a significant contributor or cause of many ailments that patients present within your office. Sprained ankles, plantar fascitis, achilles tendonitis, shin splints, Osgood schlatter disease, ACL/meniscal/knee pain, patellar tendonitis, hip pain, lower back pain, neck pain and headaches are some examples of what excessive pronation causes. We treat these conditions on a daily basis, no matter what technique you use.
When dealing with treatment we want to adjust the feet and extremities and the spine where appropriate. The use of physical therapy modalities and exercises are helpful as well, but they are not enough. Once the patient stands up and walks out to your front desk to pay your receptionist, the body goes right back into its’ over-pronated state. Essentially all of your work will be shortly undone with each subsequent step they take. So what else might you do to fortify all of the excellent chiropractic care you have just administered?
One of the key concepts in treating the feet focuses around the permanent stretching of the plantar fascia that has occurred. The muscles of the foot can be exercised, but they are not the primary stabilizers of the arch. Exercises will help in strengthening the foot, but they alone will not bring back the arches. The permanent stretching of the plantar fascia must be addressed.
Thus some type of custom molded orthotic must be prescribed for the patient. Does that mean the patient will always have to wear ?orthotics for the rest of their lives? Yes, but it is better than experiencing progressively worsening pain and watching their feet go through arthritic changes. Flexible, custom molded, three-arch orthotics have been documented to be extremely effective for helping the many conditions and joint stresses described earlier. Traditionally, flexible orthotics have been made using foam impression casting. This method is rapidly being replaced by digital scanning technology that reduces error rates by the doctor and gives the patient a “technology show” that impresses them.
Make sure that you assess the feet on as many of your patients as necessary. There may be a few exceptions to this piece of advice. However, if you routinely check the feet of your new patients and even go back and reassess some of your long-time patients, you will be surprised at what you will find. Once you determine there is a relationship between the feet and the body, you can implement an effective, specific treatment plan that will greatly enhance the positive results from your care.
For many athletes, the feet are the most frequently injured anatomical feature. The following stretches and exercises will strengthen the muscles in your feet and calves. In turn, you’ll be giving your body a better foundation.
Golf Ball Exercise Sit with a golf ball under your bare foot. Roll the ball with as much pressure as is comfortable from the front of your foot to the back, and along the arches and outer edges. Do this for up to five minutes per foot, twice a day. This exercise loosens and relaxes your foot.
Sit in a chair and place a bath towel flat on the floor. With your bare foot, reach for the edge of the towel and scrunch it up toward yourself. This exercise helps condition your arches and strengthen your foot. Try performing this exercise up to six times a day.
Sit in a chair with your foot crossed over your opposite knee. Grasp your foot with your hand and slowly bend your toes toward your knee. Hold the stretch for 10 to 15 seconds.
On a set of stairs, stand with both feet on the same step. Position your feet so that your heels hang off of the step. Bend your left knee and move your hips forward until you feel a stretch in your calf. Switch legs and repeat.
Facing a wall, place your hands on the wall for support and position one leg in front of the other. With your back leg straight, your heel flat on the floor, and your foot pointed straight ahead, lean slowly forward, bending your front leg. You should feel the stretch in the middle of your calf. Hold for 10 to 15 seconds.
Stand facing a wall with one leg in front of the other. Place your hands on the wall for support. Keeping your heels flat on the floor, slowly bend both knees. You should feel the stretch in the lower part of your leg. Hold for 10 to 15 seconds.
Next, with your left foot, bend your toes up against the wall, so the ball of your foot is on the ground. Bend your knee toward the wall, keeping it in line with your foot. The stretch should be felt in the arch of your foot. Hold for 30 seconds, switch legs and repeat.
Dr. Robert Melillo believes balancing the brain hemispheres is the key to breakthrough for kids suffering with developmental and learning disorders. So convinced is Melillo that he is launching Brain Balance Centers across the country.
“When I started witnessing the rampant increase in children taking Ritalin in the early 1990s, I decided to find out what the problem was,” says Melillo, who first began exploring the hemispheric concept in 1990.
Melillo admits his first instinct was to blame the rise in ADHD cases on pharmaceutical companies peddling prescription medicines to beef up their bottom lines. So he launched an investigation. He talked with pediatricians, but none could tell him what was going on in the brains of these Ritalin-taking kids. He talked with educators. Schoolteachers confirmed the problem of hyperactivity, but couldn’t offer him any insights as to the cause of the problems.
“I realized nobody knew what was really happening—that was the problem,” Melillo, whose three children were under 6 years old at the time, recalls. “I dove into researching this, and it has become my obsession for 15 years now.”
Obsession is an accurate word. Melillo has already written four textbooks on the topic. His research uncovered a hemispheric relationship between conditions like ADHD, dyslexia, autism, Asperger syndrome, Tourette’s syndrome and various learning disabilities and processing disorders.
“There isn’t much difference between ADHD, autism, Asperger’s and Tourette’s. The exact same areas of the brain are involved,” Melillo says, explaining that he has grouped these disorders into what is referred to as Functional Disconnection Syndrome. “The only difference is between ADHD and dyslexia; one involves the right side of the brain and the other involves the left side of the brain.”
Melillo’s first test case was the 3-year-old son of a chiropractor. Doctors diagnosed the boy with mild autism. He had never uttered a word. Within three weeks of applying Melillo’s hemispheric treatments, the parents came to his office in tears of joy because the boy was beginning to speak. “As a young parent relating to other young parents,” he recalls. “This just blew me away.”
Melillo’s success treating that 3-year-old left him with what he felt was a moral obligation to conduct a more in-depth study on the hemispheric connection, but it was inconvenient. Melillo was running a large practice and had little time to explore an entirely new discipline. That’s when he had an epiphany that changed the course of his career: If he didn’t do it, then who would? The lives of suffering children were literally in his hands. So he kept researching and conducting case studies.
Chiropractic neurologist Ted Carrick, D.C., Ph.D., is one of the instigators of Melillo’s passion. Carrick is the founder of the Carrick Institute for Graduate Studies in Cape Canaveral, Fla., which offers programs in clinical neurology. Author of “Neurophysiological Implications in Learning,” Carrick has been an active brain researcher, teacher and clinician.
“Dr. Carrick has had a tremendous influence on me professionally,” Melillo says. “The first time I saw him lecture, he blew me away. He was doing things I never saw anybody in our profession do, like picking up heart murmurs. We started out as teacher-mentor, now we are the best of friends.”
In 2001, Carrick asked Melillo to develop courses in hemispheric treatments of ADHD and related disorders so chiropractic neurologists could get equipped to deal with the epidemic of neurobehavioral disorders. Melillo has trained more than 1,000 professionals on how to use his method since 2001. However, there is a challenge to the widespread adoption of the brain balance methodology: practicality. Chiropractors have struggled to integrate the methods into their practices. The solution was to raise awareness. The solution, in part, is Brain Balance Centers.
As its name suggests, the Brain Balance program’s goal is to correct a fundamental imbalance between the two hemispheres of the brain. That imbalance contributes to a communication breakdown that results in a range of negative symptoms and behaviors. The Brain Balance Achievement Program trades drugs, medical procedures and psychotherapy for custom programs that integrate physical and cognitive exercise with dietary change and chiropractic adjustments.
Specifically, the program blends physical (sensory and motor) activities with educational and behavioral methods to achieve optimum brain and body function. The program improves each function individually and then progressively integrates the rest of the brain functions. Brain Balance Centers typically works with children from kindergarten through ninth grade and requires a strong commitment from both parent and child.
“The program is based on objective measurements rather than function or symptoms,” Melillo explains. “We do a combination of different things with the children one hour three times a week. Sometimes they get an adjustment, but they don’t always need full adjustments. Our activities are based on what we see going on with the child.”
Melillo reports life-changing results in his patients. Take Carolyn Ortiz, for example. Her son, Christopher, was diagnosed with ADHD at 6-and-a-half years old. The neurologist insisted on medicating the child, but his parents chose to find another route. That route was Brain Balance Centers. “Christopher was hyperactive, impulsive and having problems focusing and behaving,” Ortiz says. “We have seen remarkable changes. He is now calmer, more focused, more cooperative. He listens better and he’s less impulsive.”
Bella Pisano was born healthy, but her developmental milestones were delayed. Doctors gave her mother, Cara, little hope that her baby would be normal after doctors began pointing to the possibility of genetic diseases. Pisano brought Bella to Brain Balance Centers for treatment. “The changes were instantaneous,” she recalls. “She began to speak. She moved with more fluidity and she expressed her needs.”
Melillo knows there’s much more work to do. Four Brain Balance Centers, in Georgia, California and New York, are not enough. He is moving aggressively to launch up to 10 new facilities next year in the United States and Europe. The way Melillo sees it, his hemispherical approach is raising awareness for the chiropractic profession’s ability to deal with brain disorders in children. The American Chiropractic Association’s Council on Neurology is also actively communicating and educating the profession about the importance of neurology to the overall treatment of chiropractic patients.
“Brain balance disorders are the single biggest problem facing society. Think about the future. What’s going to happen with these kids in another 10 or 15 years if we don’t help them?” Melillo asks. “That’s what Brain Balance Centers is about. I realized this concept wasn’t going to take off unless we developed an organization model to go along with the treatment model. It’s a moral obligation.”
