Now just imagine you are in the patient’s place.  The scans have something to do with my spine.  The doctor has used the words nerve and stress and I still have some type of back/neck pain.  What the heck do all these colors mean?  What is he/ she satisfied with?  How much longer do I have to come for this problem?

Can you really blame the patient who comes in for spinal related pain, gets told a bigger story about stress, health and wellness and then judges their improvements on their comfort rather than their test results?  Well, before we blame the patient or ourselves, let’s look at the dynamics of the relationship and how we can ensure its honesty.  If you are seriously setting goals that go beyond pain and structure, then the scans are an ideal method of tracking progress.  If you are using the scans to measure NMS integrity alone, then the frustrations will mount within both parties. The starting point for all care plans must be built upon truths and consequences.

Truth#1: the scans identify habits that have been created by the body’s best intentions to maximize it’s efficiencies in light of the subluxated state.  They do not necessarily point directly to the subluxation or the pain and inflammation that may be attendant to the symptoms a patient is feeling.  These habits are identifiable in a variety of neural processing states and NMS positions and motions.

Truth#2: Pain and symptom management are early stage identifiers that the body is responsive to your interventions, NOT that it has healed the subluxation.  Subluxated systems are ridiculously inefficient and protective.  Scanning detects the efficiencies that neural processor possesses and relates them in regional color patterns or scores them numerically against normative scales.

Truth#3: A chiropractic care plan must have goals that identify the needs of the patient, the desires of the practitioner and the reality of the situation.  There are consequences of a short sighted plan and limited adjustments.  If the neural processors are persistently distracted then the system is out of sync and requires a chiropractor’s intervention.  Do your adjustments stabilize the spine, reset the neural sequencing, arouse innate or all of the above? 

Truth #4:  A patient will follow your care plan for as long as they value the outcomes that you are certain of.  If you have developed a certainty that your care model unwinds the neural-dural tension and sets the tone for healing and potential, then the scans will reflect your excellent work.  If your method is focused on structural integrity with the HOPE that the neural system SHOULD release its old habits, then the scan progression can appear more variable. Certainty and specificity wins the day.

Truth #5: Information is free; advice is valuable and at times priceless.  I suggest that you be more certain than speaking in generalities.  Trust your greatness and give exacting advice.  Tell the patient how long you feel it will take to clear a scan or raise the NSFi.  Develop an outcome relationship with the patient.  That’s what they are aiming at.  The days of endless attendance because of the elusive holy grail called wellness, are over. Be a master of your outcomes and assure your integrity with proper communication and commitment on your part.  Celebrate the shifts in the scans as much or more than the improving comfort in the patient.

There are a gazillion more truths to explore in practice but these were the ones that resonated as I wrote this blog.  Send me a whole bunch more of your truths and we can discuss them in this blogosphere.  As Pat Gentempo reminds us, ”You are not alone.”

I’m not going to comment on the selection process in the colleges but the results are evident when the majority of candidates are kinesiology grads with a biomechanical background.  The challenge that faces all DC’s is defining what makes them and their offerings of chiropractic unique. There is certainly nothing that warrants chiropractic uniqueness in a better approach to core training.  For God’s sake lets all get over the distinction between fixation and subluxation.  What makes the chiropractic approach unique is that the “lesion” that emerges as a consequence of altered neural tone and a limitation in the expression of innate is a subluxation.  A component of the subluxation process is a vertebral reaction that may or may not exhibit a fixation in the biomechanics of a segment or two.  We all endure fixations either episodically or chronically.  It’s part of living in a gravity and motion dependent existence.  Remember the original definition presented by Palmer via Stevenson in 1927.  There were three necessities to claim the existence of a subluxation: loss of position and inevitably motion of 2 contiguous vertebra; an alteration and eventual closure of the IVF and most of all an interruption in the expression of the Innately tuned mental impulse. Well, 1 and perhaps 2 are associated with fixation but there must be a shift in neural-dural tone to qualify as a subluxation. 

If you remember my model of subluxation for patient orientation using the three layers concept, then it is so easy to understand that layers one and two associate with fixation while a persistent disturbance interfering with the communication along the 3^rd layer of neural-dural tone means that the person is no longer suffering from the limited biomechanics of a fixation but rather, they are developing devastating health issues related to the loss of vital communication. Subluxations are identified and adjusted by chiropractors and so that is what our role is within the community of healers and health care providers.  We are also incredibly capable of coaching and advising how to optimize the results while under adjustive care and to share and care for people to limit the potential to become subluxated. There is a lifetime of work to do in our communities let alone within the world.

