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Notes from the Practice of Harold Goodman, D.O.

Follow this blog at a new location.  Sunday, October 12, 2014

I have been working on developing a real, honest-to-goodness website for a while. It also includes a blog for posts similar to the ones presented here.

www.drharoldgoodman.com

I will be posting a lot more frequently at the website and also make it easier for you to contact me.

Harold Goodman, DO
Silver Spring, Maryland
Washington, DC

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Hemorrhoids can be cured. Naturally.  Sunday, August 25, 2013

I recently worked with a patient, male, 75 years of age, who told me that ever since he was quite young he has suffered from painful, persistent hemorrhoids.

At age 15 he had an operation to solve his problem. It involved excision of a fistula and a number of hemorrhoids. The hemorrhoids continued to plague him for the last 60 years.

I was treating him for other things and he mentioned that the hemorrhoids were not responding to topical cremes. He was in worse pain than he normally was in. He had just accepted that he would live with the problem, the pain, forever.

I told him that this was unnecessary and that I would like to examine him to check what was causing his hemorrhoids.

I found that his pelvic floor, the muscles and connective tissue ( fascia) that surround the floor of the pelvis and via which the colon and the rectum pass, was very tight. The veins were being squeezed to the point where the fluid flow ( blood, lymphatics, intra and extracellular fluids) was being compromised.

Hemorrhoids are veins which have become inflamed. That is why anti-inflammatory cremes can provide temporary relief.

However, the problem, which is that the veins are not properly functioning due to being strangulated by the adjacent tissues through which they must pass, is not relieved.

And so the problem continues.

We can cut out the hemorrhoids or put rubber bands around them to destroy the venous tissues. These are very common surgical responses to this problem.

But as long as you continue to have veins in the area, which are essential for the body and without which you couldn't function, the same problem will persist.

There is a solution.

It is actually quite simple.

The physician puts his hand in the area via the inferior aspect of the pelvis and releases the tension in the pelvic floor especially that in an area called the ischial rectal fossa.

I learned this in osteopathic school. It was a standard part of my training as an osteopathic physician.

I examined my patient and found that his ischial rectal fossa was tight as could be. No wonder he was having strangulation of his veins there. No wonder they were becoming inflamed and swelling, causing pain.

I performed what we call an ischial rectal fossa treatment bilaterally as well as got his pelvis and adjacent structures functioning. His lymphatic system was opened up from the thoracic duct where it dumps into the venous system and all along the lymphatic routes. The downward pull of the anterior fascia was released.

I also tested him for Hamamelis virginiana ( witch hazel) in homeopathic form. This is an old remedy for hemorrhoids. I told him to take it until he felt relief and then to stop it. The purpose of the remedy is to get the ball rolling. Then the body does the rest on its own. He stopped the homeopathic pills after two doses since he felt so well.

The next week he returned and reported total relief of his hemorrhoid symptoms.

Examination of the area revealed that the veins were no longer swollen nor inflamed.

The patient, who is used to this type of response, was happy and so was I.

Osteopathy and homeopathy combined with a knowledgeable physician helped this patient.


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Examination/ Treatment from the Heart Center  Tuesday, August 30, 2011

Today I saw SC, a five week old girl who was born to LC, a patient whom I cared for during her pregnancy. They are soon to return to their native land so there will not be any follow-up here.

SC is the first child I have examined from the heart center since I started to center myself this way when examining and treating patients.

As soon as I connected in this way I was overwhelmed with a totally clear mind, absolute peace, profound silence. Not Stillness but peace and silence. There was absolutely no ego, "I am" sense present.

I sat in this for about 15 minutes while I examined her. There was little to treat that I could discern. Only when I returned to the head center were some strains discernible. Otherwise, from the standpoint of the heart center, all was well.

Very, very profound and transforming.

It is obvious that this little spirit was still incarnating. Her ego was non-existent. Just pure being, spirit.

This changed my experience of the rest of the day.

What a gift.

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Post-polio syndrome and osteopathy  Thursday, April 21, 2011

It is very common for patients who have had polio to suffer decades following recovery from the initial infection with what is termed post-polio syndrome. These people often have major fatigue, paralysis and muscle weakness. In 1977 it was estimated that there were over 250,000 such people in the US.