For more information, visit these websites to learn more about Dr. Melillo and Brain Balance Centers: acatoday.com or brainbalancecenters.com
Each hemisphere of the brain has specific functions, and a wholly functioning brain is necessary to achieve maximum executive functioning. The “secret” of the Brain Balance™ process is to determine the exact areas of the brain that are deficient and to work to improve those areas, thus getting both hemispheres working together. Most of the current protocols seek to strengthen the strong side of the brain, thus making the imbalance even greater.
Brain Balance uses a multimodal approach—sensory/motor, cognitive and nutritional/allergy elimination. Sensory input is what drives the brain to organize and develop—this is called “neuroplasticity.” Cognitive works with the executive functions of the brain and is dependent on sensory input. Brain allergies can create “short-circuits” to the normal function of the brain. No program is complete without dealing with allergies, and with allergies come nutritional deficiencies, which must be dealt with as well.
Recently autism has been in the news on a daily basis. With a large increase in the numbers of cases—one in 166 live births, as the most recent statistic—health authorities have undertaken significant studies related to the etiologies of autism. Characterized by multiple deficits in the areas of communication, development and behavior; autistic children are found in every community in this country and abroad. Recent findings point to a significant increase in autism, which cannot be accounted for by means such as misclassification. The state of California recently reported a 273 percent increase in the number of cases between 1987 and 1998. Estimates now hover around the four through 20 per 100,000 children. Recent findings from the MIND Institute at the University of California at Davis states that, ‘‘The unprecedented increase in autism in California is real and cannot be explained away by artificial factors, such as misclassification and criteria changes, according to the results of a large statewide epidemiological study.”
Many causes of autism have been postulated, ranging from environmental and toxicological causes to genetics. The most current thinking including that of many members of the U.S. Congress and others is that vaccination, and specifically the mercury-based preservative in the vaccines, is causing brain damage in children resulting in autism. Conflicting findings have prevailed in the literature with respect to the potential of vaccines as a causative factor in autism. Certain findings, such as those of Andrew Wakefield, have pointed to a live measles virus in the GI tracts of children with autism. Some studies have confirmed his findings, others have disputed it. Further, there are many anecdotal reports of regressive autism following administration of one or more vaccinations. Other parents report developmental problems from birth pointing to autism.
Last year the author proposed, in a widely published paper, a mechanism by which the use of amoxicillin/clavulanate may be a possible contributing factor in the causation of autism. Administered liberally since 1989, Augmentin as it is known in the U.S. began being cited in the literature for Otitis Media in 1989. During the manufacture of Augmentin, a large buildup of urea is common. The nitrogen poses a potential explosive component and the potential for nitrogen/urea poisoning of the GI system exists in children treated with Augmentin.
Most likely, autism has multiple etiologies with environmental and genetics causes all playing a role in the etiology. Whether vaccine or medication induced, other toxins or allergens as a factor, the etiology of autism continues to be uncertain.
In 1989, Horvath from the University of Maryland proposed that a child with autism who received an endoscopy had significant changes occur with respect to his autism. Determined that the factor involved was the administration of secretin which was used to detect stomach tumors during the endoscopic procedure, secretin was proposed as a potential treatment for autism. Having mixed findings with respect to the potential efficacy of secretin, the debate still rages in many quarters of the autistic community. During that time certain mechanisms were discussed as to why the secretin could potentially be efficacious. It was determined by the author that potentially certain toxins such as vaccines and or antibiotics such as Augmentin could injure the lining of the small intestine. Augmentin of course has long been known to cause GI irritation, and Wakefield’s findings of measles in the small intestines could potentially set the child up for GI dysfunction.
Injury to the lining of the small intestines could injure the secretory cells in the lining. The secretory cells of the small intestine among other things respond to the pH change in the small intestine. A bolus of food from the stomach enters the small intestine at a pH of 1 or close to 1. This acidic bolus triggers the secretory cells of the small intestine to send out the hormone secretin. The secretin, which is a neuropeptide, reaches the pancreas which responds by sending out zymogens which are the precursors to the digestive enzymes as well as bicarbonate ions. The zymogens are sent out by the pancreas to prevent autolysis of the pancreas itself that could happen in the presence of activated enzymes.
The bicarbonate ions change the pH of proximal small intestines to approximately a 6.4 pH. The zymogens are then converted into active enzymes. Trypsinogen changes to trypsin which then in turn converts the chymotrypsinogen to chymotrypsin and so on. These changes can only take place in the presence of the secretin activation.
If the small intestine or pancreas itself is injured through the use of medications such as Augmentin, or from vaccination or other insult, it is likely that the secretin mechanism is unavailable or disrupted. For example, if the secretin mechanism is altered due to injury to the lining of the small intestines by the urea/nitrogen residue from Augmentin, then the entire pH change cannot take place. If the pH change does not occur then the conversion of the inactive to the active forms of the digestive enzymes does not occur.
The face of the lack of conversion of the enzymes, incomplete or absent digestion of certain foodstuffs can and will occur. So for example, if a lipase or protease such as chymotrypsin is not converted from chymotrypsinogen to chymotryspin, or the pancreas does not manufacture sufficient amounts of the enzymes, incomplete protein digestion will occur. In the case of an incomplete or absent digestion of a fat or a protein, the molecule of undigested protein for example, remains in the small intestines and can act as an allergen. This allergen can act as a toxin to the body and produce buildup of certain substances, which are further toxic to the body.
In the case of fats, undigested fats can become rancid and cause a toxic buildup in the body. The rancid fats can create an allergic irritation or act as a poison. This is the idea which has been referred to as “leaky gut syndrome.”
By definition, “leaky gut syndrome” is a change in the permeability of the intestinal lining to large macromolecules such as those of undigested fats and proteins which generally comes from an inflammation or other change or damage to the mucosa of the small intestine. Further, if there is damage to the small intestinal lining, then the IgA (immunoglobulin A) present in that lining can be injured and absent, allowing pathogens to enter which otherwise would not be there.
The presence therefore of allergens, and pathogens can upset the balance to further allow other things such as yeast overgrowth to occur.
If we examine the fact that the GI system in autistics is affected by these conditions, and there is a lack of digestion, the brain can be significantly affected. In the first few years of life, and especially under the age of 2 years, the brain is in demand for growth. The largest growth in the brain takes place during these first few years, and if not given the building blocks necessary for that growth, the brain will be at a severe disadvantage.
If protein digestion is not taking place, then the proper number and amounts of amino acids will not be present to make other proteins. The body therefore must prioritize the use of the available amino acids, and it is possible or at least theoretical that the body will sacrifice the use of the available amino acids to allow the most function not necessarily the highest function. The same is true of the digestion of fat. If the proper fat digestion is not taking place, then there is going to be a dearth of formation of myelin and other fat necessary structures in the body.
The allergens, which can result from the lack of fat and the lack of protein digestion can therefore lead to autism.
The examination of autistic children is difficult under the best of circumstances. Due to their significant sensory issues, obtaining blood and urine samples are difficult, especially in the child as young as 2.
Examination of the stool therefore is a far more easy method of obtaining a biological sample.
When examining the potential for GI markers for autism it is important to look for those markers which keep within the physiology of the above hypotheses. If there is a potential for a lack of protein digestion, measuring the levels of chymotrypsin could potentially be a marker for this problem. If the secretory cells are damaged there could potentially be a lack of secretin in the blood stream as a result of the pH 1 in the small intestines. Without the pH change from 1 to 6.4 in the small intestines, the chymotrypsinogen never is converted to chymotryspin and the level of chymotryspin therefore should be extremely low should the hypothesis be a good one. Measuring fecal chymotrypsin has long been done in those children with cystic fibrosis (CF) for they too have pancreatic involvement and a lack of enzymes to digest food. Indeed all CF patients take digestive (pancreatic) enzymes when they eat.
Further if there is a condition in the small intestines whereby the lack of digestion allows for an imbalance and the presence of other pathogens, examining for those pathogens could be another helpful examination in determining autism. The presence of these pathogens, as measured by their antigenic presence could also be used as an early marker for regressive autism.
Examination of the diets of these children will reveal an interesting aversion to protein. These children generally have diets laden with carbohydrates and very little protein. This is most likely the
body’s adaptation to an inability to digest protein.
Fecal chymotrypsin was measured in 10 children. Fifty children with Autism and 50 age matched controls who are not autistic, or exhibit autistic behaviors. The autistic children were confirmed through the use of a CARS test (Childhood Autism Rating Scale). Fecal chymotrypsin is measured
with normal being greater than 8.4. The results are as follows in FIGURE 1:
The means of the two samples are significantly different, and meet the criteria for statistically significant findings. The use of fecal chymotrypsin is therefore an important tool to examine the potential need for protein digestion in the children with autism. Where N=100 for the total subjects,
the mean for the autistics is 3.1, and for the non-autistics 24.6.
Thirty-one autistic and 31 non autistic children had their chymotrypsin levels measured. In FIGURE
2. 13 of the autistic children who had abnormal fecal hymotrypsin were administered pancreatic (digestive) enzymes including a protease, lipase and an amylase for 30 days. The results demonstrate a significant change in the level of fecal chymotrypsin in FIGURE 3.
Elevation of the fecal chymotrypsin levels was seen throughout the study, across all subjects.
There are many issues, which can be examined with respect to the etiology of autism. While the etiology is probably multi-factorial, there has never been a biological marker for autism. Whether from a spat of chronic ear infections for which the allopath prescribed numerous antibiotics or from a vaccine, which produces regressive autism, the GI system of the child is likely damaged based upon the common GI marker findings.