Back to my patient…  I identified that indeed he was subluxated in several regions of his spinal core.  We reviewed his neural efficiency patterns and looked at the destructive changes to his spine. He was definitely fixated in many regions including his lumbo-sacral region. Undoubtedly the tissues in this region were generating tremendous pain and restrictions.  Joints and soft tissues hurt like hell when they are damaged and stressed out.  We identified his limitations in lifestyle management and we laid out a care plan that addressed his immediate issues and offered to care for him through the reorganization time frame encompassing recovery, restoration and finally, wellness care.  He was told that this was to be a collaborative effort for him to achieve the best results BUT if he chose to just use adjustments as a therapeutic approach, that was OK as well.  This thing called an adjustment works whether the patient is totally compliant with lifestyle modification or not.    In my years of parenting and “spine-parenting” I have learned it is wise to be creative in inspiring people to achieve results.  Guess what?  He is feeling better and healing at the same time.    If we were to look at his MRI and biomechanical parameters he would still be in trouble but his neural scans are shifting and easing.  He describes many wellness improvements such as clearer thinking, less night pain and spasticity, improved digestion and more mobility in the spine and he is happy!  It’s probably all a placebo because his structural metrix are all abnormal still.  I agree whole heartedly with the young DC that manipulation of this man’s lower spine is risky and non productive.

 If managing the deteriorative fixation was the goal of care, I suppose all that I would be left with is the surface approach to soft tissue and mobilization with movement.  As a chiropractor my eyes are on the subluxation and if there is a chance to adjust it, and why wouldn’t there be, then this man will improve and heal.  That’s the law of nature that is embedded in the philosophy and the principles, all 33 of them, of the chiropractic doctrine.  Of course there is limitation of matter but so long as there is a life spark and enough time, there is an opportunity to heal on many levels.

It’s just right to be and act as a chiropractor if you are going to call yourself one.  It’s a glorious and noble profession that has spent too much of its time trying to fit its philosophy and practice into the square hole dictated by medicine and chiropractic licensing boards. Be the artist that you know you are and stop defining the care you do as a modified physio approach.  Find the subluxations and adjust them.  There will be much more healing going on at that table and it won’t be limited to the person lying on it.

Happy New Year to all of you who read and respond to this blog. 2010 is already becoming a powerhouse of change. We have filled up the two coaching spots that were available and so my amazing assistant, Linda, has bribed me to open up two more.  You are welcome to call in and see if my communication training and my methods of practice development are right for you.  If not, I get a chance to meet more cool people from around the globe!  Be well and Be Great!

The post today will be of a practical vein as most of the docs that I have worked with recently need an update on the discussion of the GAP.  As you know, my coaching program is styled after that principle hence the name, GAP Coaching.  Remember that GAP is a derivative of Selye’s original concepts of General Adaptive Syndrome.  At Total Solutions, we reorganize the GAS to become the GAP which now stands for General Adaptive Potential. 

In essence, we all operate within boundaries. Thankfully they are not rigid like a set of train tracks but rather flexible and responsive to life’s nuances.  If we look at the opportunities of living big and living on purpose then we would be well served to widen the GAP as often and as much as possible.   As A Dr. Beatrice Berry puts it,” When you walk with purpose you collide with destiny.”

The lower boundary of the GAP represents entropy.  It’s where life energy has depleted and the rigors of daily living have taken such a toll that the GAP is narrow and the dis-ease is the norm.  The lower boundary is where failed decisions come to rest.  The net effect of persistent dis-stress pushes the patient or the person closer to that lower boundary. The lowest level that can be reached is when life energy, the elan vital, can no longer be expressed and death ensues.

The upper limit is actually limitless.  It represents the opportunity of expressing human potential at its nadir.  This boundary is self and evolutionarily imposed.  We mere mortals live with glass ceilings where we can envision what lies beyond but feel the constraints of self imposition.  Who knows when the next barrier to human performance and creativity will be shattered?

At each station in life we develop a state of ease that “fixes” these boundaries.  These set points become our relevant and dominant perspective.  We activate our neurology to allocate a state of ease where physical, mental and biochemical stressors are viewed as eustress (beneficial to growth and maintenance). What is one man’s poison is another’s pleasure.  We operationalize our tasks to use enough stress to get pleasure and enjoyment in life which may or may not be enough to “raise the bar”.  Eventually, we accept these limits until creativity and purpose push us to expand.   So long as the added stresses are deemed to be advantageous to our future well being, the body-mind deems these to be eustress, thereby expanding the limits.  When unintentional stress is applied, a downward force is activated and the GAP begins to close.   This can be from any one or all three dimensions of stress, simultaneously, instantaneously or insidiously.   Regardless, the perspective is altered and what used to be tolerable now changes to aggravating as the upper limit slumps.

 Stress is cumulative by nature and design and so if unmanaged or emotionally charged, a snowball effect begins.  But something worse is at play. This snowballing isn’t linear.  As stress affects the processing in the neural core and perceptions are altered, the original tranche of stress becomes another stress to deal with.  This snowball is rolling downhill, gathering speed and overcoming the inertia that has taken years to develop.   This is now an exponential problem. That is verging on “out of control”. 