I was trained as a physiatrist ( specialist in physical medicine and rehabilitation) during a three year post-graduate residency at the National Rehabilitation Hospital, Washington, DC. One of my mentors there was a specialist in this syndrome which he himself struggled with.

Osteopathy has much to offer such patients as I will now relate.

Today I had a visitor from Australia who is a polio survivor. She presented with very severe torso pain which had been aggravated by her long journey, packing and other factors. When I examined her I found that her entire body had been altered as a result of the polio years ago.

One leg was demonstrably longer than the other which adversely effected everything above it. In addition, her hip capsule on that side was so tight that her entire body appeared lopsided. Her diaphragm was in spasm since there are muscles (ex.psoas) which attach there and then go down to attachments in the hip. Much of this is also related to connective tissue continuity.

Her spine had been pulled over to one side which resulted in the ribs getting stuck.

All of this made her a sitting duck for neuromusculoskeletal pain which is what was brought her into the office.

She was treated with very gentle osteopathic manipulation which not only eliminated all of her complaints ( including pins and needles in her right arm) but also rearranged her body so that she no longer had such a leg length imbalance.

Osteopathy has much to offer such patients.

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Coccidynia: Tailbone pain in a pregnant woman.  Thursday, March 03, 2011

She called to say that she had been in excruciating pain for some time following a fall on her back.

At the time we heard from her she could no longer sit due to the pain. Since she was also many months pregnant she feared for the pregnancy as well as complications with labor.

When the patient finally came in she was miserable. She stood until she could be examined and then when I probed in the effected area she let me know how uncomfortable she felt.

The problem was that her tailbone, coccyx, the tiny bone at the end of the sacrum, had been traumatized during the fall. This is a very common and horribly uncomfortable problem since this area is well endowed with sensory nerves. In addition, there is a collection of nerves, called a ganglion, that is in the coccyx which has an effect on much of the autonomic nervous system. The result of such a trauma is that the patient may suffer apparently unrelated symptoms and go from doctor to doctor without much relief.

Most physicians including osteopathic physicians who are unfamiliar with osteopathic manipulation and diagnosis as the mainstay of their practice ( ie. over 95% of all American DO's) are unaware of how to diagnose and truly treat this problem.

On exam I noted that the coccyx was being pulled sideways, toward the right. Its normal position is sticking straight down the midline. Many of the soft tissues ( muscles, connective tissues) were also being pulled ( strained) in dysfunctional ways which were bound to create havoc in the system.

I gave her an extended dose of the homeopathic remedy, Hypericum ( St. John's Wort), which is a specific for coccyx injuries. This helped a bit but the real treatment lay in getting rid of all the trauma to the area and getting things back to where they belonged in relation to the rest of the body.

At some point we began intra-rectal treatment.

The gloved finger of the physician is inserted into the rectum and against the coccyx. The diagnosis of tissue pull is then not only confirmed but, with the aid of external aid from another finger, the coccyx is released along with all the other parts of the system that have been compromised.

It took several visits for this to be accomplished in full.

Since the first time this work was done the patient has reported more and more relief. Today she said that she no longer has any problems sitting and feels about 3% of the pain that she formerly did.

I was a bit surprised over how much additional release of the entire area we got today during the treatment. This leads me to believe that she will have not only a lot more relief of the coccidynia but also for all the back pain that often accompanies pregnancy.

I believe that this and attendant work we are doing will make her pregnancy much easier as well as bring about a safer and shorter labor than she otherwise would have had.

We are both very happy with her progress.

This is yet another example of osteopathy in action.

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Osteopathy makes for more successful surgery.  Thursday, February 17, 2011

Over the years I have had considerable experience in helping patients prepare for and recover from surgery.

As many of you know, I did a three year post-graduate residency at the National Rehabilitation Hospital, Washington, DC. This provided me with considerable expertise in supporting the rehabilitation of patients who had traumatic setbacks.

However, few physiatrists or rehabilitation specialists like myself, have the tools to work with the millions of patients who receive surgery.

As an osteopathic physician I can prepare the patient for surgery and after the procedure, aid in their recovery. The reason this is possible is that I am able, as a licensed physician and surgeon, to anticipate the trauma that surgery will create and, afterwards, alleviate the dysfunction to the system which it caused.

