Monday, April 30, 2012

Medical Doctors Improper Diagnoses

The improper diagnoses that occurs here in Indonesia by the medical doctors is "astounding". So, if you feel you have been improperly diagnosed,......don't just take one opinion......go for quite a few. Don't take a look at someone's position in the hospital as: (higher position in the hospital must mean they know more).
For many of the "old grey hairs" lack even MORE knowledge than the younger generation.
The medical doctors are "OFTEN" not qualified enough in Indonesia to the point it often scares many people to fly to Singapore, Australia or Malaysia for further opinions. I completely concur. If I needed to go to a medical doctor for any type of surgery, I would NOT get it done here in Jakarta. I would be on the first plane to Sydney.

Let me give you an example of the comments some of these "esteemed" medical doctors who are supposed to be the best in their field have made to patients.

A) One man,.....who was touted as the "best" scoliosis doctor in Indonesia, simply told her patient to "buy NEW shoes" to help her reduce her pain of scoliosis. She was told she would live with her pain the rest of her life.

B) Recently, I was told by a 50+ yr old lady that she needed HEART surgery because she had shoulder and intrascapular pain. The doctor said this often occurs because the patient has heart issues. I told the patient to go to that doctor and "punch him in the nose". The patient has a moderate case of cervical radiculopathy.........that's it....She'll be fine in a few months of chiropractic care along with postural exercises and muscle stretching and strengthening exercises.

C) A reversed lumbar curve: The orthopedists all said to this 51 year old man that he needed surgery to help him with his pain.  Outcome? He came for chiropractic care and within 3 months the curve in his back returned and he hasn't had a day of pain for the past 2 months.

D) Another patient was flown to Singapore where they performed a S$48,000 surgery where they cut open his back at L4-L5 put a "CLAMP" on his back (yes,...they charged him this absurd money for this idiotic surgery).......where the surgery was essentially NOT ONLY ineffective, but created partial paralysis of the leg and the pain actually increased......Oh MY GOD!
Outcome?....he came to chiropractic care and within ONE WEEK the pain went away. The pain has yet to return and he played GOLF after the first week. He's been in care with me for almost 2 months now, and instead of a grimace or a sad face,....he now walks in with the biggest smile on his face.

These are terrible cases of improperly diagnosed patients....and it continues on an everyday basis. I sometimes want to slap my head with sure amazement of the moronic decisions by the Indonesian medical  staff.......Please doctors,...I IMPLORE YOU,.....quit trying to make a "quick buck (Rp)" ...and start properly treating the patients.

The Medical paradigm here in Indonesia is set so they usually follow this course that I have written below. I made an example of a typical patient that goes to the doctor...and here is usually what is said to that patient.

E.g. #1 : 55 year old male/ business professional / travels 2-3 a month by plane out of country /
weight and height: proportionate / history of high blood pressure last 15 yrs. / exercises when is not in pain (about 4 hours a week) / in addition to LBPn patient has: altered posture, tightness of upper back muscles, headaches that occur in top of head or behind the head.

Patient :  Chief Complaint: Pain in between the shoulders?           ------------> M.D.   EXAM                    
                                         * pain in neck, stiffness                                            Family Hx> No issues  
                                         * pain is constant                                                      Previous Trauma> none
                                         * "pain goes across my shoulders"                           Onset of Injury> 5+ yrs
                                         * Worsens throughout the day                                 Cz of Injury> unknown
                                        * pt says they have some knee pain also                 > Blood Pressure: 150/100
                                                                                                                        > Small Muscle Test: WNL
                                                                                                                        > Pain killers prescribed
Medical Doctors Diagnosis for this?:  High Cholesterol  or Gout

I cannot tell you HOW MANY times I have heard these "improperly diagnosed" diagnoses.

