DocAltMed

Reflection creates beauty in the mundane.

Self-appointed “skeptics” frequently point to practices such as mine, claiming that I’m engaging in nothing but voodoo witchcraft, preying on those so ill and so without hope that they will grasp at any straw proffered them, ante up any outrageous fee desired, and dearly pay for the false hope which I and my colleagues allegedly peddle.

My patients, of course, know the reality is far different. They know me as a hard-headed pragmatist, whose foremost rule is “Find it, fix it, and get out of the way.” They know me as a doctor who will rather unflinchingly — though I hope not unkindly — point out how they have contributed to their own ill health, while also finding ways they can repair the damage. And they know that my fees are modest; I am unlikely to bathe in gold coin anytime soon from the revenues of my practice.

What they don’t know, unless they ask, is that each discipline that I practice, whether it is chiropractic, acupuncture, or herbal/nutritional therapy, is supported by a wealth of scientific research that supports every modality that I use.

When I have used acupuncture to treat children with Tourette’s syndrome — usually successfully, I might add — I can point to not just one, but several studies that support and guide my intervention.

When I blend a custom herbal formula for a patient suffering from a cold or urinary tract infection, I am relying on studies which show me that the herbs in question are more effective than anything in the MD’s formidable arsenal. Though of course, the FDA would have the fantods were I to be so foolish as to make the claim that herbs can actually kill the bacteria causing the infection, even though studies exist demonstrating that very fact. So I won’t make the claim that herbs can help cure the common cold, even though substantial research exists supporting that statement.

And when I explain to an acupuncture patient that Qi is a life-force running through their body, and that the flow of this Qi can be altered by placing needles at certain points along that flow, I know that I am using a time-tested analogy for a phenomena that we are only beginning to touch upon in Western science. It is likely that this Qi is actually a form of intercellular communication, and that acupuncture alters the nature of that communication. When you begin to change the body’s command and control systems, your results are going to be powerful and intersystemic, which is why both acupuncture and chiropractic have such profound effects on people. Chiropractic adjusting, through its influence on neural communication, and acupuncture, through its alteration of intercellular ionic flow, are both acting on a meta level, thus their widespread effects.

With all of that said; with all of my adherence to the logical discrimination of disease and therapeutics, and my hard-headed emphasis on results, I cannot ignore the power of my patient’s spirits, nor their immeasurable will to survive, improve, and in some cases achieve a level of health they never thought possible. Where does this will come from, and how does it manifest its results? Most importantly from my perspective, how can I help my patient harness that power?

Multiple studies have shown that intercessory prayer have little effect on disease outcome. Nonetheless, it is often through their religion or spiritual beliefs that people harness that powerful exercise of volition which dramatically alters the course of their disease.

Despite increasingly frequent forays into this domain, the realm of the spirit remains largely opaque to the otherwise piercing lenses of science. There is some evidence that  our brains are hardwired, as it were, to engage in spiritual practice; to “believe” in unquantifiable, unmeasurable forces which help to direct our lives. And those familiar with the work of Carl Jung and subsequently Joseph Campbell will recognize the hero myth as the unifying essence of almost all religions. Neurological research has shown how the regular practice of meditation, independent of the specific religious tradition of the meditator, can create long-term alterations in our brains. Nonetheless, these scattered breadcrumbs only beg the question of how these beliefs unlock such potent personal power that the course of a disease can be radically altered.

This is a question worthy of consideration, particularly today, when much of Christianity celebrates the birth of its central figure. And as I drove home from a family gathering last night, I could not ignore the beauty and tranquility exuded by the churches I passed, all decked out for their celebrations and lit with candles for their midnight services. There is a compelling power there, not just in Christianity, but in any religion as it expresses the majesty of its office in our affairs. From the miraculous birth of Jesus to the transcendental satori of Gautama Shakyamuni to the revelations of the cave-dwelling Muhammad, there is a common thread from which has emerged some of the most beautiful expressions of art, literature and music of which humans are capable.

To that I would add religion’s ability to give us the power to manifest our ideal selves in the physical realm as well as the sphere of ideas. While I cannot explain it, I would be a fool to ignore it, though it is clearly not in my scope to harness it. That is more truly the realm of the priest, the roshi, the imam. As a doctor, I must remain ecumenical to best serve my patients.