Example:

Recently a patient came to me and said, " I want you to perform a miracle."

I thought, " OK. Here we go. I wonder what she wants me to do now."

" I have been diagnosed with colon cancer and want a holistic approach to helping myself."

I told her, " OK. The most holistic approach I know of for your condition is for you to get surgery, as soon as possible."

" I was afraid you would say that," she replied.

" I am a physician and a surgeon. It is my responsibility to do the best thing to support you. This is not a religion. I am not against drugs and surgery. I oppose unnecessary drugs and surgery. This is absolutely necessary. If you don't get surgery soon there is a good chance that the tumor, if it already has not done so, may metasticize, spread elsewhere in the body, and then you will need even more destructive therapies to stop it. You could very well die if it spreads."

"What I propose is for me to prepare you for surgery using homeopathy and osteopathic treatment so that your system can withstand the trauma of surgery. Afterwards, as soon as you can get back here, I will offer you personalized osteopathic and homeopathic treatment to ensure fast and natural healing without any side-effects. You surgeon will be astounded at your progress and success with both the surgery and your recovery."

She agreed to this and went through with the surgery.

The procedure went very well. The surgeons and physicians were surprised that she did so well.

Shortly after the surgery she came to the office. It was hard for her to get into and out of bed, go to the bathroom, move in certain ways, etc. Within a single visit she had improved so much that she was able to operate a car and prepare meals for her family as well to greatly reduce her pain medications.

After the second visit she was totally off all pain medications and back to most of her ADLs ( activities of daily living - bathing, lifting, etc.).

After two weeks post-op, two visits a week, no one could tell she had had major surgery that removed part of her colon.

As one who had a similar operation for the same diagnosis many years ago I can well appreciate the benefits of osteopathy and homeopathy in the hands of a well-trained physician and surgeon in supporting patients who get surgery. The same applies to women with difficult labor and delivery.

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Beware of the 2010 Flu Shot  Monday, December 06, 2010

Today my secretary told me that after she and her husband both got flu shots they became very ill. She got so ill that she told her daughter she was afraid she would die the reaction was so severe.

My partner got the flu shot recently and became very ill. His symptoms lasted about a week.

His best friend in Florida also got very sick after the injection.

There is an unprecedented number of patients reporting adverse reactions this year.

And yet, as many of my patients have reported, their physicians are telling them that this is a normal response.

It is not a normal response.

It is a severe reaction, in many cases,that can sicken and even kill someone who has it.

The pharmaceutical companies that make this product and are paid literally billions of dollars from the US government have zero liability.

Yes, you read that right.

Under George W. Bush, a law was passed which made it impossible for them to be held accountable for the adverse effects of their vaccine products.

Obama has continued this policy.

The victims of this law are those who get the vacccinations and suffer the consequences.

The companies claim that if they are to be held responsible for the ill effects of their vaccines they would lose money, money that they want to go to their investors.

Do not get the flu shot.

You have been warned.

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Rapid ligament injury relief.  Saturday, August 28, 2010

For twenty years I have been treating patients with torn and injured ligaments. I have never done surgery on them though I am a licensed physician and surgeon and could easily do so.

The reason these patients do so well and get back into life so quickly is that the real problem is addressed. This is not the case with surgery in many cases.

Recently the baseball player, Stephen Strasburg, a 22 year old rookie pitcher for the Washington Nationals, has been receiving a lot of media attention after he injured ligaments in his elbow while pitching.

According to the Washington Post, he will receive surgery in Los Angeles and then spend one to one and a half years in rehabilitation before he is capable of returning to pitching and baseball.

This is very sad since he could easily be back playing baseball in about thirty days or so if he was treated by people trained in my work.

In addition to being a trained osteopathic physician, I went through a complete post-graduate residency at the National Rehabilitation Hospital in Washington, DC and am also a specialist in rehabilitation medicine. I know how such physicians do rehab and understand quite well the care that Stephen Strasburg will be receiving. It will be done by physical therapists and occupational therapists based on orders from a physician. It will essentially prolong his recovery from the trauma of surgery.

What do I do with such patients?

I examine them in a way that allows me to understand exactly what is the nature of their injury, how it has effected the entire body, and the best way to reverse the process.