It is important to look at the entire child, and an important part of their workup should be a GI marker test, which is commercially available. If damage has been done by outside intervention such as antibiotics or vaccination, it is possible that the child will require replacement with pancreatic (digestive) enzymes.
This study is not intended to examine the full range of scientific data surrounding these findings but rather to give the practitioner an introduction to potential biological findings in the child with autism.
A few decades ago, soybeans were not used as a food but were used instead, and more appropriately, in crop rotation. However, the discovery of long periods of fermentation has been found to be essential in transferring soy into a healthy food. This process significantly reduces the phytate content of soybeans, as well as the trypsin inhibitors that interfere with many vital enzymes and amino acids. Fortunately, fermented soy such as tempeh, miso, natto, tamari and other fermented soy products can provide nourishment that is easily assimilated.
When precipitated soy products like tofu are consumed with meat, the mineral-blocking effects of the phytates are reduced.i However, when consuming soy (tofu/bean curds) as a replacement for meat and dairy products, mineral deficiencies occur. Such a diet can lead to an amino acid deficiency.ii “Asian and Western children, who do not get enough meat and fish products to counteract the effects of a high phytate diet, are subject to rickets, and other growth problems.”iii Contrary to popular opinion concerning the healthy effect of consuming soy food has on Asians, a New York Times article (June 6, 1996) cited 100 million cases of goiters at present in China.
We are told that soybeans are high in protein, but what we are not told is that soybeans also block the action of the enzymes that are essential in digestion of protein. Soy damages the enzymes that manufacture thyroid hormones, as well as those enzymes essential to proper thyroid functioning.iv v Besides this bad news, scientists have known for years that isoflavones in soy products can cause enlarged thyroid glands (goiter)vi.
How are soy protein isolates (S.P.I) made? They are manufactured by mixing an alkaline solution to it in order to remove fiber. A toxin called lysinoalanine is formed during alkaline processing.vii Then it is separated by adding an acid. This is done in aluminum tanks, which leach high levels of aluminum into the final product. It is then spray-dried at high temperatures to make a protein powder. Nitrites, which are potent carcinogens, are formed during spray drying. A final indignity to this substance is brought on by the use of additional high-temperature and pressure. This is what produces textured soy protein. However when the soy is denatured in this way, the resulting product becomes ineffective.viii And even though much of the trypsin inhibitor content can be removed through high-temperature processing, it’s note all removed during this processing. This remnant can vary as much as fivefold.ix
This leftover anti-nutrient (a toxin) becomes more of a concern when MSG is added in order to mask the unpleasant taste of this texturized soy product. This in turn often creates more allergic reactions as well as a need to increase vitamins E, K, D, B12, calcium, magnesium, manganese, molybdenum, copper, iron and of course, zinc.x The effect of mineral blocking enzyme inhibitors in soy can result in any number of conditions, such as endocrine disruption (goiters), reproductive disorders and allergic reactions.xi
Test animals fed soy protein isolates (SPI) develop enlarged thyroid, as well as the enlargement of other glands, most particularly the pancreas. Their diets, which are high in trypsin inhibitors, are also subjected to pathological conditions of the pancreas, including cancer.xii A biochemical pharmacology study confirms that fatigue, as well as goiter problems, are associated with soy food.xiii
The National Center for Toxicological Research reports that soy isoflavones (genistein and daidzein) “inhibit thyroid peroxidase-catalyzed reactions essential to thyroid hormone synthesis.”xiv Japanese researchers studied the effects of consuming as little as two tablespoons of soybean a day. Even when healthy people were put on this diet for a short period of time suppressed thyroid function and goiters developed, “especially elderly subjects.”xv Infants have also been found to suffer from hypothyroid problem when on a soybean diet.xvi Another study confirms that autoimmune thyroid disease is linked to children who have consumed soymilk formula on a regular basis.xvii Doctors should be aware of the “potential interaction between soy infant formula and thyroid function,”xviii says the New Zealand Ministry of Health.
And a study comparing consumption of soy formula in non-diabetic children found those who drank it, as infants were prone to diabetes.xix Also, it is possible that allergies, so prevalent these days, may have been exacerbated from consuming soy formula. For instance, “the amount of phytoestrogens that are in a day’s worth of soy infant formula equals 5 birth control pills,” says Mary G. Enig, Ph.D., president of the Maryland Nutritionists Association. Nutritional experts believe that this high amount of phytoestrogens can be linked with early puberty in girls and hinders physical maturation in boys.xx In 1998, the FDA had even received warnings from the British Government’s final account on phytoestrogens, about their harmful reactions.xxi But for reasons beyond the consumer’s knowledge FDA bureaucrats have engaged in a “rigorous approval process” for S.P.I. However, we can now protect ourselves by learning more about what’s behind all these inconsistent reports as we become more aware of the health industry’s claims and political propaganda concerning food supplements.
Soy phytates reduce zinc and iron absorption. This is a concern because numerous people, who are taking iron supplements due to low levels of this mineral, are not realizing the cause of their iron deficiency. Soybeans have one of the highest phytate levels of any grain or legume that has been studied,xxii and even long periods of cooking at high temperatures will not completely eliminate the phytate levels.xxiii Phytates (an organic acid found within the outer portion of all seeds) block the absorption of essential minerals (e.g. calcium, magnesium, iron, and especially zinc. This is a concern because high levels of zinc are needed in the brain, especially the hippocampus. Zinc plays an important role in the transmission of the nerve impulse between brain cells. Deficiency in zinc can be serious, as it’s needed in the development of brain, immune and nervous system functioning. It also plays a role in collagen formation and protein synthesis, as well as our blood-sugar control mechanism and other systems in the body.
The U.S. Department of Agriculture, Agricultural Research Service, Food & Nutrition Research Briefs (July 1997) provides information showing how changes in zinc intake can affect cognitive function.xxiv This suggests the importance of zinc in the pathological functioning of the cerebral cortex.xxv Furthermore, age-related zinc deficiency in cells may contribute to brain cell death in Alzheimer’s dementia.xxvi
Congenital abnormalities in an infant’s nervous system can be caused by a deficiency of zinc during pregnancy and lactation. In children, “insufficient levels of zinc have been associated with lowered learning ability, apathy, lethargy, and mental retardation.”xxvii The USDA references a study of 372 Chinese school children with very low levels of zinc in their bodies. The children who received zinc supplements had the most improved performance—especially in perception, memory, reasoning, and psychomotor skills such as eye-hand coordination. “Both phytate and soy protein reduce iron absorption so that the iron in soy foods is generally poorly absorbed.”xxviii
As early as 1967, researchers found soy formula to have a negative effect on zinc absorption and also a strong correlation between phytate content and poor growth. Author Sally Fallon warns “a reduced rate of growth is especially serious in the infant as it causes a delay in the accumulation of lipids in the myelin, and hence jeopardizes the development of the brain and nervous system.”xxix It has even been found to increase the deposition of fatty acids in the liver.xxx
The promotional health claims about soy products that come from vitamin/food manufacturer’s ads and multi-level marketers is then passed on to medical doctors, as well as the media and are received as gospel truth. Is this how we, the consumer, want to obtain information that will affect our future health? Some of the hype about soy alleges to aid in weight loss, protect the heart, prevent female discomforts and the list goes on. One piece of literature from a vitamin company goes so far as to state that the “Japanese, who eat 30 times as much soy as North Americans, have a lower incidence of cancers of the breast, uterus and prostate.”xxxi I have not found clinical studies to back this up and if it is true, it should also be pointed out that these Asians and Japanese have a higher rate of other kinds of cancer (esophagus, stomach, pancreas and liver).xxxii xxxiii Other literature confirms that a high rate of thyroid cancer is linked to soy consumption.xxxiv
In a 1996 study, researchers discovered that women who consumed the soy protein isolates had a greater risk of experiencing abnormally excessive cell growth, a symptom that can be a predecessor to malignancies.xxxv A study called “Dietary Estrogens Stimulate Human Breast Cells to Enter the Cell Cycle,” led researchers to conclude that women should not consume soy products, thinking that they were preventing breast cancer, when in fact dietary genistein found in soy food actually stimulates breast cell growth xxxvi In fact, according to Cancer Research “Genistein…is more carcinogenic than DES.”xxxvii That’s right DES the drug that caused death and disfigurement for countless women.
Additionally, it takes a mere 45 mg of isoflavones in premenopausal women to create a biological effect that will cause a reduction in hormones needed for proper thyroid activity. Numerous women are on thyroid medication, yet at the same time they are increasing their soy intake. The two seem to be defeating each other’s purposes. Other problems concerning a diet rich in soy food are highlighted from animal studies at Brigham Young University’s Neuroscience Center. Researchers found that consumption of phytoestrogens from soy for a relatively short interval can significantly elevate estrogen levels in the brain and can interfere with and thus decrease calcium-binding proteins in the brain.xxxviii
Athletes should be aware that the “soy protein” drinks they are consuming in order to build muscle tissue, may actually cause muscle protein breakdown.xxxix Take a look at some of the studies, such as the British Journal of Nutrition, which correlates strongly to weight-training athletes, whose diets consist of inferior soy protein, which may increase protein breakdown in skeletal muscle. Soybean protein isolates were given to pigs for fifteen weeks. Cortisol levels began to rise after their morning meal. Soy meals were causing the body to break down muscle protein in order for it to get its required amino acids.xl
This soy fad is resulting in numerous physiological abnormalities. Shocking news on this subject comes from investigations made by toxicologist, Mike Fitzpatrick, Ph.D., who confirms the facts that soy consumption has been linked to disorders, such as infertility and leukemia, and that soy foods are highly estrogenic. In 1992, the Swiss health service estimated that 299 grams of soy protein provided the estrogenic equivalent of the Pill.xli In fact other studies suggest that isoflavones inhibit synthesis of estradiol and other steroid hormones as well.xlii xliii But soy food can be very disruptive as their isoflavones, genistein and diadzen, can create endocrine dysfunction.