To me, this day marks both a beginning and an end. It is the end of the work year for me, and over the next week of “vacation,” I lay the foundations for beginning the new year. I am looking forward to the changes I hope to bring about, both personally and in my practice. And I know that this question, the role of spirituality in health, will be one which will invite me back to ponder its challenges throughout this year. I am looking forward to the conversation about to ensue.

And I am also, as always, incredibly thankful to my patients who continue to be my most influential teachers. Thank all of you for your trust in me, and thank you for permitting me to join you down the short segment of your path that we are traveling together. I hope my guidance has not led you astray, but assisted you to become more of who you want to be.

And to all of the readers of my blog, thank you for your attention and your feedback. You encourage me to continue these public musings and consider new topics and new approaches.

Happy Holidays to all! I look forward to seeing you in 2012.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Drugs are not the best answer for depression and anxiety.

Paralysis. Suicide. Fatigue. Heart Attack. Birth Defects. Liver Disease. Weight Gain.

Is This Any Way To Treat Depression and Anxiety?

These are just some of the side effects of antidepressants. At the same time, research has shown that these drugs are not much better than placebo at treating depression and anxiety.

Please join me on Nov. 9 for an exploration of the dangers of medical treatment for depression and anxiety, and a look at alternative management strategies.

At this seminar, you will learn:

• What are the long-term effects of using drugs for mood disorders?
• What really causes depression and anxiety?
• Can acupuncture help people with depression?
• Which herbs are most effective for people with depression? Can herbs really reduce anxiety?
• What is the research behind alternative management strategies?

If you or someone you know suffers from anxiety or depression, call today to reserve your seat.

Wednesday,  Nov. 9, 2011
Litchfield Community Center
7 p.m.

Call 860-567-5727 and ask for Teresa, or email to depression@averyjenkins.com

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

The paths at St. Johns College lead to more than a degree.

Page A13 of today’s New York Times has an article about St. John’s College, a rather unique Great Books program. The thrust of the article is to illustrate how St. John’s professors — referred to as “tutors” — are expected to teach every discipline, regardless of their own specialty. As an example, the article features Dr. Sarah Benson, an art historian, who is currently teaching mathematics — via Euclid.

The Times article says “students who attend St. John’s…know that their college experience will be like no other. There are no majors; every student takes the same 16 yearlong courses, which generally feature about 15 students discussing Sophocles or Homer.”

I mention this article for two reasons. My daughter is a freshman at St. Johns College, and is finding the experience to be uniquely mind-expanding.

I can already hear the changes in her thinking; for example, in a recent telephone discussion about how her younger sister’s classmates feel that American imperialism is in all cases justified, daughter #1 bursts out indignantly: “But what about Virtue? Don’t they even consider that?”

In my mind, I laughed, then applauded.

The second reason is that this article brought back memories of my own undergraduate education, the School of Interdisciplinary Studies at Miami University (of Oxford, Ohio, thankyouverymuch). Cloistered on its own campus (the former Western College for Women, at which my mother was an assistant dean), the School of Interdisciplinary Studies taught us in much the same way that St. John’s College trains my daughter today. Frequent, small discussion classes, only barely run by the professors, punctuated by more formal seminars, at which the academics of the College presented insights from their own disciplines, viewed through interdisciplinary lenses.

There was one class, however, which became for me an intellectual satori. I spent a semester studying the relationship between Picasso’s Cubism and Einstein’s theory of relativity.

It was team taught by a physicist and an art historian, and we all learned together, studying the works of Picasso and Georges Braque, and reading Einstein’s original works. And somewhere, through the heat of that challenge, I emerged a changed man. Somehow, my lenses had shifted, and I never looked at the world in the same way again.

The School of Interdisciplinary Studies is long gone, replaced by a sub-department within a department, but I am glad to see that schools such as St. Johns College continue to educate men and women who will be capable of gazing out onto the landscape of culture and ideas and see things to which others are blind.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Flu shot gift card and beer on sale. Now that's real health care!