In twenty years of practice I have never sent such patients for surgery. They not only didn't need it but would have been harmed by it since no treatment is without side effects. I have care for many patients who after surgery felt better, though not always, but later on developed other problems due to the response of the entire body to the surgery and the scar tissue which it produced.

The problem is essentially one of connective tissue disfunction. That is, parts of the connective tissue system, which is a part of the largest system in the body, the musculoskeletal system ( over 60& of the body), are injured. They respond to this injury by compensation. The entire body compensates to avoid further stress on the injured area. Surgery never addresses this issue. It will later come back to haunt the patient. However, since they have no idea that such a thing exists, surgeons never consider this and, ironically, may do more surgery to treat the resultant problems.

I use very gentle osteopathic manipulation using my hands to correct the strain and sprain in the connective tissues ( ligament, tendon, fascia, dural membranes, etc.) throughout the entire body.

We must treat the entire body since the entire body responded to the injury.

One of the first things that was changed was the patient's breathing. At the time of any injury the patient is stunned. They inhale. No one ever exhales at the time of an injury! So the spasm of the diaphragm, the major muscle of resperation, must be released. Without this the recovery is limited. No one in the medical field, the rehabilitation area or other related fields is competent to diagnose and treat this.
They lack the training and, in most cases, even the awareness that it exists.

After an injury how many times did your doctor examine your breathing?

The gentle osteopathic treatment may be followed up, in cases of extreme injury where the tendon or ligament has truly been badly torn ( most are micro-tears), with injections of a sclerosing agent. This is called sclerotherapy or prolotherapy. It lays down a tiny area of scar tissue between the tendon and the bone to which it attaches. It help the tendon to be more stable and completely avoids surgery. The healing from this is very short.

I also do other things which make it so that the patient is quickly pain-free and returned to what they really want to do; living and enjoying their lives instead of endless visits to doctors and therapists.

Stephen Strasburg is unfortunately, at age 22, becoming a pawn in medical politics. Like most politics, it pits the rich and the famous against those without power or a real education as to how to best deal with their situations.

Millions more like him must suffer, miss work, and, in the end, deal with many more problems due to their treatment.

In medical school we were taught that over 20% of all problems that patients would present with are iatrogenic (Greek: iatros= medical, genesis= beginning). Actually, the percentage is a lot higher when we consider all the wrong diagnoses out there, the bogus and unnecessary treatments, the treatments that went wrong, the side-effects of treatments ( medications, surgery, chiropractic, etc.) and on an on. Twenty percent is very, very low from what I have seen.

My patients do not have to wait 12 to 18 months to feel fantastic after a ligament injury.

And neither should Stephen Strasburg.

If he ever discovers how he was duped his minders may have a major lawsuit on their hands.

But they can sleep OK.

He will never find out.

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Newborn treatment  Wednesday, July 28, 2010

Recently I have been treating a lot of newborn babies.

For the most part, the children were having problems with colic, excessive spitting up, problems nursing, sleep issues, misshapen heads, torticollis ( head deviated to one side) and other common neonatal problems.

Every one of these children presented with severe strains when I put my hands on them.

What is a strain?

It's a pull in the internal tissues of the body.

When the connective tissue, which is everywhere in the body, is twisted or pulled, the nerves, blood vessels, and lymphatic vessels ( ie. the vessels which suck up all the crud in the body and get rid of it) are unable to function normally.

The child will then get sick, be irritable, have many health problems.

So I take out the strains with very gently osteopathic treatment and the children get well.

I don't try to get the child to calm down or just get rid of the symptom.

I get rid of the reason for the symptom, the problem.

Then the child is well.

It doesn't take very long for this to happen.

If it does, I know that I am missing something important.

I also use homeopathic medicines to help the children if I believe they will be helpful.

The nice thing is that these children often do very well for many years.

Because these underlying problems in their bodies were treated early on, they tend to be a lot healthier than other kids.

There is no greater investment than getting all the problems worked out for the child when they are very young.

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Life is fluid.  Saturday, June 05, 2010

Life is fluid.

We all know what a fluid is. Water, cerebrospinal fluid, lymph, blood, urine are all examples of fluid.

But what defines something that we call a fluid?