Elaine Hollingsworth in her book Take Control of Your Health and Escape the Sickness Industry says, “Soybeans contain Hemagglutinin, a clot-promoting substance that causes red blood cells to clump together. These clustered blood cells are unable to properly absorb oxygen for distribution to the body’s tissues, which can damage the heart.”xliv In his classic book, A Cancer Therapy – Results of 50 Cases, (p. 237) Dr. Charlotte Gerson warns to stay away from soy products. “Genistein, a component of soy, is more carcinogenic than DES.”xlv
Hollingsworth says: “Increased level of tofu consumption was found to be associated with indications of brain atrophy and cognitive impairment in later life. They even found, at autopsy, swelling of the brain cavities and a decrease in brain weight among heavy tofu eaters.xlvi “ Few people are aware that most soil contains aluminium. It is one of the most prevalent minerals, but it doesn’t affect most crops. Soy, however, has an affinity for aluminium and extracts it from the soil and concentrates it in the beans. This contamination is exacerbated by the aluminium tanks, which are used in the acid wash soy, is subjected to. So, when you ingest soy in any form, you also ingest aluminium, known for causing many health problems.” xlvii
It seems like we, the consumer, have been duped by the producers and their ad campaigns regarding the so-called “health” benefits obtained from soy products. Dr. Joseph Mercola tells us that the propaganda, from so many sources in the industry, has spread like a wild fire; and that this aggressive publicity is just another “nail in the coffin…” concerning a food that is not “designed to be eaten.”xlviii Never has there been a mention of the many studies that demonstrate the toxicity to our thyroid, liver or endocrine glands.xlix
Portions of this article have been excerpted from The Estrogen Alternative and Preventing Arthritis naturally: The Untold Story by Raquel Martin. (Healing Arts Press, 2004)
i Sandstrom, B. et al., “Effect of protein level and protein source on zinc absorption in humans”, Journal of Nutrition 119(1): 48-53, January 1989; Tait, Susan et al., “The availability of minerals in food, with particular reference to iron”, Journal of Research in Society and Health 103(2): 74-77, April 1983.
ii Enig MG, Fallon SA, Tragedy and Hype, The Third International Soy Symposium. Nexus Magazine, Vol. 7, No. 3, April-May 2000.
iii Martin, R., Gerstung, J, The Estrogen Alternative: Natural Hormone Therapy with Botanical Progesterone (Foreword by John Hart, M.D.) (4th Ed. 2004 in print) Healing Arts Press, Rochester, Vt. Citing: Mellanby, Edward, “Experimental rickets: The effect of cereals and their interaction with other factors of diet and environment in producing rickets”, Journal of the Medical Research Council 93:265, March 1925; Wills, M.R. et al., “Phytic Acid and Nutritional Rickets in Immigrants”, The Lancet, April 8,1972, pp. 771-773.
iv Ishizuki, Y. et al., “The Effects on the Thyroid Gland of Soybeans Administered Experimentally in Healthy Subjects”, Nippon Naibunpi Gakkai Zasshi (1991) 767:622-629.
v Doerge, Daniel R., “Inactivation of Thyroid Peroxidase by Genistein and Daidzein in Vitro and in Vivo; Mechanism for Anti-Thyroid Activity of Soy”, presented at the November 1999 Soy Symposium in Washington, DC, National Center for Toxicological Research, Jefferson, AR 72029, USA.
viDrane, H.M. et al., “Oestrogenic Activity of Soya-Bean Products”, Food, Cosmetics and Technology (1980) 18:425-427.
vii Rackis et al., ibid., p. 22; Rackis, et al., “Evaluation of the Health Aspects of Soy Protein Isolates as Food Ingredients”, prepared for FDA by Life Sciences Research Office, Federation of American Societies for Experimental Biology (9650 Rockville Pike, Bethesda, MD 20014), USA, Contract No. FDA 223-75-2004, 1979.
viii Wallace, G.M., “Studies on the Processing and Properties of Soymilk”, Journal of Science and Food Agriculture, 22:526-535, October 1971.
ix Rackis et al., ibid
x Rackis, Joseph, J., “Biological and Physiological Factors in Soybeans”, Journal of the American Oil Chemists’ Society, 51:161A-170A, January 1974.
xi “Food Labeling: Health Claims: Soy Protein and Coronary Heart Disease,” Food and Drug Administration 21 CFR, Part 101 (Docket No. 98P-0683).
xii Rackis, Joseph J. et al., “The USDA trypsin inhibitor study. I. Background, objectives and procedural details”, Qualification of Plant Foods in Human Nutrition, vol. 35, 1985. p. 232.
xiii Martin, R., Gerstung, J, The Estrogen Alternative: Natural Hormone Therapy with Botanical Progesterone (Foreword by John Hart, M.D.) (4th Ed. 2004 in print) Healing Arts Press, Rochester, Vt. Citing: Divi, RL, Chang HC, Doerge, DR, “Anti-thyroid Isoflavones from Soybean: Isolation, Characterization, and Mechanisms of Action,” Biochem. Pharmacol., 1997 Nov 15; 54(10):1087-96.
xiv Ibid: Divi, RL, Chang HC, Doerge, DR, “Anti-thyroid Isoflavones from Soybean: Isolation, Characterization, and Mechanisms of Action,” Biochem. Pharmacol.
xv Ishizuki, Y, Hirooka, Y, Murata, Y, Togashi, K, “The Effects on the Thyroid Gland of Soybeans Administered Experimentally in Healthy Subjects,” Nippon Naibunpi Gakkai Zasshi 1991 May 20; 67(5): 622-29.
xvi Shepard TH, Soybean goiter. New Eng J Med 1960; 262:1099-1103.
xvii Fort P, Moses N, Fusion, M, Goldberg, T, Leftists, F, “Breast and Soy-Formula Feedings in Early Infancy and the Prevalence of Autoimmune Thyroid Disease in Children,” J Am Coll Nutr 1990 Apr; 9(2): 164-67.
xviii Regulatory Guidance in Other Countries: New Zealand Ministry of Health Position Statement on Soy Formulas (Adobe Acrobat file).
xix Fort P, Lanes R, Dahlem, S, Recker, B, Weyman-Daum, M, Pugliese, M, Lifshitz, FJ, “Breast-feeding and insulin-dependent diabetes mellitus in children,” Am Coll Nutr 1986; 5(5): 439-41.
xx Martin, R., Gerstung, J, The Estrogen Alternative: Natural Hormone Therapy with Botanical Progesterone (Foreword by John Hart, M.D.) (4th Ed. 2004 in print) Healing Arts Press, Rochester, Vt. Citing: “Soy Infant Formula Could Be Harmful to Infants: Groups Want it Pulled,” Nutrition Week, Dec 10, 1999; 29(46): 1-2.
xxi “IEH Assessment on Phytoestrogens in the Human Diet,” Final Report to the Ministry of Agriculture, Fisheries and Food, UK, November 1997, p. 11.
xxii El Tiney, A.H., “Proximate Composition and Mineral and Phytate Contents of Legumes Grown in Sudan”, Journal of Food Composition and Analysis (1989) 2:6778.
xxiii Ologhobo, A.D. et al., “Distribution of phosphorus and phytate in some Nigerian varieties of legumes and some effects of processing”, Journal of Food Science 49(1): 199-201, January/February 1984.
xxiv U.S. Department of Agriculture, Agricultural Research Service, Food & Nutrition Research Briefs, July 1997.
xxv Frederickson, CJ, Suh, SW, Silva, D, Frederickson, CJ, Thompson, RB, “Importance of Zinc in the Central Nervous System: The Zinc-containing Neuron,” J Nutr 2000 May; 130(5S Suppl): 1471S-83S.
xxvi Ho, LH, Ratnaike, RN, Zalewski, PD, “Involvement of Intracellular Labile Zinc in Suppression of DEVD-Caspase Activity in Human Neuroblastoma Cells,” Biochem Biophys Res Commun, 2000 Feb 5; 268(1): 148-54.
xxvii Pfeiffer CC, Braverman, E.R., “Zinc, The brain and behavior,” Biol Psychiatry, 1982 Apr; 17(4): 513-32.
xxviii Soy Nutritive Content, United Soybean Board. Enig, M. G., Fallon, S.A., “Tragedy and Hype, The Third International Soy Symposium,” Nexus Magazine Vol. 7, No 3, April-May 2000. Enig, Mary G. and Sally Fallon, “The Oiling of America”, NEXUS Magazine, December 1998-January 1999 and February-March 1999; also available at www.WestonAPrice.org.
xxix Sally Fallon, Nourishing Traditions: The Cookbook that Challenges Politically Correct Nutrition and The Diet Dictocrats, 2nd edition, New Trends Publishing, 1999.
xxx Rackis, Joseph J. et al., “The USDA trypsin inhibitor study. I. Background, objectives and procedural details”, Qualification of Plant Foods in Human Nutrition, vol. 35, 1985.
xxxi Natural Medicine News (L & H Vitamins, 32-33 47th Avenue, Long Island City, NY 11101), USA, January/February 2000, p. 8.