I’m not supposed to make recommendations regarding pharmaceuticals to my patients, because they are outside of my scope of practice, so if you are my patient, don’t read this. In fact, don’t even think about this. And pay special attention to that last sentence. Because I’m pretty sure that nobody involved in mainstream medicine wants anyone to actually think about whether you need the flu vaccine.

They just want you to line up and get the shot. You see, everybody in medicine makes money from the vaccine, from the Semi-Registered Nurse’s Assistant’s Aid’s Best Friend (i.e., part-time CVS employee who just washed her hands) who actually injects you, to the stockholders and executives at Novartis and Glaxosmithkline, who make the vaccine, to the CDC, which gets lots of money indirectly by pimping the flu vaccination each fall.

The trouble is, it’s bad medicine. And bad science.

Don’t believe me? Then believe the Cochrane Collaboration. This is an independent organization which performs analyses of medical research, and one of the sources that evidence-based doctors, such as myself, use to guide their recommendations to their patients (of course, I’m absolutely *not* making any recommendations to any of my patients, and if any of my patients are still reading this, I want you to stop immediately).

According to the Cochrane review, the advantages of vaccinating healthy adults are virtually nonexistent. This recent study found that the flu vaccine:

• Did not reduce the number of days lost from work;
• Did not reduce the number of people hospitalized;
• Did not reduce the number of complications due to secondary infection (pneumonia, etc);
• Was effective in only 1 out of 100 people;
• Paralyzed 1 out of every 1,000,000 people who were vaccinated.

Furthermore, the study’s authors hedged their conclusions even more. The authors said “Fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products and some of the evidence comes from trials carried out in ideal viral circulation and matching conditions” (Emphasis mine).

For those of you who are not familiar with reading scientific studies, this is a researcher’s polite way of saying they think the data is trash.

This conclusion was reached by Cochrane researcher Tom Jefferson, in a 2006 analysis published in the British Medical Journal. Dr. Jefferson concluded that there is an “absence of evidence” that vaccinations have any effectiveness at all.  “In children under 2 years inactivated vaccines had the same field efficacy as placebo,” Dr. Jefferson said, “and in healthy people under 65 vaccination did not affect hospital stay, time off work, or death from influenza and its complications.”

But what about our aging American population? The elderly is a group heavily targeted by influenza vaccine marketing, but that is primarily the result of easy and profitable Medicare reimbursement more than any evidence that flu vaccines actually help this population.

In fact, the evidence is so bad that Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy has suggested that those who recommend the flu vaccine for older people are at best ignorant and at worst disingenuous.

“These 36,000 deaths that we keep talking about with the flu, that we want to get people vaccinated for so they don’t happen, really is not going to occur. And we have to be honest about that,” Osterholm told NPR last year. “I know that some people are going to find it very challenging to basically understand that much of what we’ve probably done has had little impact on deaths,” he said.

Nor is the Cochrane Collaborative silent on this issue. This study, first published in 2006 and reviewed again in 2009, concluded that “the available evidence is of poor quality and provides no guidance regarding the safety, efficacy or effectiveness of influenza vaccines for people aged 65 years or older.” The study went on to note the “low quality” of the research, as well as “likely presence of biases, which make interpretation of these data difficult and any firm conclusions potentially misleading.”

Some of the research backing Osterholm’s claim includes research by Dr. Lisa Jackson and published in Lancet. Dr. Jackson’s study — which spanned 3 years and included over 3,500 people — concluded that vaccines don’t really help, particularly in the area of secondary infection prevention. Specifically, ” influenza vaccination was not associated with a reduced risk of community-acquired pneumonia,” her paper concluded.

What other studies seems to show is that, far from aiding those with weak immune systems, flu vaccines either fail to help or overtly damage people with already-compromised immune systems.

The Cochrane Collaborative’s persistent claim that the data regarding flu vaccine research is compromised has been bolstered recently. A paper authored by researchers at the British Columbia Centre for Disease Control found that data from several Canadian hospitals reported peak vaccine effectiveness before the flu season had even started. They concluded that this created a “bias tending to over-estimate vaccine protection,” which as other research has shown, is marginal at best.

However, there are research-proven ways of significantly reducing your risk of contracting the flu this winter, and the best ways of avoiding the flu involve no vaccines, no doctors, and don’t cost you any money.