One of the things that define it is that it is always shifting, constantly finding a new relation to the whole. It is not static, never fixed.

So often when approaching patients a physician will see the patient as suffering from some disease which often has a name or diagnosis.

Such a label is fixed.

Whatever may happen with the patient, the label remains unchanged.

In so many ways, this is not helpful if the person wishes to heal.

Our reality is never fixed.

When we approach others and ourselves in this way, using a fixed, unwavering lens of perception, we do ourselves a tremendous disservice.

In fact, we live a lie.

We are not fixed, never static.

We are alive. We are the manifestation of the life force which is totipotent, all powerful, omnipresent, and omniscient.

We are life incarnate.

We are fluid in nature.

Life is fluid in nature.

This is how to approach a patient.

This is the osteopathic vision of the man who discovered the art and science of osteopathy, Andrew Taylor Still, MD.

Anyone who approaches themselves or another as static is a liar.

They may be a well-meaning liar and a really nice person ( most of them are) but they are living a lie.

Open to your reality, the truth of your fluid nature.

Fear, depression, anxiety will disappear for they cannot withstand the light of the Divine which is who and what you are.

When we deny this, we effectively deny ourselves and all that is good and holy in life.

Don't accept anything less.

Life is fluid.

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Live your dream.  Saturday, January 30, 2010

Today I received an e mail from a man who watched a video interview between me and another doctor. He had sought me out and asked to record an interview. It is on the net and occasionally I hear from people who watched it.

My practice here is a small one compared to almost every other medical practice in the Washington, DC area. It consists of one part-time secretary and me. A couple of exam/treatment tables, a few desks and chairs, some lights, not much else.

I have been doing this for 18 years at this point.

Over that time I have gone through a lot in my life; cancer, heart attack, etc. etc. If I had known I had to go through it I don't know if I would have been able to. Thank God, I don't know what happens next.

As I look back I really am amazed that I have made it to this point. I never realized that I was as strong as I have been. I have gone through the fire, been tempered and am here to live on another day.

I always wanted to do something worthwhile with my life.

Something that would make this a better place than I found it.

However, I had to deal with my own private demons and those of the people around me. It wasn't easy for me to trust and find peace here in this world. The alternative was so much harder that I just forced myself to keep going.

I am not really sure of what will come next. There is a part of me that craves some structure and security but life does not seem to work that way.

My work is very personal.

I want to be the doctor that I would want for me.

The one who listens, who cries with the patient, the one who does whatever is necessary to help.

I want to make a difference for each of you.

When I walk into the room I never know what to expect. I have no treatment plan or agenda. I just want to be real because, in my experience, that is our only hope for real healing.

And we all desperately need real healing.

I wrote this because I need to.

Maybe it will be helpful to someone.

I sincerely hope so.

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Contact  Monday, January 04, 2010

E mail

hrpharold (at) gmail (dot) com

Phone

301.565.2494
(Leave message if no one answers. Speak your name and phone number slowly and clearly and we will phone you back.)

Address

8609 Second Ave., Suite 405-B, Silver Spring, Maryland 20910

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A missing link.  Saturday, January 02, 2010

Several years ago I saw a patient with debilitating low back pain. Since he had previously had surgery his insurance required that I contact his neurosurgeon to get permission to treat him.

The neurosurgeon was very pleasant and readily agreed for me to treat the man. " If you can help him then I have many more people I can refer to you." It was then that I learned that over 50% of patients receiving back surgery are actually worse following the procedure. In addition, of those who do get relief from the surgery, a very high percentage find that the pain later returns.

What did the surgery accomplish if the majority of the patients ended up with more pain? The "problem" was corrected, right? So why are they in pain?

All physicians have patients who seem to not respond to apparently well indicated treatment. This is a given in medicine. I certainly have had my share over the years. I often wonder why they didn't get better or, if they did improve, why the improvement was not long lasting.

Obviously, something is being missed.

All of us carry years and years of unresolved emotions, things that we basically push out of our consciousness because they are just too enormous to even deal with. This is true even of many people who, on the surface, seem at peace, who rarely get angry and appear quite optimistic.

However, on some level, things remain enormously unresolved.

We lead lives where we need, for very practical purposes, to function . There is simply no room for all this repressed baggage to emerge. As the years go by the situation of the unconscious becomes more and more untenable. There is no where for these bubbling emotions to go. They have become repressed.