Proper Diagnosis? : Not enough information to make a diagnosis. More information is needed. Orthopedic tests: Need to differentiate diagnosis.
Is this a Cervical Radiculopathy?..... Often the case.                                
Postural distortion: is this directly related to the problem? Most likely.......
AC joint issues? Would add to postural distortion to ease the pain at directed area
Is there any numbness or tingling down the fingers: Often w/ Radiculopathies
Radiograph's: Convexity of spine?    Vertebral subluxations?  Anterior head                          
                       translation? High Shoulder?  Often help with Diagnosis.
What do they do for a living? - Does their work environment add to their issues?
                       (ergonomics, work related stress, postural distortion during work).
Knee pain :  in this case is unrelated to gout. 1st of all the doctor cannot make that diagnosis without doing a blood test and seeing what the URIC ACID level is. If that level is above 7.0,....then other factors must also be considered. (what does the diet consist of?) Did it start as Podagra (the big toe), did the symptoms occur in the middle of the night? (gout usually occurs at night because it goes to the joint area that is the coolest....(big toe)....then gout works it's way up to the knee joints, hands..., any indications of tophi ? Unilateral or bilateral?  Any signs of inflammation at the joint?, pain is usually so debilitating with gout a patient cannot often walk. Recurrences? How long are the attacks?, the doctor just throws out this word......."gout".......and sends you home.
The patient will then be sent home. Cost: ~ 600,000 Rp including cost of the Rx: (prescribed drugs).

Patient returns to Medical doctor :    CC: same.....             -----------------> M.D.  X-RAYS (RONSON)
Medical doctors look at X-rays much differently than the US/Canadian/Australian trained chiropractors.
The Medical doctors in Indonesia often don't even know how to read the radiographs. They simply read a report. Here are the four (4) things the medical doctor is trained to look for on the x-ray.
1) DJD/DDD  (degenerative joint disease/ degenerative disc disease)
2) CA (Cancer)
3) Anomaly of bone
4) Fx (Fracture)

Medical Doctors look at these 4 things only. They will "assume" since he's a 55 year old male that he's got degeneration.....Yeah, usually the case. SO,.......the "you're just getting older" card comes out. The patient will have some types of degeneration at that age. Often the radiologist won't detect cancer, anomaly of bone or a, the result?.........Rx (more prescribed drugs) and send the patient to PHYSIOTHERAPY.....

Physiotherapy. The patient tends to feel a "little relief" during this time, but will often seek other things to help them with their pain. (belts, shoulder girdles, ointment, patches, massage, TCM (Traditional Chinese Medicine), Shiatsu, swimming, yoga, acupuncture,  heat lamps, ice packs, wraps).....all to try to get rid of the pain as quickly as possible. First of all,......many of the patients who get to this stage generally are living a life without exercise...or exercise is minimal at best. So, they become IMPATIENT. They expect the "magic pill", they go to a few sessions of physic.....don't get the results they want and quit....
Others, will go for 15-30 sessions, ...and realize that physio isn't working for them either.

Patient returns to the Medical doctor:  CC: Same........> M.D.  MRI
                                                                                                 Looking for HNP

General practitioner  will send their patient to either an orthopedist or a neurologist.

Neither one knows what the issue is and will come up with some wrong diagnosis and often LIMIT the person's movement in order to reduce the pain. Some, will recommend surgery (without having a clue what the actual problem is).....they will say.....Nerve impingement.

Nerve impingement can be reduced or eliminated through proper chiropractic care and exercise.

Now,...a HNP is very rare (extremely rare) at the upper vertebrae unless a major trauma (accident) happened. So, what is usually diagnosed is many hours of physio, swimming, reduced muscular activity (restriction), change the mattress,  where a restrictive belt, change positions of sleeping.....and whatever "bullcrap" they can think of that makes absolutely no sense. But, the patients usually buys the doctors misdiagnosis and will go YEARS with living in pain. It wasn't until just recently I just heard that a doctor recommended heart surgery without doing the following:
1) ECG:......was normal.
2) Neurologic testing and send to Neurologist for further evaluation.
3) properly look at the signs and symptoms.......Patient was often out of breath due to the fact her back hurts. I want to SCREAM at the idiocy........Listen doctor....... let's look at the facts.