• First of all, according to the CDC itself, washing your hands is one of the best ways to prevent the acquisition of most infectious diseases.
• Exercise has also been proven to prevent death from the flu as well as other infectious diseases.

Those are probably the two most important ways to prevent the flu. And the research is unequivocal at this point that nutritional status has a profound effect on immune function, which determines how likely you are to get the flu. But then again, how many doctors actually test your nutritional status to make individual-specific recommendations for improving your immune function during the flu season?

Actually, I do know of one.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Known as one of the internal martial arts, aikido is demanding both physically and mentally.

After a multi-year time-out from training in the martial art of aikido, I returned to the  dojo a few weeks ago. I will confess to some anxiety about resuming training, as I am no longer the young, seemingly indestructible force of nature that I was when I began training in earnestness 20-odd years ago. As one of one of my older dojo mates told me several years ago, at 50 years you have reached the age when if you wake up in the morning and nothing hurts, something is seriously wrong.

Between my last visit to the dojo and this one, I crossed that cryptic half-century borderline, and in addition to the miraculous and immediate attainment of great wisdom, I also acquired the aforementioned aches and pains. I think, in general, these are the dues paid by anyone who has led a fairly active life — and, of course, the gains in terms of health, longevity and mental outlook far and away offset the intermittently achy knee or shoulder which will never be exactly pain-free.

But my prior years of training had left their mark. While aikido is generally considered one of the “softer” martial arts, anyone who has watched or participated in an aikido class can understand how injuries might arise. At any given point in time, you can be thrown in the air,  have joints torqued in entirely unnatural directions or get whacked upside the head by failing to correctly implement a technique. While largely safe, aikido remains an effective martial art, and a certain level of injury must be tolerated, just as with any other martial art, or many sports, for that matter.

Which is not to deny that my tenure on the training mat has been a little more injury-prone than most. I count among the dents I accumulated over the years a broken rib, a separated shoulder, two concussions, a broken toe and a nose so thoroughly smashed that for a time I resembled a cubist painting. All of which led me, some time after I had been awarded my shodan (first level black belt) degree, to take a break (so to speak) from training. I was just too dinged up to continue, and a few off-the-mat injuries thoroughly doused whatever remaining fire I had for training.

But the call of the dojo never fully left me, and has gradually been growing stronger. So I decided it was time to put feet to mat, but before I went, I wanted to know what — if any — research had been done on injured athletes returning to their sports. There is, in fact, not much.

One article in the Clinical Journal of Sport Medicine had this to say:

“Sport psychology research, however, reveals that athletes may be physically healed and rehabilitated but not necessarily psychologically prepared to return to competition. Discussing his return from injury, Earvin Magic Johnson commented, ‘But I had lost a lot of confidence during the long layoff. And for a long time after I returned, I still held back. All I could think about was protecting my knee from another injury.’ As Johnson’s comment suggests, making the transition from rehabilitation to training and competition may not be an easy one for injured athletes. Until recently, the psychologic aspects of returning to sport from injury have unfortunately been largely neglected.”

What little research does exist, shows that there are typically four major concerns of returning athletes: Competency, autonomy, relatedness and re-injury.

Competency is your ability to perform, and for any athletic person — even when you are in a non-competitive environment, such as an aikido dojo — one’s abilities are going to be paramount. I know that I questioned whether I would have the cardiovascular stamina to participate in a hard class and the flexibility needed to perform the techniques fluidly and with less risk of injury. While my time away from the dojo had included a lot of miles on the bicycle, I knew that aikido would tax my systems in a different way.

Autonomy was not so much an issue for me, as I had no coaches or sponsors pushing me into returning. Nonetheless, this is a very real issue that many athletes do face, and not just in the pro leagues, either. For youth athletes, one’s parents can be considered as your sponsors, and the pressure from parents and family to return to play can be forceful and unrelenting.

Relatedness is an important factor, for even those involved in solo pursuits. Athletes sidelined by injury may acutely feel their disengagement from their team or the rest of their sporting fraternity. Loss of membership in that group, and alienation from it, can serve as both a spur and a hurdle to returning. One may seek to become part of that elite group again — yet fear that you will no longer be accepted because of your absence, or your impaired competency.