Somewhere along this chain of events, the body-mind recognizes this altered state and begins to produce defensive strategies.  This guarded response is to protect and alert the stress owner that something big is amiss.  Sadly the owners are rarely tuned in to their bodily state. In effect they are disembodied.  This shift from stress/ eustress to distress creates a measurable response that we term the subluxation.  It is identifiable through its spinal component, the vertebral subluxation in ways that chiropractors are trained to analyze.  For this reason, we can apply the results of the scanning technology to the concept of GAP.  WE can use the combined score of an NSFi to represent the width of the GAP that a person is operating through at the time of exam.  We can identify where and how deep the stresses( distresses) are being stored and to what extent they are altering the health of the patient by reviewing the thermal scans.  Algometry allows us to measure the sensitivity of the inflamed, upper tissues while inclinometry detects the global guarding associated with subluxation.   Dysponesis is a state of total energy inefficiecy and can be identified through sEMG readings to understand the failing state of energy management in dis-ease.  Finally the HRV is a point of reference for the doc and the patient to see how the narrowing GAP is affecting the patient’s ability to adapt and “dance on the head of a pin.”

As you can see, the goal of the chiropractor is to “widen the GAP”.  Innate allows us to have a GAP and Innate is programmed to widen the GAP so that we humans can accomplish our purpose and destiny.   If distress can narrow the GAP then adjustments can jack it open.  Keeping it open and pushing the boundaries is a combined effort of purpose, chiropractic and hygienic decisions.  I registered the website, www.widenthegap.com for some future project that could inspire, teach and train the world how simple it can be to take charge of one’s health, perspective and future.  Send me your thoughts on how this may look and we can collaborate on widening the gap in our communities. 

So, all of the airports and recycled airplane air have narrowed my GAP.  Writing to all of you has begun the process of easing the downward push on my system.   The healing is in play.  Use the GAP wisely and train your people how good it is for everyone to get “gapping”. 

DocFletch blogs are shared around the world.  Pass on the link and let the scanning and chiropractic communities know that this is the destination to learn and grow as a chiropractic warrior.  I invite all of you to drop me a line in the comments section or do as many do and write an email to docfletch@docfletch.com.  Let’s widen the GAP one patient and one family at a time.

Todays missive is a hit on reviewing  and reporting the sEMG scans.  Lets remember that the raw data bar graph is a measure of the energy that is being expended at every level and on each side to assist the person to sit upright against the gravitational pull. This data is measured against a standard, adult database and so the colors represent 1,2 or 3 + standard deviations above the normal. The yellow bars indicate a deviation below the normal.  It is a useful graph to determine energy use and efficiency as we observe it on a left to right basis, level by level.  We can observe groupings of inefficiencies as whole regions of the spinal musculature react to the stressors of life  But here’s an important point:  At least the body is capable of reacting! Note the patient that has a very quiet scan but is symptomatic and showing activity on the thermals.  Chances are that this is a system that is shutting down, and is no longer full of fight.  Be aware of this phenomenon when the profile is out of sync with the scan.  Alert the patient that a terrific sign could be a colorful scan as the body awakens.

On that point…I had a revelation of sorts today.  So often I set the goals of care for my patient’s to begin with a Release of the neural tension followed by a Rebuilding of newer and healthier strategies.  I now believe that the first comment and goal in care is the arousal of Innate followed by a release of neural tension coupled with a reconnection of the relationships that exist in healthier states:  spine to nervous system; mind to body;posture to energy; lifestyles to longevity etc.  The patient would be coached to understand that despite all medical or outside in approaches, the real starting point is to ignite a spark of consciousness while pulling the weeds so that the Innate intelligence can express itself more completely. The relevance of this lies in the intent and the style of the adjustment.  No problem reorganizing movements and muscle chains.  Just remember the sequence and ask yourself if each detail of that reconnection reflects your life calling.

See I told you that I would get lost in linking the philosophy of care with the scans!

Looking at the three significant neural tests of sEMG, thermal scanning and HRV and developing  a care plan can be a recipe for confusion and even disaster if careful communication and thoughtfulness is not properly conveyed.  As in any physiological testing the win is to see changeability and even change towards a more normal and powerful state.  This is the win that the doctors are all over.  What the patient, inherently sees and resonates with is , “color is bad, make it go away”.  Deep neural stains must release and then reorganize and all that takes time and patience. The answer to inspiring in the short term lies in relating results that are bound to change more rapidly.  Lets face it, you wouldn’t expect a tilted and degenerative xray to show resolution withing 12  or even 20 sessions.  Better but not thoroughly healed.  The same goes with HRV, thermal and sEMG.  However, global ROM and regional inflammatory reactions as measured through algometry can and will change rapidly.  Remember the older dialogue I taught you about the three layers?  Well these two tests are really indicative of a release occuring in Layers 1 and 2.  Clinically we expect a shift here. Lo and behold, what we expect , indeed comes true.  Even the most tonally based techniques and approaches, identify a slackening of neural-dural and muscular tone combined with an easing of reactionary inflammation.

Let’s set ourselves up to win with each and every patient.  Chiropractic always works…when it addresses subluxations.  Use the scans to alert the patient as to their progress and their use the proper scans to help set goals.  Of course a bigger goal is to watch the NSFi increase but in the shorter term, where the patient is evaluating their decision and your skills, set yourself up to win so that they may win.  I guess this is indeed a win-win situation.