xxxii Harras, Angela (ed.), Cancer Rates and Risks, National Institutes of Health, National Cancer Institute, 1996, 4th edition; AND Rackis, Joseph J. et al., “The USDA trypsin inhibitor study. I. Background, Objectives and Procedural Details”, Qualification of Plant Foods in Human Nutrition, vol. 35, 1985.
xxxiii Rackis, Joseph J. et al., “The USDA trypsin inhibitor study. I. Background, objectives and procedural details”, Qualification of Plant Foods in Human Nutrition, vol. 35, 1985.
xxxiv Searle, Charles E. (ed.), Chemical Carcinogens, ACS Monograph 173, American Chemical Society, Washington, DC, 1976.
xxxv Petrakis, N.L. et al., “Stimulatory Influence of Soy Protein Isolate on Breast Secretion in Pre- and Post-Menopausal Women”, Cancer Epid. Bio. Prev. (1996) 5:785-794
xxxvi Dees, C. et al., “Dietary estrogens stimulate human breast cells to enter the cell cycle”, Environmental Health Perspectives (1997) 105(Suppl. 3): 633-636.
xxxvii Cancer Research, June 1, 2001 – 61 (11): 4325-8.
xxxviii Lephart, E.D., Thompson, J.M., Setchell, K.D., Adlercreutz H, Weber KS, Phytoestrogens decrease brain calcium-binding proteins… Brain Res., (2000 Mar) 17; 859(1): 123-31.
xxxix Martin, R., Gerstung, J, The Estrogen Alternative: Natural Hormone Therapy with Botanical Progesterone, (4th Ed.) Healing Arts Press, Rochester, Vt. (2004 in print) Citing: Lohrke, B. “Activation of Skeletal Muscle Protein Breakdown Following Consumption of Soybean Protein in Pigs,” Br J Nutr, 2001 Apr; 85 (4): 447-57.
xl Lohrke, B. “Activation of Skeletal Muscle Protein Breakdown Following Consumption of Soybean Protein in Pigs,” Br J Nutr, 2001 Apr; 85 (4): 447-57.
xli Bulletin de L’Office Fédéral de la Santé Publique, No. 28, July 20, 1992.
xlii Keung, W.M., “Dietary Oestrogenic Isoflavones are Potent Inhibitors of B-hydroxysteroid Dehydrogenase of P. Testosteronii”, Biochemical and Biophysical Research Committee (1995) 215:1137-1144.
xliii Makela, S.I. et al., “Estrogen-specific 12 B-Hydroxysteroid Oxidoreductase Type 1 (E.C. 184.108.40.206) as a Possible Target for the Action of Phytoestrogens”, PSEBM (1995) 208:51-59.
xliv Elaine Hollingsworth, “Take Control of Your Health and Escape the Sickness Industry”(6th edition) Empowerment Press International. Australia, 2000, http://www.doctorsaredangerous.com citing Charlotte Gerson, of the Gerson Cancer Clinic in the U.S.A., Gerson Healing Newsletter.
xlv (Cancer Research, June 1, 2001, 61(11): 4325-8).
xlvi Ibid: Hollingsworth, “Take Control of Your Health and Escape the Sickness Industry,” cited in Journal Of The American College Of Nutrition, April, 2000, and reprinted in Dr. William Campbell Douglass’ Second Opinion Newsletter.
xlvii Ibid: Hollingsworth, “Take Control of Your Health and Escape the Sickness Industry.”
xlix Setchell, K.D.R. et al., “Dietary oestrogens – a probable cause of infertility and liver disease in captive cheetahs”, Gastroenterology (1987) 93:225-233; Leopold, A.S., “Phytoestrogens: Adverse effects on reproduction in California Quail,” Science (1976) 191:98-100; Kimura, S. et al., “Development of Malignant Goiter by Defatted Soybean with Iodine-free Diet in Rats”, Gann. (1976) 67:763-765; Pelissero, C. et al., “Oestrogenic Effect of Dietary Soybean Meal on Vitellogenesis in Cultured Siberian Sturgeon Acipenser baeri”.
Before the 1990s, it was very rare to see a child with autism in your office, but over the last 13 years, the rate of autism has dramatically risen to epidemic proportions. In the old days, the rate was usually one child per every 10,000, but now in certain regions of the country it is one in every 150 or less.
Autism is a biological brain disorder that affects a child’s communication, social and cognitive functions. Technically it is referred to as Autism Spectrum Disorder because children range in severity from profoundly severe to mild learning disabilities. Autistic children usually appear normal in appearance but they demonstrate ritualistic behaviors like spinning or repeating the same verbal phrase.
The causes have not been found and are being publicly debated in the last few years because many professionals and parents blame vaccines and their ingredients like Thimerosal.
In a recent release by Bernard Rimland, Ph.D., director of the Autism Research Institute, he states, “As a full-time professional research scientist for 50 years, and as a researcher in the field of autism for 45 years, I have been shocked and chagrined by the medical establishment’s ongoing efforts to trivialize the solid and compelling evidence that faulty vaccination policies are the root cause of the epidemic. There are many consistent lines of evidence implicating vaccines, and no even marginally plausible alternative hypotheses.”
Other causes that have been presented include certain genetic markers, environmental toxins, pregnancy problems and poor diet.
The DAN! Protocol
In 1995, Rimland, who is the leading researcher in the field of autism and father of an autistic child, gathered a group of professional to discuss the rise in autistic children and figure out how to treat them. From that initial meeting a set of protocols emerged in the first real effort to realistically care for autistic children called the DAN! (Defeat Autism Now) Protocol.
Operated through the Autism Research Institute, the DAN! Protocol addresses combination of restrictive diets, chelation and vitamin supplements as a means to produce changes in autistic behaviors in the children. Although it is not a cure, many children have achieved better health and behavior which enhances their life and learning ability.
These practitioners examine the children by running extensive testing to determine how their body is working on a functional level. Most of the children have problems with their immune system and digestive tract that can be managed through vitamins and restrictive diets. Because the protocol is based in natural therapies, some chiropractors have become DAN! practitioners with the added benefit of doing adjustments.
Autism Reading List
Autism Research Review International newsletter
Biological Treatments for Autism & PDD : What’s Going On? What Can You Do About It? by William Shaw, Bernard Rimland, Bruce Semon and Lisa Lewis
Children With Starving Brains: A Medical Treatment Guide for Autism Spectrum Disorder by Jaquelyn McCandless
DEFEAT AUTISM NOW! Biomedical Assessment Options for Children with Autism and Related Problems by Jon B. Pangborn, Ph.D., and Sidney M. Baker, M.D.,
Enzymes for Autism and other Neurological Conditions by Karen L. DeFelice
Is This Your Child by Doris Rapp, M.D.
Special Diets for Special Kids by Lisa Lewis
Unraveling the Mystery of Autism and Pervasive Developmental Disorder: A Mother’s Story of Research and Recovery by Karyn Seroussi and Bernard Rimland
“The protocol that they utilize are things that chiropractic have been talking and preaching for years, it is nothing new to us,” says Donald Blair, a chiropractor near Toledo, Ohio. “Chiropractic has always had a concern about vaccinations, chiropractic has always talked about nutrition in its coordination with health and we have one more thing to offer which is the chiropractic adjustment, which works great in these kids.”
Chiropractic and Alternative Techniques
Most chiropractors report that using upper cervical techniques on autistic children show promising results.
“You can use a variety of techniques just so long as you get to the same approach of trying to fix the subluxation that is involved,” relates Blair. “They are definitely more attentive, more cooperative and less hyper. If we can do that, then they are much more capable of learning.”
Long Beach chiropractor Rochelle Neally, who uses an Activator along with a child-size head piece drop with autistic children, says, “It is almost scary because with one to two visits the kids do not have drainage or infections. They are happier and their speech is shooting through the roof because now they can hear and they can hear themselves. They listen better; they are paying more attention; there is a sparkle in their eyes.”
There are many types of techniques and specific therapies that chiropractors are using to help these children.
|Special-Needs Chiropractic Centers
For many years, the Oklahaven Children’s Chiropractic Center and Kentuckiana Children’s Center have been serving the health needs of special-needs children, including autistic children. Recently celebrating its 40th year anniversary, Oklahaven provides chiropractic care for indigent children diagnosed with such conditions as cerebral palsy and autism. The children who come to the center have not had success with traditional medicine and have occurred large medical debts.
A similar center is Kentuckiana, which designs individual programs to help the child with special needs with the goal of having each child reach his or her optimum potential. The center follows the DAN! Protocol and offers testing, evaluations, chiropractic care, mineral analysis and nutritional planning to patients regardless of their income.
In Southern California, Rochelle Neally, D.C., is working with Kidstreet Institute in Long Beach to create another unique center for special-needs children. “I want to create a space that is a one-stop place for parents,” says Neally.
She currently offers her chiropractic services to the children at Kidstreet when they come in for speech, occupational and/or ABA therapy. The owner is looking for a bigger facility to create a little village to serve as a resource center.
“I have just finished writing a grant for the National Institute of Health on the neurological effects of chiropractic and autism in children. The American Society of Autism requested the National Institute of Health increase research on autism by $500 million in the next five years. I feel confident our grant is supporting that request,” says Neally.
CranioSacral Therapy: CranioSacral Therapy, or craniopathy, uses methods and techniques akin to Sacro Occipital Technique (SOT).