A final concern is the fear of re-injury. Particularly when a severe injury takes one out of participation, the fear of being injured again can cripple an athlete’s ability to perform, regardless of their physical state.

So how can these handicaps be overcome?

First, if you have a coach, good communications about what you both see in store for the future is necessary. In my case, I had a discussion with my sensei of the past dozen years. We talked about why I left, and what some of my concerns were in returning. I was reassured by this conversation that a return would be possible — though it was equally clear that the nature of my practice would have to change.

A second task is to find a role model. Search out other athletes who have done the same thing you are attempting, and learn from their experiences. Love him or hate him, cyclists have a phenomenal role model in the form of Lance Armstrong. In the martial arts, one cannot ignore the story of George Foreman, who returned to boxing after retirement, and captured the world heavyweight title for the second time nearly 20 years after he first won the belt.

Another important step to take is to get very, very clear on your motivations for returning. If it is to regain a championship or title, or match an older personal best, an honest personal inventory may save you from re-injury. It is best to be clear in your understanding, as I was, that you will be bringing a different game than you had before.

For my part, such introspection proved invaluable, as it gave me a good understanding of how my practice would change, and what I could expect from myself.

So far, this approach has worked well. I was — shall we say — a bit tender after my first class, but I quickly got used to the aches and pains of regular training. There have been a couple of interesting surprises, though.

First was the recognition that I hadn’t lost as much as I thought I had, mentally, at least. The throws and other techniques still flow nearly naturally, to the extent that they ever did. Interestingly, a few times, my brain kicked into a weird overdrive where, instead of doing the throw that I intended, or was instructed to do, I went into an entirely different technique without consciously intending to. Perhaps I was responding to some subtle variation in the attack which made the alternative technique more attractive; or, perhaps, my mind just slipped a cog. The jury is still out on that one.

More expected was the sensation of trying to do things that my mind knew how to do, but that my body had simply lost the physical capacity to perform. This is most notable when being thrown, as I knew how I wanted the roll to go — I just couldn’t get my body to do it. I know I’ll get there eventually; I just need more time on the mat.

Other factors have been playing a role as well, particularly nutrition. Getting my nutrition back to spec to aid my return has also been a priority. Again, the nutritional approach that served me well before The Great Divide is not the same nutrition which is working now.

I would encourage anyone who is considering returning to their field of dreams to give me a a call. Together, we can help smooth the transition from reformed couch potato to athlete.

And if you get the sudden urge to train in Aikido — there is no better place to go the Litchfield Hills Aikikai. It is blessed with an excellent sensei, and a helpful and welcoming group of students.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Antidepressants: Failed drugs based on a faulty theory.The numbers are, frankly, horrifying.

The numbers are horrifying.

Ten percent of Americans over age six take antidepressants. Antipsychotic drugs, once reserved for schizophrenics, have become the top-selling class of drugs in the US, with over $14 billion in sales in 2009. ADHD, bipolar and autism diagnoses have exploded in the past two decades with at least 5 million US kids now on psychiatric drugs. Ten percent of boys take drugs for ADHD. Half a million kids take antipsychotics, including preschoolers.

Do Americans really need all of these drugs?

My answer for years has been a resounding NO! And, at last, mainstream thought is catching up with me and other like-minded thinkers.

When Prozac hit the market in the mid-1980s, the “chemical imbalance” theory of mental disorders began its ascendance. The theory was that an imbalance of neurotransmitters was the cause of depression, anxiety, and other psychological disorders, and that drugs were necessary to correct this imbalance.

The trouble is, the cart was put before the horse. In a spectacularly brassy display of marketing illation, drugs developed by pharmaceutical companies were found to affect levels of brain chemicals, and only then was the “chemical imbalance” theory of mental disease was developed — as a means of selling the drugs.

In real science, as opposed to medical marketing science, one usually hypothesizes and tests for the cause of a disorder before developing a tool for influencing that process.

Nonetheless, the success of the Prozac marketing juggernaut was phenomenal, with medical doctors worldwide clinging onto it even after rigorous meta-analyses of the drug testing data showed that Prozac and other SSRI’s were little more than prescription placebos.