We are a unified whole. No part is a solitary part unaffected by the rest of what is going on. Even though we do separate the mind and the body, for practical purposes, this is not the way things work. It is like trying to separate two sides of a coin.

Who and what we are is a process, a living, physiologic reality which, moment to moment is seeking balance.

And it has a lot to balance.

The more stress there is in our life, the more extreme the balancing act.

At some point, the unconscious can no longer be simply repressed. The maelstrom that it is must, for the safety of the entire system, manifest in some way.

One way, a very common way, this occurs is via physical symptoms.

We have feelings. The way we feel is via our body. The body is where the physical symptoms of the unconscious appear.

Back and neck pain. Pain in the nervous and connective tissue system. Pain and problems in the muscles of the various organs.

These various pains and other symptoms are never erased for too long by medical and other treatments if they are in any way a compensation for what is going on in the unconscious.

The patients wander from physician to physician without any real relief or resolution.

Naturally, they become desperate. Their lives begin to fall apart.

What has occurred is that the balanced relationship which the system craves has become seriously unhinged.

Things are out of control.

And we all know how much we like control.

Some of the cases that present to physicians are caused by serious disorders like cancer which must be ruled out before it is assumed that the pain is due to suppressed emotions of the unconscious.

When that is accomplished appropriate care may begin.

The first step in this care is for the patient to realize that there is nothing physically wrong with them.

This, in spite of the many lab tests, imaging studies and other evidence that they have a real physical problem, is the foundation for recovery.

However, this is very challenging for most patients to accept. Everyone is telling them that, for example, you have a ruptured disc and you need surgery. The fact that the majority of all people walking the streets of the USA have ruptured and bulging discs but are without any symptoms is rarely revealed to these patients.

In spite of all the medical evidence of physical illness, the only hope is to understand that they are not sick. There is nothing wrong at all.

The system is doing what it needs to do under the circumstances. It needs to blow off steam from the unconscious, so to speak. It is doing this by creating physical symptoms.

Patients rightfully resent the implication that "it is all in your head". This is not what I am saying at all. That implies, in my experience, that the clinician is saying that the patient is making it all up.

These patients are in pain, often very severe and long standing pain. The pain is very real. They are not making anything up.

However, the basis of the pain can be traced back to the system's need for balance. There is a very real reservoir of unresolved, unconscious emotions. They need not be resolved for the pain to disappear.

Rather, the role of the unconscious and the system's need for balance simply needs to be acknowledged. That is the cure.

I know it sounds simple but, believe me, for those patients who make the connection it is a life-changing matter.

Many years ago, John Sarno, MD, a rehabilitation medicine specialist at NYU Medical Center, began to discover that if he educated his pain patients to understand what was actually happening that the majority of them found that their pain would simply disappear.

He has written several books. My favorite is The Mindbody Prescription. It contains virtually everything you need to know about these matters from his standpoint.

I, too, have discovered similar states in many of my patients.

Long ago, a woman who had suffered with years of back pain, came to me. She mentioned that years before, she had journeyed from Washington, DC to NYC to watch Dr. Sarno lecture on what he referred to as TMS ( tension myositis syndrome). Following the lecture, during which she had an epiphany about her situation, all her pain disappeared. This lasted for several years.

What happens is that a light bulb goes on. You suddenly realize what is really going on. You suddenly have an ah-ha moment. You get it.

Nothing is wrong. It was all a misunderstanding based on years and years of believing that they had a physical problem which needed to be fixed by physical means. Now they know that, actually, the mind-body was simply doing its balancing act.

Once this understanding occurs the pain resolves.

For me, a totally new relationship emerges between us ( conscious mind) and the unconscious.

It is like suddenly awakening from a dream or, in this case, a nightmare.

A physician can facilitate this process. That is my role.

If I believe that a patient has what Dr. Sarno terms TMS ( tension myositis syndrome) then it is my duty as a physician to support them in getting better with a treatment that will actually address this condition, a condition of a fundamentally skewed relationship between the conscious and unconscious mind.

When this is successfully accomplished then the pain usually disappears.

