My Take on "Chiropractic Mission" Trips

This post may end up being slightly controversial but it's a subject that is dear to me.  As you know by now, my passion lies within serving the international community so one may automatically assume I'm a fan of chiropractic mission trips? Right? Well... you'd be wrong.

For those of you who do not know what I'm referring to, chiropractic mission trips are trips that are focused on traveling somewhere and adjusting/treating the masses gratis.  The idea behind these, I do support however it is how they are organized, who they are marketed to and the service/disservice that they do, is what forms my opinions.

Throughout my chiropractic education, I've heard tens of stories from students who have gone on these trips. These are my conclusions:

1.  They are not recruited out of a mindset of service but out of a want to travel and experience culture.
2.  No adjusting skills are necessary "we'll teach it to you".
3.  They serve one area for a day or two and no one will ever return to continue care.
4.  The companies who coordinate these trips, make money out of exploiting students.

The students who come back from these trips regale in their long days, adjusting hundreds of people and the boost in their adjusting skills.  Which is fine, they are utterly excited about their experiences and FINALLY feel ready to enter clinic.  But I ask you, why aren't these students focused on honing their craft with their peers and professors? Why do they feel the need to "practice" on unknowing people in an exotic location somewhere?  I believe this misstep to be unprofessional and borderline dangerous.

This?

Or this?

The key is that these students feel theses trips makeup in what they think their institution lacks.  Heck, if you put in front of me the options to go to Peru or to sit in a lab for hours, weeks, months, years to perfect my art.  I'd probably choose Peru too! But what about all of the things you learn from being in the lab for hours? Perseverance, Collaboration, Hard Work, Dedication? Why are we short changing ourselves?

In the mission trip option instance, the patient is the last thing they are considering.  In our field, the patient comes first! To be a successful healthcare practitioner, this is how your mindset must be.  Why aren't we of that mindset when we first step foot into our educational career?  I'm not sure.  Some will argue that being adjusted once is better than never being adjusted at all.  I think that's cruel!  These patients experience a glimpse of hope, perhaps pain-free movement for the first time in Lord knows how long and then you're just going to leave?

IF a "Chiropractic Mission Trip" is a must then at least do it in an area where you can refer them to an office.  Or better yet, GO SERVE THE INTERNATIONAL COMMUNITY and actually make a difference!  Set up a clinic and make cultural impact, don't drop in for a few days just so you can have a resume booster.  It's irresponsible and unprofessional. Rant over.

Updates

Hello everyone!

Just wanted to give a quick update, I spent all of my 2013 summer in Ghana, West Africa completing my final internship under the guidance of Dr. Bryan Cox at The Spinal Clinic.  The experience was more than I ever could have asked for and I am too excited to return and get some larger things started!

My typical Sunday in Ghana, on the beach!

From the awesome experience, I graduated from Life University in September holding the clinic record for adjustments.  To explain that a bit, we don't count total number of adjustments, we count each person in their entirety as one adjustment (no matter how many segments you addressed).  I graduated with over 1,600 making me one extremely experienced new graduate :)

Graduation with my parents and grandparents

I was also extremely blessed with the Student Organization Leader of the Year Award from the Life University first ever Student Services Awards.  I have been blessed to serve the best WCCS Chapter in leadership positions.  Nothing I do, would mean anything without them and their support.

I am still serving the World Congress of Chiropractic Students (wccsworldwide.org) on the Board of Directors and in various capacities.  I am so in love with this organization and all that it offers.  Through my service I have been lucky enough to attend the CCE (cce-usa.org) USDE re-accreditation hearing in December of last year and most recently the National Chiropractic Legislative Conference (it's still my favorite to attend in the United States).  In a few weeks I'll be heading to Malaga, Spain for our 36th Annual General Meeting.  I can't wait to see our members and feel the passion that we all share.

The WCCS Americas Region in Durban, South Africa 2013

Cancer: Everything Happens for a Reason

I've had this particular entry sitting in my drafts for several years now, I think it's time that I publish it (unedited from it's original draft form).

For the first time in quite a while, I am at a loss for words on how to start writing this blog. Let me start by saying that I wake up every morning for my patients. I love each and every one of them dearly and strive every day to make their lives better, they have all become like family to me now whether that's because I'm young and naive or it's a normal feeling that doctors have for their patients, I'm not sure.