In a recent book review, Dr. Marcia Angell, former Editor in Chief of the New England Journal of Medicine, finally agreed with what I, and other doctors, have been saying for years.

“Instead of developing a drug to treat an abnormality, an abnormality was postulated to fit a drug,” Dr. Angell said. “Or similarly,” she says, “one could argue that fevers are caused by too little aspirin.”

I have treated patients with depression, anxiety and other behavioral disorders for years, through a variety of means. Acupuncture, lifestyle, supplementation and herbs can all positively affect people with psychological disorders — in fact, just recently, research demonstrating the effectiveness of acupuncture on people with schizophrenia was released. From my experience, and from what I’ve seen of the research, these means are far more effective than drugs at long-term relief free from side effects.

Of course, the mere thought that I, or other physicians like me, might say something like “alternative therapies are more effective than drugs at treating anxiety and depression” would give the folks at the FDA a case of the fantods, so I wouldn’t dream of making a statement like that. (Since the FDA allowed Lilly Pharmaceuticals to lie through its teeth about the effectiveness of Prozac for decades, even after the APA’s landmark study disproved Lilly’s claims, I’m sure they wouldn’t permit honest, research-based statements. That would be a bridge too far.)

What, then, are some current explanations for depression and anxiety that make more sense than “oh noes, you have a Prozac deficiency!!”?

One theory that I find interesting in its coherence is the Malaise Theory of depression. This theory is based on the idea that depressive behavior in humans demonstrates the same symptoms as what is called “sickness behavior” in animals. When an animal is sick, it acts fatigued, has disturbed sleep patterns, moves and acts with extreme reticence, and shows an inability to take pleasure in normally pleasurable activities, such as eating and sex.

But in animals, this behavior is the response to an infection or injury, because it is energy-conserving, risk-minimizing, and immune-enhancing, allowing the animal’s body to utilize its resources for opposing the infection or repairing the injury. In other words, depression is a normal response to a major physical illness.

Which may be why, in some cases, I have been able to resolve depression by helping people to eliminate chronic gastrointestinal infections. In other cases, the body may be reacting as if there were an illness present even though there is none, prompting an ongoing, inappropriate depressive response. Thus, by eliminating the signals of illness, we can change the behavioral response.

Using this model of depression, it becomes apparent that antidepressant drugs, on the rare occasions that they do work, are enabled by analgesic properties which have nothing to do with their manipulation of brain chemicals. Other analgesics, including herbal or dietary analgesics can be more effective with considerably less danger to the individual.

I am also intrigued by the powerful analogies and symbology of Traditional Chinese Medicine when it comes to the causes of mental disorders. For Chinese medicine since the time of the Song dynasty, emotional dysfunction serves the reverse role of what I have just described — emotional imbalance results in physical symptoms, and emotions play a fundamental role in treating the majority of diseases under this paradigm. In modern times, psychiatric illness was stigmatized much as it has been in the West, and the treament by traditional Chinese doctors focused on the physical.

Jing shen bing, the Chinese term for mental disorders, is seen as damage to one of the five phases of matter — wood, fire, earth, metal and water — each of which is associated with different emotions, such as joy, anger, anxiety, thought, sorrow, fear of fright. And, not surprisingly for a neoconfucian society, both the absence or excess of any of these emotions is to be avoided. Through both acupuncture and herbs, the balance of qi through these phases was restored, normalizing the aberrant behavior.

Yet the value of psychological interventions was hardly ignored. Though it is not handled directly by a profession such as psychology, as in the west, behavioral therapy in the East is indirectly provided by religion. Alan Watts, in his seminal work, Psychotherapy East and West, wrote that “If we look deeply into such ways of life as Buddhism, Taoism, Vedanta and Yoga, we do not find either philosophy or religion as these are understood in the West. We find something more nearly resembling psychotherapy.”

And, in fact, the addition of psychotherapy or talk therapy, or behavioral therapy is critical to a successful treatment for mental disorders. Probably the most frequent referral I make is to mental health professionals.

When I am feeling optimistic, I see paradigm shifts such as the abandonment of the brain chemical theory of behavior disorders as a sign of a healthier future not only for patients but for the health care system as a whole.