Caveat

Dr. Sarno teaches that almost all pain and a myriad of other conditions fall into the category of this conscious/ unconscious balancing act.

However, not all of the TMS diagnosed patients, by his own admission, respond to this approach. The vast majority seem to respond but, like anything in medicine, this is not a panacea. I believe that the diagnosis of these patients needs to be carefully arrived at as a diagnosis of exclusion.

That being said, I am also convinced that this approach to helping patients needs to become a central feature of medical training and practice. I find a psychosomatic component in most conditions. The degree needs to be established in order to truly help the patient. I look forward to the day when the repressed emotional component of suffering will become one of the first and not the last thing to be addressed.

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It's all about function.  Monday, December 14, 2009

Over the years I have come to a better understanding of what my real job is.

Physiology is the science of how biological systems do what they do, how they work or function. The osteopathic approach is to access the functioning of the system via its form or anatomy.

My job is not to make the symptoms disappear though, of course, I realize that this is why the patient comes to me and I, too, want this outcome for them.

However, as an osteopath I understand that the way to accomplish this is to concentrate on the way the system is actually functioning. This is also a lot more satisfying for me since it liberates me from the tyranny of the disease and diagnostic labels which the patient shows up with like so much heavy baggage. A label is carved in stone. It allows for little change. We can all do net searches or read the medical literature and learn all about the label and how the medical profession views it and its certain history. Often this is rather depressing. Patients frequently become overwhelmed, to use a word that one person mentioned recently, with all that they read about their label. In addition, they often discover that many clinicians differ in what their most appropriate label is. That brings in even more confusion and frustration.

All of this robs them of the little energy that they have, energy which is desperately needed for their healing journey.

By concentrating on function, on how the system is doing what it does, I am able to keep from getting sucked into this black hole. If I concentrate on the label then I enter into a co-dependent relationship with the patient and I don't find that helpful.

Also, quite frankly, some of the symptoms and labels are packed with such horrendous cultural and scientific baggage that it brings up many of my own fears and feelings of inadequacy. This is just a huge impediment if I am to be of any use to the person who has come to me for help.

So I am delighted to concentrate on what the body is doing in this moment, how it is choosing to function, and to track the changes in this physiology. I can tell when it is going toward health or not. This is a very honest relationship for me.

I know my job. It is to promote normalized physiology, improved systemic function.

When I stick to this then things go well.

I can always promote better systemic and localized function.

That is very satisfying for me.

I take refuge in this.

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Organs have range of motion.  Monday, November 09, 2009

Every structure in the body has its own specific range of motion.

We learn in medical school that this is true of joints. However, few physicians understand that this is true of all the body's organs as well.

The practical application of this fact of nature is that just as a limitation in joint motion translates into a limitation in the function of that joint, since motion is the key function of the joint, so, too, does limitation of internal organ motion have a negative effect on the function of that organ.

A few recent examples from my practice:

Bladder:
A patient arrived with a lot of bladder pain following a procedure with a well-known university urologist. The procedure was done to help him with a very dysfunctional bladder. While the procedure was judged successful the patient was absolutely miserable. The doctor had counseled him to just tough it out and that eventually he would feel better.

The word eventually was left undefined.

I examined him and found that his pelvic floor was very unbalanced with the muscles on the left in spasm. In addition, the left side of the bladder was very irritated.

However, not unexpectedly, the bladder itself and the ureter were both moving in an abnormal range of motion.

When the above issues were corrected by gentle osteopathic treatment he got better.

Immediately.

He had no more pain following the treatment.

Heart:

A patient had a heart attack and received open heart surgery.
Besides feeling very weak which is natural for a while after this surgery, he also had a lot of chest pain. His breathing was compromised as was his ability to move about.

The heart range of motion was very limited. This is not something that physicians know of and even if they did how would they measure and treat it?

I released the rib heads which were jammed into his back and spine when the sternum was cracked open. I also treated his thoracic diaphragm which was in spasm.

However, the most dramatic thing was to restore the range of motion of the heart.
He was able to visit his extended family for the first time following this and is now doing much better. He is fully ambulatory and able to pretty much take care of himself, drive a car, etc.
Best of all, his entire body is functioning better than it did even before the heart attack.

I am convinced that correction of range of motion of organs can spare us all problems with those very same structures in the future.

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