Pillow talk

I once made a joke about a pillow never leading one astray.  But ever since then, I've wondered: was I too flippant?  Did I make light of a serious subject?  It's kept me up at night, I've barely slept a wink.

Pillows are important!  The one you sleep with should be soft enough to make you comfortable, firm enough to support you, and attractive enough to entice you into bed in the first place.

I not ashamed to admit that I have spent the night with more than a few in my past. Some were one night stands - regretted as soon as I woke up in the morning with a stiff neck. Others were longer affairs, pillows I'd grown quite attached too, but sadly our relationship had run its course and the time came for a new pillow. Then there were the pillows I met while I searched for 'the one'.  You know the types.  Pillows you stayed with for too long when you knew they'd only continue to hurt you, the pillow you met that crazy weekend at a friend's cottage, the cushions that lured you in with false promises of peaceful slumbers.  And let us not even discuss those pillows from the 'experimental phase' (I'm thinking of you, water pillow).

I'm happy to say that I think I may have finally found the one. My current pillow is supportive but not rigid. Giving and soft but strong enough to maintain its identity. It is blue and orthopedic, and not the type of pillow I thought I'd spend my nights with - but the head wants what the head wants.  Strange bed fellows indeed!

Between us, I've been tempted lately to upgrade to a fresh version, but suffice to say, I'm sleeping well these days. Well, aside from the crying baby - but that's a whole other problem.

Your perfect pillow is out there!  
Hope you find each other.

Happy Chiroversary!

I'm not one for dates.  Sure, I'll say yes if the right person asks, but I'm talking more about the calendar variety - I just don't remember dates very well.  So I'll forgive myself for forgetting a recent milestone - my 10 year chiroversary.

I've been practicing chiropractic for 10 years!  You'd think by now I'd have had enough practice and could do the real thing but there you have it.  Still practicing... after a decade!  And it's weird, because the math doesn't really add up - how can I be at once a youthful twenty-something, and also a seasoned decenial doctor of chiropractic?  One of life's mysteries, really.  But there you have it.

I want my spine mug

And what do I have to show for my 10 years of service?  Files, lots of files, and memories, and experience.  I've gained so much from my patients over the past decade.  I've learned a lot about back pain and joints, about healing, and about not-healing.  I've treated lots of regular cases, and a few fascinating ones.  I've seen so many people get healthier through chiropractic, and I've witnessed time and time again the remarkable ability of the human body to heal.  And I've been honoured to be a part of it all.
What I DON'T have to show for my service, is a spine mug.  For shame, chiro-authorities... what better way to commemorate 10 years of dedicated spinal service?  What have my annual dues been funding?  Research!?


A professor once told us that when we graduate as chiropractors, we will be competent, at best.  He went on to describe how technically proficient we can expect to be after x and x+1 years, but I was too insulted to keep listening.  Competent?  COMPETENT?  I mean, I know rule number one is to 'first do no harm', but talk about setting the bar low.  But after 10 years, I sort of get it.  I remember those first few adjustments - sure they got the job done, but with no finesse, little style.  Experience has given me a great set of hands with which to pat myself on my back and crack yours, and pardon me for bragging, but after 10 years I'm not only competent, but dare I say it... I'm an excellent chiropractor.

And I couldn't have done it without you, my patients past present and future, and your trust and your vertebrae.  I'll be sure to mention you in my speech when I accept my 20 years of service spine watch.

Time for an adjustment!

chiropoetry

It is said that people come into our lives for a reason, a season or a lifetime.  A tad cheesy, but lovely and evocative, methinks.  

This triad parallels the three types of chiropractic care; symptom, supportive and maintenance.  In symptom care the patient is usually acute, and the immediate goal or reason for coming in is pain relief.  Supportive care lasts a season, and the intent is to thoroughly fix the cause of the problem. Maintenance care is ongoing, though to touch on one of the more persistent chiropractic myths, a lifetime commitment is not required.  Chiro- and commitment-phobes, you can relax!

Some chiropractors don't like being called on only for symptom care, they get frustrated when thought of as (back) pain doctors.  They can offer you more than that, they hawk things like 'wellness' and 'prevention' and 'vitality', and to be sure, these are valuable things and I peddle them too, but lots of things have value.  To me pain removal seems pretty damn valuable, particularly to one in such a state.  I don't mind being a pain remover, it may be the one noble thing I can do.

We all experience pain, and yet... what does yours feel like?  I ask you about it; is it sharp or dull?  Constant or intermittent?  Achy?  Sparkly?  Maybe it's green?  And I'll process this information, use it to formulate a diagnosis.  But I'll never really know your pain, will I?  What does it feel like?

It hurts.  Pain hurts. 

I've had pain too, of course.  I've had searing pain and cramping pain and head pain and shooting pain, and labour pain and mystery pains.  Some of these were mild and eased quickly.  Others were more stubborn or more scary, and some made me wonder if I'd ever be be the same again.  I try to remember all these pains, because I think each one carried an important message; of mortality, suffering, redemption, hope, time, of healing.  I try to remember my pains, because I want to understand your pain.  You are more than just a misaligned spine, you feel, you hurt. 

Symptom care works really well for some people, so why deny them that?  They call me when they feel a twinge or a tweak or a kink or a spasm, and I remove it.  If things are simple and not permitted to linger and get complicated (as things are wont to do), then I can often resolve the situation in a few treatments.  Easy peasy, pain removed, and I'll see you next time, if ever or whenever that may be.  Of course many people need more fine tuning than that.  But some of you, the smart healthy lucky genetically superior physically active ones, you respond well to reason care, you'll be OK. 

Reason, season or lifetime.  It is more charming than symptom, support and maintenance, that's for sure.  And some come for many reasons over a lifetime and some seem to come season after season for different reasons, but ultimately, I'm just here to help and crack and realign.  I try to leave you in better condition than I got you, wishing you well(ness) and good health, until we meet again next reason, season or lifetime.