a) patient has tingling/numbness in fingers.
b) pain in between the shoulder blades
c) NO pain on left medial arm.
d) patient ISN'T out of breath during regular inspiration without activity.
e) Patient doesn't complain of chest pain.
g) blood test : all within normal limits
h) Patient has : Anterior head translation, rounded shoulders, pain upon palpation in pectorals, tightness/stiffness in upper back...but not too painful/...more sore.
i) Patient isn't leaning to one side or another ..or leaning forward to protect their heart.
j) her diet doesn't consist of high cholesterol food.
k) she doesn't have a stressful job

Does any of this sound like a patient who needs Heart surgery?
The patient was properly diagnosed with cervical radiculopathy. Three- four months of regular chiropractic care and exercises (ligament laxity, postural changes, muscle stretching, muscle strengthening),...the patient will be JUST FINE.......JUST FINE!!!!

People? Does this sound like you? Do you know someone like this? It happens every SINGLE day. I get patients in telling me the same bologna all the time.

It's time to put a stop to this and let people know that chiropractic care is the proper solution to many of these improperly diagnosed cases. However, since the medical community doesn't make any "money" off of chiropractic,....they'll never recommend chiropractic to their patients. Become educated people!!!! Learn to get your life back the proper way.

To good long, live strong...   -Dr. G

Thursday, April 19, 2012

Pregnancy and Chiropractic

I was able to SEE the wonders of chiropractic on a pregnant expectant mother, someone close to me was pregnant and I adjusted her all throughout her pregnancy....up until 7 hours prior to delivery.

Zachary Lucismael....the little man that was in the belly of the mom I adjusted regularly during pregnancy!

One of the biggest questions I will get is: Is chiropractic SAFE for a woman and child during pregnancy? ABSOLUTELY YES!

There are 3 trimesters during pregnancy.
First Trimester (Months 1-3)
Second Trimester (Months 4-6)
Third Trimester( Months 7-9)

During each trimester, the mothers body changes to prepare for baby. During the pregnancy the mother's musculature changes. It is important to have the body as ready as possible for a smooth delivery.
* Making certain the pelvis rotated so the pelvic inlet is as accessible for the baby to be born.
* Making the pregnancy as painless for the mother. Ligament laxity occurs in the mother which will allow a larger lumbar lordosis, but this often puts undue stress on the mothers back, often making the mother less mobile and sometimes even bed ridden.

It is important that the mother prepares her body, as best as she can prior to pregnancy. However, if the woman is already pregnant, then taking proper precautions to minimize the pain, increase chances of successful delivery should be her priority.

The mother will often experience a lot of "tenderness", and fatigue, as the body is working overtime to prepare for the fetus. The ligaments in the body start to become more "lax"... therefore if the posture wasn't good to begin with,......this problem will lead a mother right into the path of : low back pain.

People are NOT usually going to change.........This is a problem we must deal with as chiropractors every single day. A person that doesn't do exercises prior to pregnancy, isn't going to wake up one morning and all of a sudden jump right into 30 minutes of exercise...........So, this step has to be slowly done.
1) Doctor must stress importance of exercise
2) Patient must recognize the importance of exercise and the ramifications of a lack of exercise
3) Doctor must educate the importance of chiropractic care.
4) Patient must recognize the importance of that chiropractic care for her body and the importance for the expectant baby. Patient must recognize that chiropractic care is completely safe and harmless to the fetus and mother.
5) Step by step direction into exercises. Walk the mother through it.
6) Postural correction is vital for success during pregnancy. The ligaments are loose and the musculature will act in accordance to what the body is told to do.

Mothers often experience morning sickness, nausea, leg cramping, pain tingling and numbness in the fingers (a cervical radiculopathy), constipation, body aching all the time, sense of smell increases, incontinence, hemorrhoids, body swelling, general back pain, mood swings, general back pain, and body weight changes significantly.

Kegel Exercises are important during this time. It starts to build up the perineal floor....the muscles that support the bladder, uterus and her bowels.

Chiropractic care in conjunction of seeing the gynecologist, and Kegel coach or Yoga/Palates instructor for perineal floor strengthening exercises. (Swimming is highly recommended during the 2nd trimester of pregnancy. )

TO do Kegel exercises one must remember that this a a "contractile muscular exercise"........NOT difficult to do at all.

