Primary Care

Michael D. Thomas, D.C.

In Florida law, chiropractors are primary care, portal of entry physicians.  It’s a mouth full!  What it means is that you can come and see us directly by making an appointment.  You don’t have to see your medical doctor (who is also primary care, portal of entry) to get a referral.  Florida law places medical doctors, chiropractors, and acupuncturists on equal footing in this respect. 

Yesterday, one of my patients told me that she put me down as her primary physician on a form she filled out. I have had people call me up and tell me they have broken their arm.  They wanted to check with me before heading anywhere else.  I don’t set fractured arms or make casts, so I did, of course, send them on to a more appropriate setting.  No one does everything in this specialized world, but a real relationship of trust and confidence trumps technology and the rushed and all too often impersonal nature of most ‘medical’ visits. 

In our office, I think there are two critical factors that create the care you receive.  One is that we really do care about you as people, and often friends.  I have been in the same office for seventeen years now and I have watched little kids grow up and have kids themselves!  I have cared for people as they aged and grew old too.  The relationships we share are as important to me as they are to you.  It means we move a bit slower and perhaps make a bit less money, but as important as money is, it is not the most important part of life.  On my website, we refer to our office as ‘an oasis of peace in a challenging world’.  Each day we strive to make that true for those of you who find yourselves coming in the door.  And as life continues to shift and change, certainly becoming more challenging, the peace of the office feels ever more important.

The second critical factor in our office is the care itself.  Orthogonally based, upper cervical chiropractic (what you know as NUCCA care) offers the most powerful way I have yet found to remove interference to the nervous system and allow Life to unfold as it is meant to.  I became increasingly unhappy with medicine back in the days I worked at the bedside as a critical care nurse.  If there is however, a place that medicine shines, it is in emergency situations.  When the symptoms of the problem are overwhelming and life threatening, there is no better place to be than in a place where these symptoms can be controlled and reduced.  If symptoms are going to kill you, then it is time to stifle them!  This can give your body the time it needs to restore itself.  This is the great problem I have with medicine and the whole medical paradigm (way of seeing the world).  Medicine sees healthcare as a war.  Drugs are weapons designed to force the body to move in a specific direction.  Most drugs are toxic agents that shut down specific metabolic pathways.  Killing the messenger is not the same thing as being healthy.  Being numb is not the same thing as vitality.  Your blood pressure is normal on medication but at what ultimate cost to your body?  Your cholesterol can be made to reduce to a low level but at what ultimate cost to your brain and muscles? 

Our brains are made to respond to the greatest perceived threat we are aware of.  Medicine can be used to make the acute symptom lessen in a short time.  People certainly like this part.  To maintain this relief, the medicine must be taken repeatedly, usually multiple times every day and in problems that have become chronic, this can mean for the rest of your life.  Every day, you have to take pharmacological agents that interfere with the normal functioning of your body (yes, symptoms are a normal part of function- not one you enjoy, certainly) in order to maintain the relief from the symptom that will return if you stop the drug.  For some problems, this is the best we can do.  For many others, it is a sad shadow of what real healthcare can be. 

There are a couple of ideas that medicine is bound up within that cause them to see healthcare the way they do.  The first one is the idea that stopping the symptom has no other consequences.  Our bodies are incredibly complex systems.  The math (for example) that we have grown up with dealt with simple systems.  This means that if you have an equation, -for example: x+2=y, ‘y’ will always be 2 more than ‘x’ no matter what value you give to ‘x’.  This is how simple systems work.  It was only in the 1960’s (See Mandelbrot if you are interested) that we began to be able to use math to describe more complex systems.  I won’t dive into this topic because it has great depth and breadth, but what we found was that this assurance we had about what goes in being proportional to what comes out was dashed on the rocks of reality.  This became known as ‘The Butterfly Effect’.  The metaphor being that a butterfly fluttering its wings in in the Amazon could alter wind currents a tiny amount and that could feed into other factors in the vast and complex system that the weather on this planet encompasses, ultimately creating a hurricane in Japan.  We refer to this disproportional process in medicine as ‘side effects’. 

We have moved very quickly in the past century.  The scientific method has opened up vast new arenas for us to participate in.  Knowledge has opened up so fast that we haven’t been able to completely understand the effects of our actions.  Just one example would be the use of antibiotics.  Antibiotics changed the face of medicine in the Second World War.  We found a way to go to war with bacteria and win.  Infections that had often been overwhelming before were now treatable.  It is only now, decades later that we see the insidious harm that is coming from our actions.  The overwhelming majority of antibiotics now go into livestock which is then passed on to the environment in feces and directly to us in their meat.  In addition, people have often demanded antibiotics from their physicians for problems not requiring them.  Because doctors gave in to these demands (why else go to the doctor?) we now have a huge problem with resistant micro-organisms.  Many people know about MRSA (methicillin resistant staph aureus) which grew first in hospitals and now is spreading into our communities.  These new ‘super-bugs’ are the direct result of over-use of antibiotics.  These bacteria grow resistant precisely because of the success of the war strategy.  Most of the organisms are killed by the antibiotics at first.  It is the ones that are left that cause us to have this new calamity.  The bugs that are left are resistant to the antibiotic and they have a clear playing field to grow and reproduce.  All the other bugs are gone and there is no competition.  After generations of killing off the weak and susceptible bacteria we are now left with mutant bugs that laugh at the antibiotics.    It will be no laughing matter however when epidemics of antibiotic resistant bugs careen through our society and we may not be so far away from that now.  The effect of these antibiotics in our environment is a whole other matter. 