Bad Medicinery

It used to be a simple question, an ice breaker: "what do you do?".  Correct answers included doctor, spy, fireman.  Or maybe you're the guy who puts the ends on shoelaces, or replaces the lightbulbs in street lamps.  I know from personal experience that lightbulbs don't just change themselves, so it follows that someone's gotta do it!  Nowadays, when I ask that simple question, I'm left flummoxed.  You're a systems analyst?  You conduct market share valuations in the bonds and the whatnow?  You say you're a plumber?  I don't get it.

Ask me what I do - go ahead, ask.

Why I'm a chiropractor!  I treat musculoskeletal problems, most often by adjusting the spinal vertebra, though any old joint will do.  See?  Simple.

It's when other people try to explain what I do, that things get a little murky.  For starters, ya'll want to call me a back doctor.  Which I guess is ok, I've certainly been called worse, but why limit me?  I treat backs, necks, hips, a whole lotta shoulders... I've been known to help headaches and feet and wrists too!  I might argue that I treat 'people', not just backs and aches and such, but I worry about seeming sentimental.

There is also the issue of consistency among chiropractors, namely our lack of.  We are a wacky bunch... all doing different things with different instruments and different terminologies, and each calling it 'chiropractic'.  This subject deserves a post of its own, but suffice to say that our lack of clarity with respect to our scope is confusing at best, and undermines our expertise at worst.

But you... the regular people, the non-chiros as you are sometimes called, you ruin our good name.  How can you be expected to understand the intricacies of what we do, when you can't even figure out what to call us?  I meet you at parties, and you ask me how long I've practiced chiropractory.  In line at the grocery store, you tell me that you've had this back pain for a few months, and you've been thinking about chiropractory.  At my weekly kickboxing class at the gym you tell me how chiropactory changed your life.  Fine, I'm exaggerating on the last one - I haven't been to the gym in 2 years.  But still.

People, it's not a word.  Chiropractory.  Not a word!  Irregardless of how sure you are, fact remains: not a word.  It's a ginormous problem, this invented word.  Wanna know another?  Preventative.  Patients often express an interest in preventative maintenance.  And it's a real problem for me!  Because here is someone who values their health, who has come to recognize that it is easier to keep you well than to get you well.  They are embracing wellness and everywhere chiropractic hearts are warming... but me?  I'm stuck on preventative.  PrevenTAtive?  It just sounds wrongly.  Do I then practice alternitative medicine?  And yet, 'preventive maintenance' doesn't have the same zing.  And don't we all want a little zing from our chiropractor?

Also, it's single.  Chiropractic.  No 'S'.  ChiropracticS sounds to me like fireworks, I'm not sure why.  And lest you doubt my expertise on such chiropractish vernacular, let me assure you that I've been chiropracting for almost ten years now.  I'm a chiropractician!

Feeling foolish for calling your chiropractor something unintentional?  Not to worry, no harm done, he's probably just honoured to have been called in the first place.  There are bigger problems in the world than this, right?  Like how to pronounce chiropody.

human v1.2

I'm fascinated by the human body. We are remarkable machines (most of us), at once so complex and so simple. Carbon-based bags of bones, made mostly of water, held together by tissues and guts. Simple! Able to simultaneously break down food into energy and poop, turn oxygen into carbon dioxide, jump and run and swim. We remember and learn and emote and evolve, and all the while, without even thinking about it, our hearts keep a-pumping, our livers keep living, and our brains do whatever they want. That said, there are a few design flaws I've found in human being version 1.0, and I propose the following modifications and updates when the next updates are released.

Appendix. It has been suggested that there is some immunity function from this vestigial colonic appendage. But it often becomes crudely clogged and then infected, necessitating its removal. I propose either redesigning the wee thing so that it doesn't block so easily (perhaps a flush valve?), placing it elsewhere in the body (a more sanitary locale?) or losing the worm shaped poop pouch all together.

Sinuses and eustachian tubes - the openings are too small, the tubes run almost horizontal, fluid can't drain and we are left with a warm, moist cavity = petri dish. Introduce bacteria (tube, meet streptococcus!), and you've got yourself an infection. And then my baby is up all night, screaming and crying. And then my ears hurt. Fix this.

The spine. I'm fond of this structure, it certainly keeps me occupied, but the current design is better suited for walking on all fours than for upright posture. Since the majority of my patients are evolved enough to walk erect, perhaps this is why the majority of my patients also have back pain?

Adult female pelvis. Babies' heads. Might I recommend better size matching?

Spinal discs. I have a personal grudge with the designer of discs. Particularly with whoever who selected the jelly-like substance in the middle. While well suited for shock absorption, add force on to this anatomical jelly donut and witness the innards squeeze out. Onto your sciatic nerve. Four days before your wedding. Love hurts, indeed.

I could go on. Like how about fixing things like inherently weak arches (70% of us have 'flat feet') and unaccommodating eye lenses so I don't have to accessorize with such sexy accoutrements as orthotics and eyeglasses? Then again, some gentlemen dig nerdy ladies. I don't judge.

I just think that after billions of years, we are due for some updates to the human hardware. Or software... or should that be firmware? Cut me some slack, I'm still using my Commodore 64. Let's get on these Sapien improvements. Isn't there an app for that?

Chiropractor's Almanac

There is something in the air, and it is not just love...

I don't know why, but it has been BUSY in the clinic lately. Have all my patients conspired to get sore at the same time? Did you all get together to practice different ways of bending wrongly (is it just me, or does that word sound wrong?)? Was there a limbo party to which I wasn't invited? Has Twister made a comeback?

I'm happy to see you all... but what the hell is going on?!

I've noticed this before. The sudden influx of patients from time to time, all with similar complaints. I've been working on theories.

Theory 1 - a reason for every season
This theory is popular with patients. After every snowfall, I'm asked if I'm very busy these days, what with all the snow shoveling and slipping on ice. And yes, I do see more than a few injured shovellers, but do you know what happens when it is really, really, really cold and snowy out? People hibernate. Perhaps this is why I seem to treat more acute low backs in winter - if you're braving February cold to come in, you're gonna make sure you really need it.

Theory 2 - word of mouth
Say you came in with neck pain. And say I 'cured' said neck pain. You then tell your friends about the fabulous Dr. Fagen who fixed your neck pain, and they'll tell two friends, and they'll tell two friends, and so on, and so on... next thing you know, I'm up to my neck with neck patients.