In a study completed by John E. Upledger, D.O., titled “An Etiologic Model for Autism,” he concluded that CranioSacral Therapy has provided impressive improvements in autistic children by the manual stretching of the restrictive dura mater. Many believe the growth of the skull and brain are contributors to autism and this therapy provides some relief from the membranous restriction imposed upon brain and skull bones.
“Autistic children are not going to lie still long enough, but craniopathy seems to work real nice in that they do seem to relax quite a bit when you work on those areas,” says Blair, who has a 12-year-old autistic son. “When you work with cranial, it is a lot of pulling and holding. You are dealing a whole lot more of the percentage of the central nervous system inside the skull and it definitely has its reactions.”
Chiropractic Neurology: Chiropractic neurology is similar to medical neurology except it uses natural, non-surgical therapies such as adjustments, brain exercises and stimulation by light, heat, water, sound and electricity.
“From my perspective as a chiropractic neurologist, there is inflammation of the brain and the first thing to do is localize which areas are most affected or affected by it,” says John Donofrio, D.C., president of the American Chiropractic Neurology Board. “We do neurological testing by looking at their eyes and putting them through a series of tests with eye movements.”
He adds, “Since the major memory learning system is driven by the cerebellum, we start incorporating the cerebellum to start driving the cortex to function again. We try to start stimulating the cerebellum with exercises as well as sensory input to the different areas of the brain along with proper nutrition.”
Tympanogram: Using an instrument similar to a common otoscope, a group of chiropractors are having good results in preventing ear infections. The tympanogram blows a small amount of air into the ear which bounces off the tympanic membrane to a computer which measures fluid behind the ear.
Neally has been successfully using this technique with many special-needs children. “Some of these kids have chronic ear infections because their immune system is depressed. If there is fluid in the ear, it sounds like everything is underwater.”
Applied Kinesiology: Doctors using kinesiology, conduct examinations that rely on knowledge of functional neurology, anatomy, physiology, biomechanics and biochemistry derived from many disciplines including chiropractic and osteopathy.
|The New Autism
Researchers have discovered that many children with autism exhibit extensive health problems including heavy metal toxicity and leaky gut. Here is a brief list of the major conditions that might be causing a problem.
Digestive Function: Autistic children often exhibit chronic digestive problems that are linked to changes in mood and behavior.
Intestinal Permeability: Many autistic children have “leaky gut,” a condition which may increase their body’s toxic burden and make them more prone to antibody responses to various environmental antigens.
Essential Fatty Acids: Significant imbalances of fatty acids in red blood cell membranes have been reported in patients with autism.
Element Imbalances: Exposure to heavy metal toxins, especially when combined with nutrient mineral deficiencies, pose a threat to the healthy neurological development of children.
Detoxification: An inability to properly detoxify harmful environmental substances could play an important role in autism.
Amino Acids: These basic building blocks of proteins form neurotransmitters in the brain that regulate mood and behavior.
Food Sensitivities: Many caregivers of autistic children report a worsening in symptoms after the children eat certain foods.
Source: Great Smokies Diagnostic Laboratory
Based on a study using applied kinesiology with children with learning disabilities that printed in the British Osteopathic Journal, “All of the children in the treatment group made significant gains in IQ scores… [S]ignificant improvements were observed both at home and at school with regard to motivation, attitude and performance.”
EEG Neurofeedback: Some doctors use this technique on autistic children, but it is most effective with higher functioning patients because it requires concentration and understanding. It is a technique that helps patients train their brain to regulate bodily functions by using a computer which measures brainwave activity.
Sensors are attached to the patient’s head to measure electrical activity which is presented on a computer monitor and the patient attempts to control their brain functions. With this ability, patients have been known to improve sleep patterns, manage chronic pain and control emotions. It is not a cure; it simply helps patients organize the brain to function better.
Nutritional Counseling and Intervention
Most autistic children have food allergies because their digestive system is not properly breaking down certain foods and additives in their diet. Commonly, these children can not tolerate gluten (grain products) or casein (dairy products) aside from food dyes, sugar and yeast.
According to Great Smokies Laboratory, they may display increased permeability of the intestinal mucosal layer, allowing more peptides from foods to enter the bloodstream and trigger immune reactions that may be associated with behavioral abnormalities.
By doing blood testing, laboratories can identify immediate (IgE) and delayed (IgG) sensitivities to hundreds of common foods and environmental substances. With the results, a doctor develops an individualized restrictive diet.
“You can see visual signs like red cheeks, red ears, circles under the eyes, they are all signs of allergies,” says Arturo Volpe, D.C. “We want to build a healthy diet. Gluten and casein may or may not be a problem, but first we have to avoid all the junk foods, the dyes, the additives, sugar. Virtually most of the kids will show some improvement when you start working on the diet.”
|Informative Web Sites
Autism Network for Dietary Intervention – www.autismndi.com
Autism Research Institute (DAN! Protocol) –
Autism Research Unit – osiris.sunderland.ac.uk/autism/
Autism Society of America – www.autism-society.org
Good News Doctor Foundation –
Great Plains Lab – www.greatplainslaboratory.com/home.htm
Great Smokies Diagnostic Laboratory – www.gsdl.com
Natural Health Solutions – www.doctorvolpe.com
Getting Into the Business
The chiropractors caring for autistic children enjoy their work. They all agree that it takes a lot of time and energy, but that the rewards are great.
“I have some kids who have become normal. One of them was severe; he was clearly autistic. He is now a normal first grader although he is a bit quirky. It is a wonderful success. That is a real motivator in this job, you see results,” says Volpe. “You do have to make a special time just for them. You can’t incorporate them into a normal, busy day because it takes too much time. We probably spend 45 minutes to an hour because you might have to take 10-15 minutes just to get them on the table or in a position where you can start working with them,” says Blair.
Attending a DAN! conference is the best way to learn about autism along with reading some recent books (see reading list).
“This is a labor of love. It takes a lot of training and knowledge but it can be achieved,” says Volpe. “The advantage I think we have as chiropractors is that we are focused on paying attention to the person. Chiropractors understand the power of nourishing the body properly because a lot of this can be reversed, maybe not 100 percent.”
Blair says, “There is a tremendous amount of kids that have definitely had marked improvements. I think the adjustments are key. When you combine the adjustment and nutrition, we are one up on everybody else because it has a whole lot to offer. I would love to see chiropractic as the mainstream for these kids.”
It’s a unique practice that can serve 500 or more patients per week. It reflects a special discipline, both in the doctors’ own attitudes, as well as in the fiscal management of such a high-volume business. We caught up with Drs. Abeckjerr, Fenster, Andersen and Hedgelon recently to gain some insight on their practices. Here’s what they had to say:
Dan Abeckjerr, D.C.
Cloverleaf Chiropractic Clinic
North Miami Beach, Florida
Weekly Rate: 650-700 patients
Years in practice: 20
Graduate: Life Chiropractic College
Staff: Three fulltime, three to four part time
Schedule: Three full days, two half days
Today’s Chiropractic: Was it your goal to have a 500+ practice?
Dr. Dan Abeckjerr: It was actually a goal that I had. First I worked for one of the Dynamic Essentials (DE) doctors, so I learned a lot of the ins and outs of running a busy practice. So basically I learned pretty much what he did and I applied it to my office about 20 years ago and it has worked for me.
TC: How did you get there?
DA: We do a lot of promotions where we go out into the community and talk to a lot of people. We do a lot of spinal screenings at different community events that has helped me build my practice. We do lectures; I think lectures are basically the key to educating the patients and basically getting them to understand what chiropractic is. We go to the schools, we do career days, we also do radio shows. We just tell the story, very simple, very to the point. It has worked quite well for us.
TC: Explain how your office processes work.
DA: I start at seven in the morning and all I do in my office is adjust. I don’t do any X-rays or anything else. I have an X-ray technician. All I do is go from room to room and do adjustments. I have the CAs set up everything for me, and I have the technicians do everything for me. All I do is walk in, the patient is lying face down and I just adjust them. I go from room to room; I have little doors between rooms, so I don’t even have to go in the hallway. I just go back and forth, back and forth. It is really simple [in terms of the] procedures that I use; I just do the adjustments. It is nothing really fancy; it is really not impressive at all, I just adjust people and I go in the next room. My lay lecture is very strong, so when patients come into my office, they know that all I am going to do is adjust them.
TC: Do you talk to your patients when they need special attention?
DA: We sit down with them and we talk right there and then if they need to talk to me. But most of the time my patients know what we need to do is adjust them and they really understand that because we explain it to them during the lecture.
TC: Do your patients feel like they get quality care?
DA: Most of my patients, I would say 40 to 50 percent, have been with me about 10 and 15 years, they are long-term patients. Most of them are patients that have been very satisfied with my care, and they consider us like family members. They don’t really want to stay in the office a long time, they like getting in and out. They know I am not going to keep them waiting in the waiting room more than five minutes.
TC: Is your practice mostly cash, insurance or a mix?
DA: It is about 60 percent cash and 40 percent a little bit of everything. I accept all patients regardless of their financial ability to pay.
TC: How do you deal with the physical strain and stress?
DA: I have a rhythm in my practice, I feel like I work long days, so on my off days I spend a lot of time with my family. I like to go out on the boat, so we spend very quiet times just going to little islands near our house. The balance is there and it is really nice.
TC: Who manages the office?
DA: My wife is actually the office manager and she runs the front and I take care of the back. She takes care of everything and writes the checks, and all I do is adjust and take care of the patients. Mostly I don’t get involved with the paperwork—I try not to.