FIRST, the mother contracts her muscles as if she is trying to stop urine flow or from passing gas. Contract,...let go,....contract,....let go. Mother can perform these exercises while sitting or lying down. The muscles she will NOT want to contract will be the stomach or the buttocks. Once she can do that,...then she is properly strengthening the perineal floor. 2nd trimester : 5 times a day for about 3 minutes each. 

More weight gain, low back pain, bed ridden mothers, cervical effacement and dilation, abdominal achiness, sometimes (as in my friend) morning sickness can continue, neck stiffness, leg pain, brest tenderness, and fatigue.

Chiropractic care at this time is critical. This is the time the doctor makes certain the pelvis is properly rotated for delivery. (This will take a great deal of patient participation by meeting regularly scheduled visits and performing all stretching and strengthening exercises. The doctor will not be able to rotate that pelvis all by him/herself).

In my clinic, I will give in clinic and at home strengthening exercises to perform. The patient will be able to get those exercises from me. The strength and time of the exercises will be determinant on these factors:
1) How pro-active is the patient?
2) What did her back look prior to pregnancy?
3) Signs/symptoms patient is experiencing during the pregnancy.
4) Ability to complete the assigned exercises without issue.

If you are pregnant, or have thought about getting pregnant, need to worry yourself during your pregnancy. Understand that "preparation" is the best medicine...not drugs.

Good Health.

Dr. G

Monday, April 9, 2012

Hurrying Up Care-Plans Isn't the Answer

Many times I will have patients who love to hurry up patient plans. This could be for various reasons. (time, don't see the value anymore, lost interest, financial). Whatever the reason may be, the only person they are doing a disfavor to is THEMSELVES. I will often say this to my patients. HEALING IS BY MOMENTUM.
Your body is like a well oiled machine. But when it breaks down, it's not because it JUST broke down, but it was decayed down , or dwindled down. Meaning, it often took an extended period of time before the body ended up in that state. The pain they feel is a result of that body breaking down over an extended period of time. 

Here's where the problem often lies. The patient no longer "feels pain". If they associate pain as their measure stick,...or determining factor of how well they are,......they will never progress to full wellness. The reason being? Because PAIN removal is often the first part of healing the body, that often occurs. It is often takes the shortest amount of time in the healing process.  

So, what if the healing takes a long time? What if I keep coming back for the same things?
Everybody's body heals at different rates. We often tell patients that within 48-72 hours during the first 3 months, the body will often return to a subluxation. Why is that? Postural distortion, unbalanced muscles, repetitive stress on the job, poor ergonomic repetition, lack of exercise that the doctor instructed the patient to perform, lack of sleep, lack of destressing the body, etc...all play in the role of "return to subluxation". 

I often have a patient come by my clinic, time after time, with the same problems, and when instructing the patient  to change simple ergonomics at work, or practice postural exercises, or perform proprioceptive mirror image exercises,... but the patient FAILS to do so,... the problem will consist over and over. I give the chart of 6 things a patient must have in their live for improved health.

1) Proper Nutrition: (this is working the body on a cellular level). 
2) Proper Supplementation: What you don't get by diet, you get through supplements.
3) Regular chiropractic care: Making sure the Nervous System operates as it should.
4) Proper sleep: can't run a body ragged. You'll run the body down. Lower it's immune system. The body won't function properly.
5) Proper exercise: Again, the body will not function at it's fullest potential if it's sitting all day behind a desk.
6) De-stress the body: Lowering the cortisol stress in the body reduces weight, lowers blood pressure and allows the body to feel "fresh". 
Only ONE of these things requires an outside person to perform. That would be 'regular chiropractic care'...the rest are completely up to YOU. So, ~17% is the chiropractor, ~83% is ALL YOU.

So, as you look further into chiropractic care, you will realize that healing the body is NOT done by the's done by your own body's innate intelligence. We, as chiropractors, remove those nerve interference's and ALLOW the body the opportunity to heal itself to it's utmost potential. If you think you can go through your same problematic situation and still get the same results,...well then, you'll need to rethink about chiropractic, for chiropractic isn't a magic pill. Good luck and good health.

Dr. G