Theory 3 - ancient chinese secret
When I studied acupuncture, I had the privilege of learning a bit of Chinese medicine theory. It is wonderfully complex and highly structured, and accounts for so many factors, including weather and seasons and energy and the universe. Each season correlates to a different meridian, which governs different organ systems and areas of the body. In the spring I often see shoulder and elbow problems. In the winter, stiffness and low back pain. These findings are explained well by Chinese medicine's 5 elements theory. Hey, a billion people can't be wrong...

Theory 4 - misremembering
Perhaps it is just me. Maybe I'm so eager to prove myself right, that when another acute neck patient shows up during an August heat wave I say A-HA!, but I don't think much of the same presentation any other time? It is possible, I have been wrong before. Once.

Theory 5 - conspiracy...
Who sent you in? Shoulder pain you say... what a coincidence. Why are you really here!!??

Theory 6 - Murphy's Law
The deluge of patients right before the Christmas holidays? The panicked calls in August, during peak vacation time? March break madness? If you've got somewhere important to be... stop in for an adjustment first!

The truth probably lies in the middle of this blog... (well except for the conspiracy theory part (unless you've got something to hide... in which case I'm on to you...)). We are more intimately connected to the earth and it's energies, weather and seasons included, than we realize. And our disconnections, like air conditioning and heating, affect us too, becoming part of our seasonal factors (not unusual for late summer stiff necks to be associated with sleeping under the air conditioner). Sports and activities affect us immensely, especially when we return after a hiatus. It's no wonder my hockey players all seem to ache in the preseason and my golfers will inevitably call me when the greens open. Stress certainly plays a part in pain, weakening the body to exacerbate an injury and making healing a longer ordeal.

Understanding your body means understanding your pain patterns. It is not unusual for an irregular patient (as in 'infrequent', not 'weird') to need treatment at the same time each year... spooky, no? We need to each know ourselves, to know what seasons are our hardest to navigate, to be body conscious when starting new sports and activities, to be able to identify the stresses and triggers to which we are vulnerable. And then prevent them from knocking us down - by stretching more/relaxing/seeking treatment/doing whatever gets you on your feet again.

The truth is out there. In the mean time, get your back treated, and help me with this most valuable research.

Holiday Public Service Announcement

Call your chiropractor.

The holidays are coming up. You're going places! Down south to Kingston perhaps, or eastbound on the 401 to Kingston... just come see me before you go.

Maybe your only plans are to lounge around in PJs, watch Elf over and over again, and eat left over leftovers. Sounds perfect. Visit me first.

The holidays are hard. Too much time with family (there is a reason you moved out in the first place, is all I'm saying...), too much time driving from one partay to the next, too much shoveling, too much packing, too much snow, too much traffic, too much eating, too much shopping, too much schlepping, too much... just too much. Factor in your chiropractor's holiday office hours... spinal mayhem ensues. This is when I get your panicked phone calls on December 22... you put your back out - and you are leaving for Boca in two days! You can't move your neck - and you're on the way out the door to spend four days with your in-laws!

Book your appointment now. 416.482.1332 in case you forgot.

I will be away from the office from December 23rd, returning January 4th. Check the holiday schedule for details.

Consider yourself forewarned.
Call me!

... and have a wonderful, healthy, pain-free holiday!

Tick Talk

They say Time Heals All Wounds.

This prognosis makes me uneasy, both as a wordie (for lack of a better word) and a doctor, because a) I dislike cliches and 2) it's just a way of beating around the bush, no? Isn't this what we say when we don't know when a problem will go away, or even if? Romance gone awry, lingering injuries, problems big and small that we are powerless to mend. Just when you think you are out of options - don't despair! There is one thing you haven't tried - Time! And the good news? It has a 100% effectiveness rate!

Furthermore, there is absolutely nothing in the entire universe that I despise more than hyperbole. All wounds? Each and every one? I assume this extends beyond basic flesh wounds and lacerations, but to what end? Wounds in which salt has been rubbed? The walking wounded? A wounded heart? Does it matter if the heart was broken via love lost or arrhythmia? Dropsy? (Does anyone even get dropsy anymore?)

I say with confidence and authority that time most certainly does not heal all wounds. Like trepanation, reparative therapy and retail therapy, Time as a treatment modality is not guaranteed effective (though I once used retail therapy in the form of these shoes to cure a particularly stubborn cough*).And I wonder - are we ever fully healed from the things that affect us? My own back injuries have been treated and no longer impede me the way they once did, but I still bear the scar and my nerve will never be the same. Am I healed? Does being healed mean that all evidence is cleared? Or just that the symptoms are gone? We are remarkably markable, us humans. Our bodies remember. And if therapy and treatment and ice cream and love can't heal us, what makes us think that something so amorphous (and debatable!) as Time, will?

One of the most common things I hear in my office is "I thought it would go away". Or else the problem seemed to 'go away', but then came back, usually with a vengeance. This is the problem with waiting instead of treating; you risk making an acute and often simple problem into a chronic and complicated one. Scar tissue builds up, compensating muscles take over. Inflammation sets in, pain cycles develop. Sure, healing takes Time, but it also takes effort. And in my experience, waiting and seeing is rarely the best choice of (in)action. All chronic problems started out acute, and only worsened with Time. So much for its healing powers...

So what is it about Time that we have such faith in, anyway? And if it truly is such a miraculous healer, wouldn't someone besides Jim Croce have bottled it up and marketed the hell out of it?

(get it? Time in a bottle? I've been working on an ending for weeks... and all I can come up with is a 70s song reference. But the point stands - when injured, don't wait! Get treated!)



* results not typical

Things that are a pain in the neck

1. The pain between your shoulder blades. You may think you have been stabbed in the back, but unless your name is Caesar, that sharp pain is probably due to a 'pinched' nerve in your neck (and not your best friend!). It is called cervicogenic dorsalgia, fancy for 'back pain originating in the neck', and it is very common. Et tu, Brute?