Dan Fenster, D.C.
Manhattan, New York
Weekly rate: 500+ patients
Years in practice: 18 years
Graduate: Life Chiropractic College
Staff: Four employees
TC: How did you get grow your practice to the size is is today?
Dr. Dan Fenster: Getting here is like winning the world championship—work, practice, work, energy, work, money, work, training and work. Did I mention work?
TC: Explain how your office processes work.
DF: Processing of patients is very simple. On the first visit, patients fill out a card that folds and becomes their travel card. It also has room for both clinical and financial info. That’s the card that is used on every visit to the office. I have five adjusting rooms. When the patient comes to the office, they are sent to one of the rooms, lie down and wait for me. After I adjust them they take the card back to the front desk.
TC: Do your patients feel like they get quality care?
DF: I hope all of my patients feel like they are getting good quality. I feel that the quality is based on the product, not the process. Getting results has always been chiropractic’s strength.
TC: Do you talk to your patients when they need special attention?
DF: When a patient has a special need, I do my best to deal with it right then and there. It’s rare that I would schedule a special time for them to come in, but it does happen. In general, patients get the rhythm of the office and I’ve learned to deal with special needs quickly.
TC: How do you deal with the physical strain and stress?
DF: Taking care of me is an important priority. I get adjusted as often as possible. I used to be a runner, but have switched over to biking to reduce the pounding on my body. I also try to stretch as often as possible and get massage frequently.
TC: Is your practice mostly cash, insurance or a mix?
DF: The practice is 50-50 cash-insurance.
Andersen Family Chiropractic
Weekly Rate: 460-520 patients
Years in practice: 12
Graduate: Life Chiropractic College
Staff: Three fulltime
TC: Was it your goal to have a 500+ practice?
Dr. Darcy Andersen: It was my goal. I had gone to DE since 1982, when I was working for a chiropractor down in Miami as a chiropractic assistant for five years. He would take me to DE and I would listen to Dr. Sid saying, “See yourself doing 500.” That is what I visualized myself doing. So after about a year in practice, I was seeing 500 patients a week.
TC: How did you get there?
DA: My primary focus was to see the people and by preparing myself innately, inwardly, it just manifested. The first year I sent out 5,000 flyers and in my first week I had over 125 visits. From there it just kept growing. I don’t do any promotions now. I will periodically speak to a group of people when they ask me to, but other than that it is all referral within the office. I think it is because I prepare myself, I do mediation two times a day, if my intent is to reach and teach the people about chiropractic and how it can make your life better.
TC: Explain how your office processes work.
DA: It is actually very simple, I have three CAs that work for me and I keep it simple. The patients come in, they just receive an adjustment. I think a big part of the practice is that I do an orientation one to two times a week, sometimes three. I always do them Wednesday nights, sometimes Friday morning or sometimes Thursday evenings depending upon the new patients. It gives people a better understanding of what chiropractic is about. Although it is symptoms that might bring them into the office, I am not taking care of them based on their symptoms. So I don’t have a lot of patients that will tell me all kinds of things, and I don’t take care of them based on their symptoms. So when they come in it is very easy.
Now there are always certain patients that address you based on symptoms, and my only response is, “Okay, let’s have you lie down and I will check your spine.” I relate to the patients well and I think that is why it was easy for me to build a practice. I listen to what they are saying, but I know what I am supposed to be doing as a chiropractor.
TC: Do you talk to your patients when they need special attention?
DA: I address them as a whole person, I explain to them that my main emphasis is on correcting the subluxation, but I will address things. I don’t turn their questions away if it is not chiropractic.
TC: Do your patients feel like they get quality care?
DA: When I am with a patient, I give them my total attention—real-time presence—and they react to that and appreciate it. Also, my (C.A.s) will do a thorough case history, because when we do a periodic reevaluation, the patients will realize that all these other health things that came in with that they didn’t even think chiropractic could help, all of a sudden they’re gone or much improved.
TC: Is your practice mostly cash, insurance or a mix?
DA: Some of the insurance might only cover 12 to 15 visits, then after that the patient goes on a cash basis. That is not a lot of care when you are in it for the long term. If someone is just in for symptoms, then their insurance covers it. But I would say I probably have about 40 percent insurance and 60 percent cash basis practice.
TC: How do you deal with the physical strain and stress?
DA: I get adjusted a lot. When you do take care of a lot of people, your body has its wear and tear. I do a variety of techniques, but I use drop tables, so I utilize the table to be able to put the force, so I don’t have to expend as much energy. I work out two or three times a week, but I think the biggest thing is the mediation helping me to keep centered. One of the most important things is that I attend DE four times a year which helps me reenergize.
TC: Who manages the office?
DA: My office manager (a C.A.) can do everything in the office, so she kind of oversees everything. She will process the new patients before I go back to see them, she’ll take the X-rays and she is at the front desk when she is not doing re-evaluations or things like that. It really frees me up.
Paula Hedgelon, D.C.
Hedgelon Chiropractic Center
Pompano Beach, Florida
Weekly Rate: 750-800 patients
Years in practice: 17 years
Graduate: Life Chiropractic College, 1985
Staff: Two fulltime, one parttime
TC: Was it your goal to have a 500+ practice?
Dr. Paula Hedgelon: I wanted a high-volume practice, always from the beginning. When I started taking care of people, I worked at Franks Chiropractic Life Center and saw lots of people. Also, my brother (Dr. Armand Rossi) has a high-volume practice. Basically I just followed the way they did it, and I went to DE. Just by taking care of people and focusing on people getting chiropractic care, principled chiropractic care, it just kind of happened. But my roots were from DE when I was a student.
TC: How did you get there?
PH: First I was with Dr. Rick Franks, and then I went to Florida after I had my daughter, I was in practice by myself in 1988. It took my about five years to get to 500 patients, and I did spinal screenings and yearly open houses. We have a family-oriented practice and people feel warm, they feel welcomed when they come in and they come in groups. They know each other. I have a big referral practice and that is important to because they already know what to expect.
TC: Explain how your office processes work.
PH: I don’t have set appointments; patients come in and I just adjust them. The patient comes in, they lie on the table and I look at them, palpate them, and I adjust them, mainly I start with the atlas. I have a very family-oriented practice, I have lots of children, so I have lots of people come in groups. All of the patients are like family. They come here on a regular basis, just to get checked. We love and care about them, that is the main thing that we do here. We just stick to chiropractic.
TC: Do you talk to your patients when they need special attention?
PH: Naturally I will sit with them, but if they want extra time, I will make an appointment time away from work to have them come at a certain time when it is not so busy.
TC: Do your patients feel like they get quality care?
PH: They don’t want to wait a long time. They come, they get their power turned on and then they go out and they function better. A specific chiropractic adjustment with the extra something and that is what makes them feel loved and that what heals the body. The healing comes from God, it doesn’t come from me, and all I do is step aside and let the healing come from God. The body heals itself.
TC: Is your practice mostly cash, insurance or a mix?
PH: Actually it is 30 percent insurance and the rest is mostly cash.
TC: How do you deal with the physical strain and stress?
PH: There is no physical stress. The more people I adjust, the more energy I have. It is like a spiritual place here. When you are in the flow of adjusting, I don’t have a physical stress at all because the more you do, the more energized I become. It’s like running, you stop and you run, you stop and you run, it is just easier to jog and keep going.
TC: Who manages the office?
PH: I have someone who takes care of everything and has for 10 years. We have a billing service, but she takes care of the insurance that has to go to billing service, the patients, collecting the money, the phone and more.
Some day soon, more than 20 million veterans and their dependents will have a new choice in health care. For the first time in history, doctors of chiropractic will be a part of the mammoth Veterans Administration healthcare system, where they will be checking for subluxations and providing care to former service men and women on a par with medical doctors.
At least that’s the idea behind legislation signed by President George W. Bush last January calling on the VA to make chiropractic care available to all vets. Before the first adjusting table is installed, however, a somewhat reluctant bureaucracy must figure out what this upstart profession is all about and how it can best be used in hospitals and outpatient clinics.
While the idea seems simple in theory, there are studies to be completed and questions to be debated before chiropractors can be hired. When it comes to introducing a new idea into the federal government, nothing is simple.
While the final say on details rests with the Secretary of Veterans Affairs, Anthony Principi, much controversy has swirled around his appointment of a Chiropractic Advisory Committee. The 11-member body—made up of six chiropractors, two MDs, a physical therapist, and a doctor of osteopathy—is charged with issuing recommendations. They must come to grips with sticky issues such as scope of practice, whether chiropractors should be contracted or hired, and whether patients have to get a medical doctor’s permission prior to seeing a D.C.
This is new territory for everyone involved, and the committee members are determined to tread carefully.
“We need to make sure we don’t jump into this just to get chiropractic’s foot in the door,” says committee member Dr. Leona Fischer, an Elmhurst, Ill., D.C. and Navy veteran who serves on the World Chiropractic Alliance’s International Board of Governors. “If it’s done in a haphazard manner it’s not going to reflect positively on chiropractic. So the object of the game is to make sure we have looked at what’s going to work best to get direct access and deliver quality care.”
The committee came together for the first time in September and that meeting was largely consumed with getting acquainted and “housekeeping details,” says member Brian Murphy, a PT and clinical manager of rehabilitation at the VA’s Salt Lake City facility.
The real work will take place in the coming year as the committee members come to grips with the details of the new program.