This week has opened my eyes up to a grander plan, allowing me to share this once in a lifetime case with you.

A 72 year old female presented to clinic the day after Thanksgiving (I'll never forget the day, I had complained about having the Black Friday shift for weeks, my family came out to Missouri to bring Thanksgiving to me since I would have missed it otherwise). She came in alongside her husband after taking several months off from care. She had no major complaints, just knew that she could use an adjustment. She is in perfect health EXCEPT for the fibrosarcoma on her right distal humerus (arm just above the elbow). Her soft-tissue fibrosarcoma (meaning within the muscles and fascia instead of within the bone) was about half as long as her humerus and protruded about 2-3 inches from her arm. It was an inflammed, heat-generating mass that ulcerated. Being that I'm well on my way to becoming a chiropractor, this was the case of a lifetime, how often are these seen in practice? Hardly ever. I worked her up and she come in every other week for about a month until she started having horrendous low back pain of insidious (unknown) onset. Radiographs were instantly obtained to r/o (rule out) metastasis. The radiographs suggested osteolytic (bone-destructing) lesion in her sacrum.... which means metastasis from the fibrosarcoma in her arm to the sacrum because as we all know, there are types of cancers that spread. Unfortunately, this patient passed away before I could inform her of this new progression...

There will be Doctors of Chiropractic that will tell you outlandish claims in regards to healing cancer.  My friends, colleagues and readers I offer you this:  It is not our place, as the health care practitioner to make these claims (whether we believe them or not), it is our job to facilitate the health of these patients whether it's only pain management or not.  The outpouring of love I was received at her funeral was unreal.  As a student, I felt completely inadequate while overseeing her care, she apparently felt otherwise.

Changes

     It seems to have been ages since I've posted last and so much has changed!  Where do I even begin?  Firstly, I want to thank those of you who read this blog, I've been lucky enough to have students in passing thank me for helping them with their radiology exams and emails from practicing Doctors of Chiropractic.  I'm in awe of my readers, and it humbles me.
     Secondly, CHANGES!  Magnificent changes!  My motto in life, like many others, is that everything happens for a reason.  I've been at Life University in Marietta, GA since the Fall of 2011 enduring a transfer process that has not the easiest, albeit worthwhile.  Something that has not, and will not change, is my passion for Chiropractic on the global scale.
     Since I've posted last, I've been blessed enough to be able to travel to Perth, Australia and Durban, South Africa to the Annual General Meetings for the World Congress of Chiropractic Students, a student run corporation that I am innately passionate about.  Please visit our website and check it out: www.wccsworldwide.org If you have any questions about this phenomenal, on-point, organization please email me! In Durban, my peers elected me onto the Board of Directors and I could NOT be more excited to continue serving our membership in such a capacity!
      I vow to focus on this blog again, as time allows.  Keep focused and stay passionate!

Props to Chiropractors and Ground-breaking research!

I just want to take the time and dedicate this blog to a former prosector and chiropractic colleague of mine, Dr. Frank Scali and his team for their ground-breaking research that discovered an anatomical connection between the rectus capitis posterior major muscle and the dura mater.

Let me first explain the anatomy behind this research. The rectus capitis posterior major muscle (RCPM for short) is a muscle located in the occipital triangle or at the base of your skull at the top of your neck (see picture). The action of the RCPM muscle is to extend the head (like your looking up at the ceiling) and to rotate the head at one of the superior-most joints of the neck: the atlanto-occipital joint.

The dura mater that this muscle has been found to be connected to is a layer of what is called the meninges. The meninges are known as the coverings for the central nervous system aka the brain and spinal cord, and are made up of 3 layers: the dura mater, the arachnoid mater (named for it's web-like connections to it's adjacent meninges layers) and the pia mater that is directly attached to both the brain and spinal cord (see picture). The dura mater is aptly named because of it's toughness and the need to cut through this layer in order to visualize the contents below.

Now that, hopefully, everyone understands the anatomy let me move on to the significance of this discovery, if you haven't already put two and two together. The connection between the RCPM muscle and dura mater is EXTREMELY signifigant. If the RCPM muscle is in spasm, like it usually is in those with tension headaches, it will pull on the dura mater directly effecting the nervous system! Of course, further research needs to be provoked from this study on how much tension, etc is placed and how much muscle contraction is needed to add tension, etc but this anatomical discovery is astonishing and adds to the great body of knowledge and to the future of research.