2. Tailgaters. Especially when you have to keep checking your blind spot, because some jerk is attempting to drive into your trunk.

3. The pain in my neck. Really, it hurts! Fortunately I was able to get an adjustment of my own today. Someone needs to treat the chiropractor!

4. Your flat pillow. Your really fluffy pillow. Your 4 pillows stacked one on top of the other. Find a pillow, one pillow, that gives you sweet dreams and neck support. I like a cervical pillow with memory foam.

5. Necking. Actually, I have yet to see a patient injure their neck while necking. So consider making out a chiropractically safe activity!

6. Headaches. Neck tension and misaligned vertebra in the cervical spine are a major cause of headaches.

7. The albatross around your neck.

8. Rubbernecking. It causes 16% of distraction-related traffic accidents, and whiplash is another major cause of neck pain.

9. Younger sisters. (Hi Pam!)

10. Trying to think of a 10th witty and relevant item to complete this list. Yeesh...

Lunch is on me...

Pregnancy is said to be a beautiful and wondrous time in a woman's life. And it is. But in retrospect, it is also a bloated and hormotional time in a woman's life, and let's face it... a totally surreal and bizarre time in said woman's life. You not only double in size, but in number of people.

As my pregnancy crept ever so slowly to an end, I thought a lot about whether I would miss the experience of nourishing this other, of being able to provide everything it (he) needed to survive. Then I started having contractions, and 3 short weeks later Oliver was born. We got off to a great start breast-feeding, and while nursing him before dawn it dawned on me - aside from baby Gap, I was still the sole provider of everything he needed. Just the method of delivery changed.

I love nursing. I love that my son's chubby thighs are from me (my milk and my genes!), I am privileged to spend every few hours (a little less privileged in the middle of the night) cuddled up, bonding, nourishing... it is lovely. I didn't know I'd enjoy it this much - it surprises me still. It is sort of like discovering that what was previously only decorative is suddenly functional - like your favourite bracelet is also a GPS unit. Breasts - pretty and useful! Who knew?

I realize how fortunate we are, Oliver and I, to have navigated nursing with only a few minor injuries*. This 'natural' process is not so natural or easy for some, and I urge those mamas who have trouble nursing but want to forge ahead to seek out a lactation consultant. Irrespective of how you feed your baby, from the bottle or the breast, poor posture at mealtime will cause discomfort in the upper back; do this every two hours and it can become agonizing. Add in a lack of sleep and bending over a change table... and you get the picture. I'll leave the technicalities of nursing to Janice, my favourite doula, prenatal educator and breast-feeding instructor, but allow me to draw on my dual qualifications as a nursing mother and a chiropractor to offer a little help and some relief for nursing pain and discomfort unrelated to the chestal region.

• Breast-feeding moms, nature and the laws of engorgement are on your side, since they dictate that you hold the baby on alternating sides with each feed. Bottle feeding moms (and dads!), on the other hand will usually pick a preferred side, leading to asymmetry and more pain. Another downside to single-sided feedings is that the baby may develop neck muscles asymmetrically from turning their head in one direction. Consider switching sides, even if holding the bottle in the other hand feels odd at first.

• The most useful prop is a nursing pillow - especially in the early weeks when the baby is tiny. It helps bring the baby closer to the breast, to prevent hunching over. There are a variety of different types, so find the one that works for you. Mine was polka-dotted, that worked best for me. Really any pillow will do, you don't need a cleverly-named one (really - breast friends?) to support things (the baby, arms, low back). Stack pillows under and around yourself and the baby until you are comfortable. It's not rocket science.

• Put a pillow or other support in the small of the low back - maintaining this curve is key. When you collapse through the low back, your shoulders are thrust forward and the neck must compensate to stay upright. Keep the lumbar curve supported, and your upper back and neck will fall into a better position.

• Get a massage! Have someone watch the baby, or ask if you can bring the baby along (they sleep so much in those early days, and many therapists will be happy to accommodate you, especially during slower periods in the middle of the day). At the very least, have your partner attempt a shoulder rub. If anyone deserves a massage, it is a new mom. 'nuff said.

• Get an adjustment! Really... just do it. Your posture has experienced so many changes throughout pregnancy, hormonal changes have relaxed and tensed your ligaments, you now carry around an ever growing load of baby... the stress on your spine is significant. A chiropractor can restore mobility, reduce pain, get things back to normal, whatever that is! The relief from that first adjustment after baby arrives is enormous. Moms... get your back adjusted. Aaah.

• Relax the shoulders. There is a tendency to raise the shoulders when we don't need to! This shoulder hiking happens when feeding the baby, holding her, rocking her... but your shoulders are not needed! Relax them. You can hold the baby just as well with them down, away from your ears.

• Get comfortable at the start of a feeding, so that 10 (or 45!) minutes later you aren't going numb or in pain from holding the baby in an awkward position. In a cradle hold, soften the shoulders and rest your elbow on a pillow, not against a hard arm rest. A food stool is great too, for taking pressure off the legs and low back. In a side lying breastfeeding position, put a pillow under the neck and another between the knees. If Mama's not comfortable, NO ONE is.
  

• Experiment with different feeding positions. Bottle feeders, switch sides, or have someone else take over a feeding or two to give yourself a break. Breast feeders, there are many positions to try, and even though you may have a favourite, mixing it up may prevent muscle overuse. And be creative - you don't need to use the positions listed on a website or breastfeeding pamphlet. Whatever gets the baby to the breast comfortably is good. Lying across your chest, sitting on your lap... really, whatever works, works. Oliver will quite literally latch in any position possible. I once fed him suspended from the ceiling by a series of bungee cords.

Hopefully meal time is an enjoyable one, for all parties involved. Luckily, my young son has a sophisticated palate and really enjoys eating; indeed I am consumed with joy.

*don't let the baby latch onto your chin. It may seem funny at the time, but you will regret it.

Hi Ho, Hi Ho...

Back to work I go!

My maternity leave is over. Though I much enjoyed the time with Oliver, I am excited to return to work, happy to have conversations with people who converse back and who don't drool on me. During these early days I will often have my young son with me at the office, which is convenient for feedings, cuddles and getting an early start on his chiropractic training. It also allows me to use him as a tax deduction - an 11 week old can be considered an 'assistant', no?