It is in those meetings that early congeniality is likely to be sorely tested. The non-D.C.s on the committee frankly admit that their own knowledge of chiropractic is limited.
“That’s a concern for me, because I’m not sure how you can advise on something that you have not experienced,” observers Fischer.
To help remedy that problem, Committee Chairman Dr. Reed Phillips directed that the first order of business at the December meeting be a mini-seminar on chiropractic. Each D.C. is charged with delivering a presentation on the ins and outs of chiropractic education, practice, and politics for the benefit of their non-D.C. colleagues..
In addition, the committee plans to visit a site where the Defense Department is providing chiropractic services to military personnel.
“Certainly to see how (chiropractic) has been implemented in the military is one part of it, but also I understand we will be able to witness patients being treated,” says committee member Dr. Cynthia S. Vaughn, president of the Texas Board of Chiropractic Examiners. “They’ll be able to see patients receiving treatments in the room.”
The fact that chiropractic has gotten this far represents a considerable victory. The VA Healthcare System—dominated by medical doctors—has long resisted any inclusion of chiropractic. Many within the medical community are continuing to voice concern over the prospect of D.C.s acting as primary care providers.
The American Medical Association—powered by a $7.3 million lobbying budget—has fought to keep chiropractors from winning the right to be primary care physicians.
The chiropractors themselves must also come to grips with their own widely divergent philosophies. The major associations held together a shaky alliance long enough to shepherd the VA legislation through Congress. No sooner did it pass, however, than the infighting that has long characterized the struggle between straights and mixers flared up.
The ACA argued that members of the advisory committee that participated in the Defense Department’s chiropractic project should be reconstituted for service on the veterans’ panel. When this proposal was rejected in Congress, each organization submitted their own nominees.
Three members of the Defense committee were named to the new advisory body, but there were also representatives from medicine, osteopathy and physical therapy. To the horror of many D.C.s, even Dr. Charles DuVall, Jr. president of the National Association for Chiropractic Medicine, and a longtime ally of anti-chiropractic QuackWatch founder Dr. Stephen Barrett, was also given a seat.
Dr. Daryl Wills, ACA president, believes that “it is very alarming to me that the (VA) Secretary would also choose to include someone like Dr. DuVall on the committee. He is a divisive force, and, in my judgment, does not want the chiropractic profession to gain additional acceptance, nor does he wish us to make progress in any way. I fear that his appointment is a warning sign that the well-entrenched, anti-chiropractic bureaucracy at the DVA is alive and well, and will be working hard to sabotage or severely limit the scope of the new benefit.”
The accusations weren’t directed just at the VA bureaucracy. The ACA was also quick to blame the ICA and WCA for this turn of events.
Writing in Dynamic Chiropractic, Garrett Cuneo, ACA executive vice president, charged, “Once President Bush signed the legislation, the agreement was broken by the ICA and the WCA. . . How much of this disunity encouraged the VA to appoint a committee, which appears to have a majority bias against chiropractic, is difficult to document.”
Committee members are optimistic that the committee will be able to put aside their differences and make the legislation work.
“I know historically the ICA, ACA and WCA have all had contentious issues, but this meeting was wonderful,” contends Fischer. “Everybody was committed to working together for the greater good of chiropractic.”
Long-held divisions between the camps are obvious in the struggle over the VA advisory committee.
The ACA wanted to ensure that chiropractors be able to act as primary care providers, diagnosing illnesses and providing services beyond adjustments.
The more conservative groups such as ICA and WCA pushed for a more limited approach that emphasized adjusting the spine and correcting subluxations.
While the results didn’t seem to satisfy anyone, in the end it seems that just about every viewpoint is represented.
“If we are indeed going to work in a multi-disciplinary facility, I think it probably is wise for us to have input on how our role will be structured by other professions who will be impacted by this,” says committee member Dr. Michael McLean, a Virginia Beach, Va., chiropractor.
McLean believes that differences between chiropractic and the medical approach can be addressed and worked out before the program is launched.
Just how much consensus the committee can reach remains to be seen, but observers say total agreement isn’t necessary or even desirable.
“Federal advisory committees are not required to come to consensus,” says Sara McVicker, the VA official who serves as manager for the committee. “It’s nice if they do, but on the other hand, if you can get all these people with all these views in one room and they all agree, why do you need an advisory committee?”
She predicts that over the next two years, before it expires in 2004, the committee is likely to issue a series of recommendations—some of which may be unanimous, while others come in the form of majority and minority reports championing different points of view.
While the VA is not the first government agency to include chiropractic—D.C.s are already working under contract at various defense department locations—the sheer size and reach of its health care facilities offers tremendous opportunities for exposure. Presently, VA patients have to get a referral from their MD or other provider to see an outside chiropractor under the agency’s “fee basis” system.
“If VA doesn’t provide a service, we send the vet out to someone who is a private provider—in this case a provider of the patient’s choice,” says McVicker.
During fiscal year 2001, just 945 patients received chiropractic care during a total of 10,938 visits.
“That really didn’t surprise me much given the age of our patient population,” explains Murphy. “In my medical center (Salt Lake City) the average age of our patients is 73. Half of the people we treat are over 65.”
Murphy—like many in the medical community—believe patients suffering from osteoarthritis and other musculo-skeletal problems common to the elderly are not good candidates for chiropractic care.
While the details of chiropractic care remain cloudy, one thing that is clear is that a growing number of D.C.s will soon be working in the VA system side-by-side with other health professionals. For many of them it will be a new experience that may very well require the development of new skills.
Some observers predict that the long-term effect on the profession could be profound, as chiropractic becomes more closely integrated with the Allied Health Professions.
“It’s important to realize that virtually all of the work that will be done in the VA facilities will be done in a hospital context,” says McLean.
He believes this experience will have a profound effect on the profession. D.C.s will need to become much more familiar with not only the methods practiced by medical doctors and hospital staffs, but with the nature of patient illness as well.
“There are definitely protocols if you’re working in a multi-disciplinary setting,” he explains. “Many of the patients will have a variety of problems and may be under a variety of different care providers while they’re in the hospital, and we will be one of those. We will have responsibility for receiving referrals, but if a person should have some life-threatening condition, certainly we will have responsibility for making referrals.”
It will present a very different environment for most chiropractors, who are more familiar with a solo office practice. This change is also likely to force chiropractic colleges to begin training students in the skills needed to function within a hospital setting.
“I’m certain it will make a big change in the preparation of chiropractors,” he predicts. “I’m not saying it will change our scope, but we have to be more aware of what other practitioners do, and we have to be more open for professional interaction.”
That professional interaction may also change the way the medical community views chiropractic as well. With more than half of all medical physicians receiving their training in VA hospitals, D.C.s have an unprecedented opportunity to build relationships that can be carried outside the VA.
“For these providers to receive training in a facility where there are chiropractors working will literally change their view of the chiropractic profession,” says McLean.
Clearly, the opportunities for chiropractic are great, and perhaps that explains the passion that surrounds the push to inclusion in the VA. Much still remains in doubt, but to a greater extent then ever before, the profession has been extended the promise of greater acceptance. What D.C.s are able to do with that promise is now up to them.
All 50 states have exemptions to vaccination written into state law but, with the exception of the medical exemption, the right to a religious, personal, philosophical or conscientious belief exemption varies from state to state.
Those who wish to take a religious exemption to vaccination should be aware of the need to exercise this exemption only if there is the existence of a sincere and deeply held religious belief that conflicts with the secular state law requiring vaccination.
The religious exemption to vaccination exists in all but two states, Mississippi and West Virginia, where its absence has never been challenged at the state Supreme Court level. In states where the religious exemption has been worded restrictively, in that it requires a person to belong to a church with a written tenet opposing vaccination, legal challenges at the state high court level have struck down the state’s attempt to force a citizen to belong to a certain religion or church in order to take the religious exemption to vaccination.
In other words, a person may hold a sincere personal religious belief opposing vaccination without being required to belong to an organized religion or specific church that officially opposes vaccination.
However, most states can and do require some demonstration that the person claiming the religious exemption to vaccination holds sincere and deeply held religious beliefs opposing vaccination. This means the person asking for the right to take a religious exemption should be prepared to defend it on spiritual or religious, not secular (i.e., scientific or medical) grounds.
The Supreme Court of Wyoming and recently a federal court in New York have both set limitations on the lengths to which public health or school officials may go to require a person to prove their sincerely held religious beliefs regarding vaccination. However, these boundaries do not eliminate the requirement to give some demonstration of sincerity.
To protect the integrity and legal viability of the religious exemption to vaccination, it is extremely important that those who belong to and practice a particular faith—whether it be Christian, Jewish, Muslim or any other organized religion—do not change their faith or join another church with the idea that it will be easier to take a religious exemption.
The religious exemption to vaccination is protected and can be defended under the law, no matter what faith is embraced. And it is very important for more individuals who belong to mainstream churches to defend their religious beliefs about vaccination within their own faith.
On Jan. 31 this year, New York federal Judge Michael Telesca ruled in favor of a mother, who is Roman Catholic and opposed to vaccination of her daughter based on her religious beliefs within her faith. Judge Telesca said that the mother had “demonstrated her religious beliefs were genuine. … This Court may not pass on the wisdom of [her] belief, nor on the manner upon which she came to hold that belief, provided that she maintains a sincere and genuine religious objection to immunization.”
Religious beliefs are personal and sacred. In order to defend them against all who would challenge their sincerity, the individual must hold them sincerely. Those who choose to take the religious exemption to vaccination need to remember that.