Lumbar Disc Injuries

Low back pain is the number one condition treated by chiropractors with lumbar disc injuries leading the differential diagnosis categories for each low back pain patient. Let's first discuss the lumbar spine and it's anatomical details.

The lumbar spine is referred to by the non-medically minded as the low back or the small of your back. The lumbar spine is composed of five vertebrae that when properly aligned form a lordosis or inward curvature. Between each of these vertebrae lie a disc or more properly named an intervertebral disc (IVD). The IVD is made up of two components: the annulus fibrosis and the nucleus pulposus, better described as a jelly doughnut. The jelly in the middle of the doughnut represents the nucleus pulposis which is held in place by the actual doughnut or the annulus fibrosis. The nerves that supply the buttock and entire lower extremity do exit the lumbar spine and are often effected by disc injuries.

There are multiple types of disc injuries: discitis, disc herniation, disc bulges, disc fragmentation/sequestration, disc degeneration, etc. What I'm going to focus on in this blog are the disc bulges and herniations. Symptomatology for these two conditions can be identical in the form of radiating or traveling pain from the lumbar spine to either the buttock, the posterior thigh, the posterior knee, the plantar or bottom of the foot or as far as to the big toe. The causation of this pain pattern is determined by the level of IVD bulge or herniation and it's effect on the correlated nerve exiting at that level (see diagram, nerves are in yellow). Disc injuries can also be asymptomatic or cause little to no pain at all.

Mechanisms of injury can include but are certainly NOT limited to: poor lifting posture, sudden rotational moves, over-use injuries, poor lumbar spine biomechanics/support or can be as simple as bending over and picking up the newspaper. Diagnosis for these problems are often quick and are made through orthopedic testing, radiographs (although the IVD cannot be visualized on xray, the space where the disc lies is), and MRI. MRI is usually the "gold-standard" diagnostic imaging preferred for disc injuries as visualization of the lumbar spine osseous structures (the bones) PLUS the IVDs AND the nerves are all possible.

Treatment options are vast from conservative options ie. chiropractic care via spinal adjustments and therapeutic modalities to radical surgical procedures that can involve removing the disc and fusing the two adjacent vertebral bodies together or an insertion of a disc prosthesis.

For research and more information on what chiropractic can do for disc herniations and injuries see the following research:
http://www.ncbi.nlm.nih.gov/pubmed/8976479
http://journals.lww.com/joem/Abstract/1991/08000/Cost_per_Case_Comparison_of_Back_Injury_Claims_of.8.aspx

Autism & Chiropractic

"Autism is a developmental disorder that appears in the first three years of life, and affects the brain's normal development of social and communication skills."

A.D.A.M.

As part of my second clinical nutrition class, I, along with a select few of my classmates, decided to do our term presentation over autism. As a part of our project, we put together a blog so that our information will be put out on the web. The blog does focus more on the CAM or complementary and alternative medicinal approach to treating autism but does offer both treatment paradigms.

There are many different theories on how autism occurs in a child and they range from genetics, diet, vaccine-induced, tylenol-induced, etc. But what it boils down to is how to treat these children. Chiropractic care has been proven to be an effective treatment, post-adjustment many autistic children are able to focus better, have better eye contact, hand figitting stops and their social skills improve greatly. (Improvement in Autism in a Child Coupled with Reduction in Vertebral Subluxations: A Case Study & Selective Review of the Literature Journal of Pediatric, Maternal & Family Health - Chiropractic ~ Volume 2010 ~ Issue 3 ~ Pages 107 -115 and Improvement in a 3½-year-old autistic child following chiropractic intervention to reduce vertebral subluxation [case report]; J Vert Sublux Res. 2008 ;APR(7):Online access only pp. 1-4)

Spinal adjustments are not the only way that Doctors of Chiropractic address autistic children, dietary and nutritional supports are a MUST. I highly recommend that you visit autismandcam.blogspot.com for more information on all of this, there are GREAT research articles, sources and videos for your educational pleasure.

The month of April is dedicated to Autism Awareness, please educate yourself and earn some compassion for those that you do not understand.