There is a lot going on at the clinic now; I am excited to start working with Devon Strachan, a wonderful registered holistic nutritionist who has joined the practice. She is a real foodie who understands that healthy can and should be delicious, and that simple is usually best. Monday night yoga classes are ongoing, and our monthly baby massage classes are a hit. There is nothing cuter than a roomful of nearly naked babies. NOTHING. Of course we also offer acupuncture treatments and qi gong classes and massage therapy, and of course... chiropractic.

Spring is a wonderful time, for renewal, returning to work, getting in shape, getting back into health. Let us know how we can help you fully express yourself this spring.

Welcome to the last resort, enjoy your stay

There is a time and place for everything.  That's what they say.  Actually, Barclay said 'there is tyme and place for euery thynge', but that's the kind of spelling you'd expect from someone who travels on a ship of fools.  The point is I haven't slept in a couple of months... oh, I've already used that excuse, excuse me.  

Ah right.  The point is, there is a time and a place for everything.  Of course, this assumes that I am referring to the observable universe and not the possibility of multiverse, in which case there would be more than one time and place for everything.  But dopplegangers and Hilbert Space are beyond the scope of this blog, so I'll leave the parallel dimensions to the less sleep deprived, to people whose conversations don't regularly include such poetics as "did someone make a poopy diaper?" and "who's mommy's little puppy bear?  yes you are!  yes you are my puppy bear!!". 

The point, for real now, is that there is a time and place for everything.  Of course, this relates to chiropractic, as do all things chiroscope.  See, chiropractic is remarkably effective.  It is safe, efficient and great at fixing a lot of ouches and twinges and whatnot.  But sometimes, it can't. Medicine and surgery, on the other hand, are also great.  Sometimes.  You see?  A tyme and a place for euery thynge.  

Take me, for example (well, I don't see any other volunteers...).  Chiropractic helped me manage my lower back issues for many years.  It still does.  But when the situation became unmanageable, despite my most dogged attempts at all things conservative, surgery was recommended to prevent permanent nerve damage.  It was time to visit the last resort.   And though I was drug-free and as natural as could be during my pregnancy, when my son's heart rate decelerated enough to make my own heart stop, a cesarean section was recommended. Again, I visited the last resort.  

It is not a place you go to easily, the last resort.  It is not a choice destination, but rather a choice we make when it seems we are out of choices.  Both times I have resorted to the last resort, I've been lucky and grateful to have the option.  I'd exhausted all other avenues, and it was the right place at the right time.  

For people who pride themselves on being healthy or able to resist pain, on choosing the natural path or being able to self-heal (uh... me?) it can be difficult to succumb to more drastic measures and interventions, hard to acknowledge that the simple solution isn't going to work this time.  For people whose identity lies in these factors, say practitioners of natural healing arts (me again?), it can be hard to admit 'defeat', that we couldn't fix this problem, that the philosophies and techniques that we espouse weren't helpful, this time.  

I've stayed at better places, but I'm glad to know that there is always an vacancy at the last resort.   

Fight The Good Fight

I am a pacifist. Actually, lately I suspect that I'm also a pacifier, though I try to encourage the baby to not loiter too long after eating. The point is... what was the point? Oh, the point is that I haven't slept in a long time and can no longer hold a train of thought.

Oh! No. The point is, I generally avoid confrontation. If you are going to yell at me, I'll probably just give you what you want to save my eardrums. Please don't tell my child this, though he likely suspects my weakness for shreekiness. Take last night, for example, when I felt that 3 hours seemed like an appropriate amount of time to swing a person. My 10 lb 14 oz opponent disagreed. We compromised, concluding that I'll just swing him in my arms until he starts high school, and he'll never cry again. And it's fine, really it is!

There are some times though, when I cannot walk away from a fight, when standing up for myself becomes not just a matter of principle, but my well-being and possibly my survival. This is when the discussion turns to my health. There are no people more worth fighting for than myself and my family, nothing more important than our health, and no doctor or facility that will ever back me into a corner. Which is not to say that I go around looking to fight endocrinologists or to imply that I enjoy going head to head with psychiatrists. I have deep respect for those in the health professions, especially in Canada where the vast majority are overworked and underpaid for their efforts. Actually, Canada is a big part of the problem. Canadians are the rest of the problem. Oh, Canada.

Because of our FREE! and wonderful health care system, we wait in long lines to see a doctor and are just grateful to be seen. We are less inclined to realize our rights, since we aren't paying for the service (directly) and, well, the doctor knows, right?

But what about when the doctor isn't right, or the treatment just isn't right for you? What if the wait time is too long? Maybe the specialist you were so lucky to get into didn't listen to you or rubbed you the wrong way? Well, then you remind yourself that your tax dollars pay for these services, and you speak up. I realize this is easier to do when you have the vocabulary and training behind you, certainly hospital staff are less likely to think you are just a pain in the butt when tell them you have an acute gluteal antalgia, but even the less eloquent have rights. You are entitled to a detailed and thorough examination and explanation of your problem. You deserve to know your treatment options, including what happens if you don't accept a proposed treatment. You are entitled to seek a second and even a third opinion. You should be free to ask as many questions as you have, even the stupid ones. You deserve to be treated with respect and empathy. We need to understand that when we visit a doctor, we are hiring him to do a job, paying with our tax dollars instead of our wallet. We have rights.

I recently exercised my right to fight the system. A day after checking out of the hospital with my new son, I had to return. The baby was fine, but I was only a few degrees away from having cat scratch fever. The doctor recommended antibiotics, which after confirming that they were compatible with breast-feeding, I agreed to take. It was further recommended that I stay the night, and since I had no plans except to hallucinate my fever away, I also agreed. Then I was told that while I was welcome to stay chez Women's College, for FREE! natch, my 4-day-old son was not welcome, since he had already checked out. The hospital claimed that there was nothing they could do, it was impossible, their hands were tied. This was the best option they could come up with.

And just like Dee Snider, I wasn't going to take it.

