Hyde Park Corner has some thoughts from my soapbox.
Looking back on an extended period in the Netherlands, seven full, fruitful years, hopefully not followed by an equal number of lean ones as one patient quipped, I reflect on this gracious time of our lives. Tomorrow we leave.
Four months later I've had a good deal of time to think about what I should spend the next ten years of my life. Every chiropractor knows dozens of patients who retired and within two years had died of boredom.
I have other RETIREMENT SENTIMENTS.
And now 13 years later still finds me in fine fettle, with the blood pressure of a teenager and the same weight as when I left school; the good wife and I still take no medication. The emphasis has shifted to plenty of nutritious, organic food from our garden and plenty of exercise. We both need occasional but regular chiropractic adjustments.
It is so good at 75 to be enjoying a life without medication.
I came to the Netherlands seven years ago, specialising as a "back doctor," with an interest perhaps in diet and the chronic diseases; but few skills in the management of so many other conditions that respond well to Chiropractic, unaware how much there was still to learn.
This was a period that echoed that of Michelangelo, quipped at 85 reported. "I'm still learning."
Hyde Park corner considers the need for a large toolbag so that one can help more patients.
One of the first courses attended was on the TMJ. It wasn't long before I began to appreciate the intimate relationship between the jaw joint and the upper cervical spine where the sensory nucleus of the Trigeminal nerve is to be found.
Extensive reading, and plenty of patients on whom to practise, I quickly discovered how much more Chiropractic has to offer to the patient suffering from migraine, jaw joint pain, facial pain, trigeminal neuralgia and very occasionally tinnitis, and even one case of deafness. Perhaps DD did it after all!
Slipped into that course was my first introduction to the management of Vertigo using the Epley manoeuvres and unknown tests like the Hallpike Dix test. How this revolutionised my chiropractic practice having so many more tools to manage the dizzy patient.
Whilst I have caused my share of Chiropractic Iatrogenic Illness or doctor-caused disease, it is difficult to beat the scope and severity of the side effects of drugs. Of particular concern is the disastrous effect of taking more than one anti inflammatory medication (eg Motrin plus aspirin) on one's quality of life.
Three FICS seminars with experienced Olympic Chiropractors gave me a totally new outlook on the upper and lower extremities. Tools for Monday morning enabled me to start the management of conditions like Carpal tunnel syndrome, severe foot and ankle conditions, and most marvellous of all, the hip joint.
The knee remains an arrow yet to find a place in my quiver.
Long had I known that the young hip could demonstrate arthritic-type signs of stiffness, pain and limited range of motion, but it was a radiological seminar with the inimitable Dr Michelle Wessely that introduced me to Femoro Acetabular Impingement syndrome.
Coupled with skills learnt at FICS I soon realised that Chiropractic has much to offer to the patient suffering from hip joint conditions.
Self study soon led me to an interest in developmental hip dysplasia and Hip arthritis. More skills meant helping more patients... I had no need to actively grow my practice.
As patients found that their chiropractor could manage their foot pain, frozen shoulders and their children with hip dysplasia the appointment book started to fill of its own accord.
Meralgia paresthetica has no acknowledged medical treatment, yet soon I found chiropractic had solutions for this stubborn condition too.
I hold only three things against my alma mater where I received a marvellous education under the guidance of the famed Dr Janse. One was that we spent months dissecting the mysteries of the omentum, the large intestine, the bladder... and there was no time left for the upper cervical spine, for the inner mysteries of the ankle, knee or hip...
The second was that I graduated under the impression that only hip arthritis and inguinal hernias caused pain in the groin, and to neither did Chiropractic have a contribution to make. What a misconception!
The third is that the work of Dr Clay Thompson was never mentioned. Two weeks spent with an elderly Palmer graduate in my fourth year in the Netherlands completely changed my outlook on the management of the pelvis.
Suddenly I was able to help older folk, mainly women for some reason, suffering from failed total hip replacement surgery, unable to walk with horrific pain in the hip and sacroiliac joint.
Sacroiliac Joint treatment is uppermost in every chiropractor's training, but there are so many different techniques.
A chance happening on a pamphlet on the chiropractic management of rib conditions brought new insights into a condition that had evaded my successful intervention for twenty-five years.
Suddenly new vistas of rib conditions, costo-chondrosis and their relationship with hiatus hernia were opening up to chiropractic management.
As a "back doctor" I now realised how limited my management of patients was. No wonder we Chiropractors never treat more than 10% of the population.
With new skills came a new confidence. Gradually, an interest in nutrition, never far from my heart, I was able to help patients overcome the ravages of obesity, with high blood pressure and diabetes; constipation, stop smoking and rehabilitation therapy too.
There is an enormous vacuum that medicine gives lip service to, prevention is better than a cure, but in practice it seems that only a minority of doctors venture therein.
I have always had a deep suspicion of practice building seminars. Chimes Consulting helped me understand that even the very best chiropractor in the world cannot help many people if s/he is unable to manage his patients properly.
Thank you John and Terry for giving me a new understanding of our patients; not how to squeeze more money out of them, but educating them to the benefits of Chiropractic, and how they can best benefit from what we have to offer.
Placebos have been clearly shown to be superior to no treatment at all; what are the ethics on the subject? Is it okay for a medical doctor to prescribe an NSAID for a condition for which it's known not to benefit?
Or for a chiropractor to adjust the cervical spine, when no
subluxation has been found, just to keep the patient happy? That's
another Hyde Park Corner question?
Read more about this thorny question at placebo special needs.
Firstly, there will now be time to do a literature search on the contribution Chiropractic has to make to the hip joint, followed hopefully next year by an MSC and who knows perhaps even a a PhD. That is probably wishful thinking, but it's good to dream.
Two short courses are in the planning; the management of Meralgia paresthetica and Tietze's syndrome, available only to Chiropractors and full-time students.
Then there is a whole new development: videos for Chiropractic Help. The first very tentative step, Introduction to Lower Back Exercises is complete.
Without a dream, a goal, Thomas Edison's hard work, stick-at-it-itis and a modicum of common sense there would never have been Bernard Preston's Frog in my Throat, Bats in my Belfry and Stones in my Clog.
Nor would there have been a Chiropractic Help, attracting more than 50 000 unique visitors per month. To dream, to do, to make it happen.
Few things excite me more than setting up practice with my daughter Dr Jane Ackerman. With two grandparents, Drs Dick and Unity Lewis DC (Palmer 1944, Lincoln 1945) in the genes, we are certainly going to make things happen!
Nope, I see no time for sitting behind the Cape Viooltjes; geraniums, as they say in Holland). There is still too much to be done.