Remember, when you take a pill, you only use 5 % or less of it for the reason you took it.  The rest of it exits from your system in your urine and feces.  Down the toilet and back out into the environment it goes.  The aquifer below your feet (where you get all of your drinking water) has admittedly low levels of drugs (all of them –from Viagra to birth control pills, heart medications to chemotherapy drugs!) but at levels that seem to be biologically active already.  This means they can begin to affect us as we drink the water we need to live.  I am just getting started but it is already too depressing to go on. 

Medicine should not be a war.   Science has come to be used in a mostly reductive fashion.  This means we use the scientific method to break whole systems down into tiny chunks that can be better understood.  The implication is that if you understand all the tiny chunks, you understand the whole too.  This is not and never has been true.  Complex systems (human beings, the weather, plants,…basically every natural entity) are more than the sum of their parts.  You can take a car and separate all the pieces on the floor.  You can then put them all back together again and the car will start if you did your job correctly.  You can’t do that to Life.  Life is an expression that occurs in wholeness.  The wholeness doesn’t stop at the boundaries of our skin either.  We are intimately interwoven into the fabric of our world.  We are a part of it.  We can’t reject some parts and embrace others.  We are comprised of all the parts: the air that rushes into and out of our lungs many times each minute, the plants that we grow and eat, the people we live our lives with; and today that means almost seven billion of us.  The meanings of our lives directly affect us.  So many people hating their job, feeling a bit more deadened inside each day?  The media that we feel compelled to stare at and listen to.  I hope this doesn’t reflect your life, but there are many I listen to who speak this way.

Obviously I could go on and on but the point here is that we face tremendous challenges in our lives.  More than ever we must find ways to increase our resilience, our vitality.  More than ever it is important to recognize that there is a power of life inside us.  It doesn’t need to be suppressed (the great majority of the time).  It needs to be released!  Frankly, the medicine of our day is primarily suppressive and does not value the power of life.  In fact, this power of life is devalued to the point that it is called ’the placebo effect’.  This is the scientific name for that irritating ability of some people to heal even when they haven’t taken any of the pharmaceutical nostrums.  Sometimes we get better just because we believe we will get better. 

In chiropractic we say that the power that made us heals us.  Our profession has had a difficult and unfocused history.  There are more than two hundred different techniques operating under the rubric of chiropractic.  In some way this is our strength because there have been so many different ways to look at what is going on and how to make meaningful change.  People have been free for many decades to explore the relationships between our structure and our functionality.  The battle between those who want to turn off symptoms and those who want to remove interference to the power of life has been and still is being actively fought within the chiropractic profession.  As usual in these times, those who want to remove interference to the power of life are in the minority.  Upper cervical chiropractic is firmly in this camp.  Many would say it IS our camp. 

It is immeasurably easier to stay in the therapeutic camp.  Everyone likes pain to go away.  It is the interrelationship of all of our ‘parts’ though that can make the goal posts move.  An aspirin for a headache taken once in a great while will probably work to relieve the headache and do no other harm.  It will decrease platelet aggregation for a few hours and that can be a good thing.  Taken by the handful, frequently over a long time and you find 40,000 people who die every year in the US from gastrointestinal bleeding secondary to non-steroidal anti-inflammatory use.  It’s not that it won’t take the headache away but at what ultimate cost?  Now, obviously not everyone who takes aspirins on a routine basis die from GI bleeding.  This is the problem.  Our brains tend to stay focused on the acute issues around us.  Chronic problems tend to fade into the background.  It’s how we are made.  We can’t worry about everything although some of us try! 

The upper cervical adjustment will take away pains too.  Often those who come in for care find that their headaches resolve.   Their dizziness fades.  Their balance improves.  They can take a deep breath again.  Their gut begins to digest food properly again.  Their low back pain and sciatica fade away.  These acute reasons are why people come in to see us.  After twenty years of watching the effect of this care on thousands of people, I believe that it offers more than just relief from pains.  It is truly primary care.  By that I mean that we seem to be able to tune the autonomic nervous system in some profound ways.  Decades of clinical results have shown us that we can restore postural alignment with gravity.  This levels out pelvises and untwists spines.  The NUCCA work is the only technique in chiropractic that has shown the ability to restore normal blood pressure in people who couldn’t get there even on two different medications.  New studies are suggesting that a corrective NUCCA adjustment at the junction between the neck and head can greatly improve blood-flow through the brain.  If further studies validate this, it will be of great impact. 

Doctors who practice upper cervical work have long known more than they could prove.  This sounds facile until you have had the experience for yourself.  As with most things that are not even imagined by the great majority of people in our society, this works progresses one patient at a time and has for several decades now.  Pain often brings people to us.  It is the clarity of mind and ease of body that makes people return to maintain the health they have recovered.  I am confident that our research will finally open the door and allow us to reach to suffering people of the world who desperately need this work and don’t even know it exists. 

For those of you who understand the effect of the adjustment in your own lives, you may have come to see it as one of my patients who told me it is her ‘flu shot’.  I told her I hoped it was a lot more effective than the flu shot!  You may remember a recent blog in which I discussed the ineffectiveness of the flu shot.  According to a Cochoran meta-study, the effectiveness rate is about one percent!  After decades of frustration and inability to publish our work, we are now finding great success.  We are just at the beginning of this road, but we are definitely on our way.  What is self-evident to the person receiving a corrective adjustment will soon be communicated in a form that the world will be able to read.  That’s when it will get interesting!