To separate a newborn from his mother, his comfort, and his food source because of administrative 'impossibilities' was unacceptable. So much so, that I was prepared to take my medication, go home with my infant and return the next day for my next dose and follow-up, a plan the hospital did not like. After negotiations and help from my husband and midwife, we came up with an acceptable solution, one that satisfied my medical and personal needs. But I wonder what a more timid or 'compliant' patient would have done, and I feel for the patient who doesn't know that they can say no or request a different plan of action.

Fighting for your rights doesn't mean being belligerent or demanding, but rather it means tactfully insisting on getting the care you need. In my health history, this has meant 'hiring' a neurosurgeon, a midwife and an obstetrician, a family doctor, and many, many chiropractors. These experts have helped me to manage different concerns, but always it is me who is ultimately responsible for my health decisions and outcomes. I have declined some medications and taken others. I have refused some tests and demanded others. I have asked for help getting earlier specialist appointments when my body told me not to wait and been a patient patient at other times. I do my best to make my doctors aware of my expectations, my needs, and my preferences, and this way I have been best able to look out for myself, and know that I will always be OK. I hope that you can say the same.

As the Beastie Boys teach, "you've got to fight for your rights"...to party... but it still applies. Give a new mother a break, this was the best closer I could come up with on 3 hours sleep, besides, I'm busy swinging my son.

You Make Plans...

There is a lot of talk these days about 'health plans'. These two words don't always go together well though, 'cause when it comes to your health, anything can and will happen.

I hope this isn't scary, but rather freeing. You might exercise a little or a lot, eat at Burger.King daily or never, follow the rules or break them, and typically, your health will follow suit. But sometimes the exercise freak has a heart attack, and his chubby friend rushes him to the hospital. Sometimes the yogi has low back pain and the weekend warrior cruises unharmed. Sometimes genetics/fate/happenstance intervene, despite (or in spite of) our best intentions.

So what is a fatalist to do? How does one accept that we can't always control or even predict how our bodies will behave? As corny as it sounds, I think the answer is to accept and let go. Search for the message in the event. Listen to your body, really hear what it is saying.

It is not unusual for people to come to me in crisis right before Christmas. Or a vacation. Or a wedding. Back pain often strikes at the worst time possible, in part because there really is no good time to be laid out flat on your back (well, not many good times). Fortunately, there are things you can do to expedite the healing process - chiropractic comes to mind (!), but always, time and patience are required. If you are injured, as frustrating as it may be, listen to your body, hear its message. It might be that you need to slow down, rest more. When we ignore the whispers (ooh, my back is a little tight!) the body shouts (AARGH my back REALLY HURTS!!!). Pay attention, spine owners!

I have a long history of painful back episodes, most coinciding with major life changes, as though my body was trying to sabotage my plans; the first time my back 'went out' was right before I started university. Other major flare-ups conveniently occurred at the start of my chiropractic internship, the week before my wedding, and during the first trimester of my pregnancy. My back is my weak spot and is at risk when I am under stress, and I now understand that I need to take extra precautions ahead of potentially stressful times. I get an adjustment before the vacation, start yoga before I'm stressed, get a massage before I really need one. I try to avoid being shouted at by my body by giving it what it needs, before it NEEDS it.

But it doesn't always work, and inevitably, we all will get aches and pains. So when those old familiar (painful) feelings come back, relax. Cancel your plans, call in sick, visit your chiropractor, have a massage or some acupuncture. Invest in a good reusable ice pack (really people, spend the $5, and make the peas for dinner!) and rent some DVDs (I recommend Arrested Development - even funnier the second time around). Get some rest, chances are you need it.

Remember, this too shall pass.

If I can't have you right now, I'll wait dear...

People have much to say about pregnancy, everyone seems to be an expert. Take me, for example - I've written how many posts about having a baby? And I don't even HAVE a baby!

Old wives, new wives and even my plumber all have tales about what to do, what not to do, what to expect when you are expecting. (Interesting fact: I've dealt more with my plumber than my midwife in the last few weeks. Everything water-related seems to be breaking, except my water.) Now that I'm officially overdue, I hear a lot about how to induce labour. I thought I'd sum up my experiences so far.

• Chiropractic adjustments. These have been a part of my routine this whole pregnancy. Drs Bain, Steiner and Weisberg have all kept me aligned and feeling well. To be honest I didn't bother making an appointment this week, since I'd obviously be busy with my newborn. Ha.   

• Red Raspberry Leaf Tea, said to tonify the uterus. I've drunk (drank? drinken?) so much of this. It is all we have in the house. Even my husband is drinking it. And neither one of us has birthed a baby, yet.

• Prenatal massage. This is not a luxury, but a necessity. Amanda saved me when my back flared up early on, Kaaren kept me going in the middle months, and Kristy has worked her magic on my ribs and hips in these last weeks. I managed to get one more massage in last week, though if this baby stays put, I guess I'll just have to book another treatment!

• Energy Work. I visited with Shawn Gallagher last week to try out some new therapies she has been studying. This is the same woman who taught us hypnosis for childbirth, a class I really enjoyed and will report on after I've had the chance to put her lessons to use. She is a wonderful practitioner, intuitive and calming, and we worked on releasing any blockages or fears that I may be holding onto surrounding this upcoming birth. I felt remarkably lighter after the session with her, no small feat for a person carrying around so much weight! I can't recommend her enough. 

• Stretch and sweep. The midwife does this. On one's cervix. You may feel crampy after. That's all I'll say about that. 

• People have recommended, uh, partaking in certain, umm, activities to induce labour, the kind of activities that get a lady in this sort of predicament in the first place. Ha Ha. That's all I'll say about THAT.

• Acupuncture. Lisa Quaning is one of my favourite people, and without a doubt my favourite acupuncturist. She personifies tranquility and exudes peacefulness. Her treatments are as lovely and relaxing as they are effective. She painlessly inserted the needles, smiling as she suggested that there may be some tenderness to come... and I'll admit it, it was a bit tender.  But the baby moved a lot and got the hiccups, so that has to mean something, right? I will try this again on Monday if I haven't had the baby. 

• Eviction notice.  Unfortunately the tenancy laws in Toronto are notoriously biased toward the resident, who at this point is technically a squatter.  

• Evening Primrose Oil. I took this, though it is hard to say if it worked, because I also ordered in take-out that night. Leading me to...

• Eat spicy food. Indian! Chicken tikka massala, aloo ghobi... yum. But I think it was the lamb vindaloo that got me. Because a few hours later, I woke up having contractions! They increased in intensity and frequency, enough that we called the midwife... only to be accused of the rookie move, jumping the labour gun.  Back to sleep it was.  
  

So, those are my experiences so far. I'm resting now, hoping that tonight's full moon works its lunar magic, but I'm open to suggestions for next week, just in case. I'm thinking: return to work (maternity leave isn't really living up to its name, is it?), trampoline lessons, eat jalapeno peppers, more acupuncture, install new shelving in the laundry room, begging and bribing the baby.

But you know, (love,) there's one more thing to consider - the words of the poet Axl Rose, who said woman take it slow, it'll work itself out fine, all we need is just a little patience...

As the twig is bent...

There is a saying in chiropractic.  Well, actually there are a few sayings in chiropractic, such as "Chiropractic adds years to life, and life to years!"  (incidentally, this was disproved...)  and "See you next Tuesday, Janice".  But one I really like is "As the twig is bent, so grows the tree".  

It is used to illustrate the necessity of chiropractic for kids.  For some reason the idea of adjusting kids is off-putting to many adults.  They picture me cracking delicate little spines, crunching tiny vertebra.  They reason that kids don't, or shouldn't, have back pain, that this is an affliction of the middle-age, like arthritis and mom-jeans.  

I'm not going to convince you that your children need to be adjusted regularly, I'm not convinced myself.  If it ain't broke, don't fix it, right?  But what do you do for the 8-year-old complaining of back pain?  Or the 4-year-old who fell really hard on his bum at the park? Maybe your child has been having unrelenting digestive issues but has been cleared by every specialist in town... and you've heard that chiropractic just might help??  What then?

Then bring that child to the chiropractor.  Find a doc who is comfortable working with little kids and little spines.  Learn how gentle adjustments are on children, the force proportionate to the person.  On tiny babies it is really more of a gentle, sustained pressure at a specific spot! 

We ask a lot of kids.  We encourage them to be active, making them vulnerable to the usual sports injuries, then sit them at a desk all day long like adults, predisposing them to postural problems.  Yet we are shocked when little bodies hurt, and often reluctant to treat them.  "Dylan shouldn't have back pain, he is only 10-years-old!"  Can you imagine doing this with any other health problem?  "Little Madison shouldn't have bronchitis, she is only 10-years-old!".  Pain is just as real and important in kids as in adults, and they are no less deserving of treatment than we are.  

One of the best things about treating kids is their lack of attachment to their aches and pains, combined with their short attention spans.  Most of the time when I treat a child, only two or three visits are needed to 'resolve' the problem.  They just... get better.  When I ask at follow-up how their pain is, they often shrug and say 'fine', as if only 3 days ago they weren't complaining about the pain and asking to be let out of gym class.  They just... get better.

As a chiropractor, I enjoy treating kids if and when it is appropriate.  As a parent-to-be, I'll treat the spine of my spawn the same way - conservatively, if and when needed.  I don't plan on ignoring their problems simply because they seem too young to be having them, and I don't plan to include back problems in their inheritance.  

So back to that saying.  As the twig is bent, so grows the tree.  Injuries in childhood can become big problems in adulthood.  Taking care of them early, nipping them in the bud as it were, will encourage good posture and spinal health.  

Comings and Goings

I can't believe it is already now. Today, or soon from it, once seemed so far away. Impossibly far away. Unbelievably far away. In the spring, when I first considered the passing of time and what it would bring, the seasons seemed resolutely unchangeable. But it's astounding, how time is fleeting... almost like a time warp.

And here we are. Now is the winter of my content, and I'm full with child, (yes, still only one in there...), due in about 4 weeks, getting ready to take a break from work to do... well, I'm not quite sure. Other work, I suppose - more motherly, less chiropractically.

We all must leave sometimes, right? Change is good, right?

I will likely start my maternity leave around Christmas, just like Mary did. I anticipate returning to work... sometime in March, in part because our socialized government never thought to extend any maternity leave benefits to self-employed women (If I were the type to get angered by unfair politics and policies that punish female small business owners, I'd surely blog about this sort of thing...). This is of course dependent on the whims of my new boss and his feeding and sleeping schedule.

During my baby sabbatical, my patients will be attended to by Dr. Alanna Steiner and Dr. Zachary Bain. Many of you have already met Dr . Bain at the clinic, but please allow me to introduce Dr. Steiner, an extremely caring and competent chiropractor.

Dr. Steiner's technique is remarkably similar to mine, and I will be in regular contact with her to make sure that she is up to date on the details and particulars of any patients she will be treating. You'll be in good hands!

Remember, although I'll be absent physically (and mentally from what I hear - apparently Baby Brain progresses to Mommy Brain) for a few weeks, I'm never really gone. I'll be posting blog updates (chiropractic! babies! random thoughts!!) and I'm always reachable some way or another... in the meantime, I'm still here, so get that adjustment while I can still reach across the chiropractic table!

My Hips Don't Lie

Today's blog post is about hips.

I know... you think you know 'the hips'. Often curvy, located between the thigh bone and the back bone. (Oh, those bones, those bones, those crazy skeleton bones.)

But when patients come in complaining of hip pain, it often becomes obvious that one of us didn't pass Anatomy 101. "My hip hurts", you say, pointing to your waist or lower back. "Fix my hip" you insist.

The picture to the left was found by Googling 'hip pain', though I'd refer to that area as the low back, the upper glutes, or even the 'iliac crest' if I thought you'd be impressed by that sort of thing. True hip joint pain will present in the front near the groin, as demonstrated by the picture to the right. Note that these are my favourite patients, the ones who present with their bones visible through their clothes and the problem highlighted in bright red. Makes for an easy diagnosis.


Just so we are clear: the hip joint proper refers to the connection between the femur (leg bone) inserting into the pelvis. So in fact, the thigh bone connects to the pelvic bone, and I don't really know what the hip bone is. It is a fascinating joint, the hip (to me anyway... though my favourite joint is the shoulder. Fun!), influenced by a host of muscles like the iliopsoas and the gluteals. It is a stable ball and socket joint, which sacrifices mobility for stability. This means that it is strong enough to hold up your hefty 'hips', Beyonce, but just mobile enough to let you walk, and rarely mobile enough to do the splits or the cancan.

I've had some of my own hip pain lately, thanks to a certain fetus who shall remain nameless (Especially if it is a girl, seriously, we can't agree on a name. Suggestions welcome...). This is a common pregnancy complaint, hip pain, due to pressure from the growing baby directly on the pelvic joints as well as muscular compensation around the area. In my case, the baby was positioned diagonally, the head pushing against the inside of one side of my pelvis.

Funny thing, it felt just like someone was pushing my pelvis apart from the inside.

My relief came in the form of massage, pelvic adjustments, and the baby committing to a more head down position. A complete cure for my particular condition apparently involves becoming a parent. Fortunately, most hip pain problems are much simpler to treat. Hip pain from arthritis is often managed with a combination of massage and modalities such as ultrasound, as well as nutritional supplements like glucosamine. Hip pain in runners is commonly due to iliotibial tightness and can be relieved by releasing that muscle. Hip pain may also be due to bursitis, a local inflammation that responds to ice and rest.

Tragically, hip pain is often misdiagnosed due to simple anatomical confusion. (Tragically Hip pain is entirely different, often due to pain in little bones, but can be fully completely treated.*) The important thing is to really understand the origin of your 'hip' pain, and treat it accordingly.

So, Shakira, your hips may not lie, but they sure are misleading. Work that into a catchy tune.

*I'm so sorry for this... so very sorry.

Top Ten

We all love David Letter.man, right? (Please don't tell me you watch L.eno...) He is funny, Chiropractic is funny, so it was only a matter of time before his writers came up with a top 10 on this subject. Granted, though, it was aired in 1994, and a lot has changed since then. Like now maybe Jon Stew.art is funnier.

Letter.man's Top 10 Signs You've Gone to a Bad Chiropractor

10. When you walk, you make a wacky accordion sound.

9. Keeps saying, "A spine is like a box of chocolates."

8. Repeatedly asks, "You a cop? You sure you aint' no cop?"

7. Over and over, you hear crunching sounds followed by, "Uh-oh."

6. There's a two-drink minimum.

5. At end of session, lies down on the table and says, "My turn!"

4. He was nowhere near Woodstock and yet he's covered with mud.

3. Rushes in late to your appointment still wearing his Burger King uniform.

2. Hints that for an extra $50, he'll "straighten" something else.

1. You're fully clothed and he's naked.

Ha! Ha!
Since I'm a funny gal, I'll counter with a top ten list of my own. Except it won't be as funny.

Dr. Fagen's Top Ten signs you need a Chiropractor

10. You make a crackling sound when you nod yes or no.

9. One of your legs is longer than the other. Seriously, if you find yourself walking in circles, your seamstress has to do more work on the right leg than the left, or you just notice being 'off' - this can indicate pelvic unleveling, a major contributor to back pain.

8. Old people comment that you walk like an old person. Hunched is not flattering on anyone.

7. Your back pain is affecting your social life. When you are not just in pain, but can no longer participate in the things that make life enjoyable - well, you are choosing pain over life. See a chiropractor.

6. You are known as the 'girl with the bad back'. C'mon... there are better ways to get a reputation!

5. Your fashion is dictated by pain.
When your low back demands that you wear orthopedic flats all the time or carry a (gasp) backpack purse, you need a chiropractor.

4. You can't check your blindspot. Drive (carefully!!) to the chiropractor at once!

3. The top shelf of all your closets is wasted space - because you can't raise your arm to reach there. Did you know that chiropractors help shoulders?

2. You've tried everything else! We love a challenge...

1. You are moved to tears by the robax.acet commercials... you really relate to that dancing wooden puppet!

Danke schön, darling, danke schön...

We shouldn't need fowl to be outwardly appreciative of our blessings. This year I've decided to kill two birds* with one blog; declare my gratitude this Thanksgiving day and produce yet another sincere and moving blog post.

I am thankful for my health. Really, we are all really just a carbon-based bag of bones, our bodies guaranteed to last a lifetime, the caveat being that the definition of 'lifetime' is subject to change without notice. So I'm grateful to be healthy at this moment.

I am also grateful for my experiences with poor health. My biggest challenges have been lower back related, though without having those experiences I may not have found my beloved vocation. My experiences with herniated discs gave me perspective and insight into my patients' suffering, and the ability to truly sympathize with my fellow disc herniators. We are a brave bunch. That said, I am forever grateful to my neurosurgeon, Dr. Tator. I doubt there ever was or will be a more competent or patient surgeon.

I am grateful for the little person inhabiting me. We haven't formally met, but I've got a good feeling about this. What an experience so far.

I am thankful for the internet - really, what did I do without it? So, thank you, Al Gore. I am thankful for my readers - those who read my silly posts regularly and those who pop in from time to time. I'm even thankful to those readers who find me by searching phrases such as "good chiropractor jokes". Hope you find some knee slappers here.

I am grateful for knowledge. As a self-declared (and other-declared) know-it-all, I love knowing stuff. I also love that there is so much that is unknown, unknowable... that some of the the most beautiful things are mysteries - love, the universe, where we come from and where we go when we are done, what really happened to Mikey from the Life cereal commercial. These things cannot be proven, and where there is no proof we are left with possibility. How lovely. I guess then, that I'm grateful for that too: possibility.

Finally, in keeping with the theme of this blog, I'm grateful to be a chiropractor. To have wonderful patients who put their trust and spines in my hands, to work with amazing associates who teach me and treat me, to have found something I love to do so as to never have to 'work' a day in my life... for these things I owe thanks.


*no birds were harmed in the writing of this post.