Today, I and my peers currently serve as an underground railroad largely bypassing that system, shuttling people to health through hidden pathways — out of sight, out of mind, and noted by the mainstream medical polity only when we appear to be a threat to the status quo.

Which is a shame. A lot of people could use our help, especially for the treatment of mental disorders.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Cycling is the best vehicle on the path to better health.

Just recently, I had one of the proudest moments I have had as a doctor. No, it wasn’t a visit from one of my patients who have undergone successful acupuncture fertility treatment. Nor was it one of those patients who end up on my doorstep after seeing three specialists at the Mayo clinic and the hot-shot New York doctor from Yale, and all of a sudden start to get better after a couple of weeks under my care.

(As I told a new patient the other day — a patient who had come to me after exhausting all other options, “I don’t mind being the House of Last Resort. If I do what I do and it works, you’re going to think that I’m Thor, God of Thunder. If I do what I do and it doesn’t work, I’m no worse than the rest of those chumps that you’ve already seen. I’ll take those odds.”)

On the surface, what happened the other week was nothing spectacular at all. It was just a patient who parked her bike out front and came into my office. And as soon as I found out that she had ridden to the Center for her appointment, I broke into a smile that lasted the rest of the day.

Any of my patients who are reading this blog know why this would be so. It is only the new patient who will come in and say, “I didn’t know that anyone was here! I didn’t see a car parked out front.” A patient who has been here more than twice is more likely to say, “Oh, you rode the Redbike today.” (Of course, when it is the dead of winter, 10 degrees F outside, and 4 feet of snow on the ground, the comment is generally more along the lines of “You rode your bike today?! What, are you nuts?”

I’m what is known as a “transportational cyclist.” I ride my bicycle for almost any trip under 10 miles, including grocery store runs, trips to the hardware store, and I’ve even been known to fill up my bicycle trailer with Jerry cans of kerosene for the space heater. I would, under most circumstances, rather ride my bicycle than drive a car, and will hop on a bike with limited provocation.

And I am an absolutely shameless shill for cycling when it comes to my patients. Many of my patients are suffering from chronic diseases from heart disease to diabetes to fibromyalgia. And every single one of those diseases is responsive to lifestyle modification, particularly exercise. So my most frequent recommendation to my patients is to begin exercising, and I mean more than the rather ineffectual 20-minute meanders approved as “exercise” by most mainstream doctors. I suppose that is a fine starting point; but most of my patients will have to exert far more than that to knock those diseases back on their heels.

As I like to say, “If you aren’t panting, it doesn’t count.”

The call to exercise is not a suggestion which meets with frequent approval, particularly because the lack of exercise is one of the causes of many chronic diseases. So I’m already addressing someone for whom physical activity may be not only a distant memory, and at this point difficult to perform, but disdained as well. It’s an uphill battle.

Over the years, I have noted that the responses fall into one of four categories, much like the four children of Passover. The first, and my favorite, is the general agreement, as in, “You know, Doc, I’ve kinda been thinking the same thing.” This is wonderful, because already the patient and I are on the same page. All I have to do is find the wedge to get them moving.

More often, the response is a variation of “I know I should exercise, but I just don’t have the time.” This may be true — most mothers of young children really don’t have much time to exercise — but more commonly, it is an excuse. We tend to be able to find the time to do things that we feel are important. Sometimes it is my job to make sure you know how important exercise, and your health, really is.

A third type of response comes from a failure of confidence. “Oh no, I can’t do that,” this patient will say. These patients have often led entirely sedentary lives, and at this point are utterly disassociated from their bodies. They really have no idea whatsoever what their body can do, and may be terribly afraid of finding out the answer.

And the fourth, and most disappointing response is “I don’t want to do that.” These patients are not only unwilling, but will actively oppose any recommendations on my part that require physical activity. These patients are the ones whom I know stand little chance of succeeding in becoming healthy, because they are unable to accept the responsibility for their own health. They are the patients for whom “a pill for every ill” is a legitimate approach to wellbeing.

The best way to exercise, I have found, is to incorporate exercise into your lifestyle. And cycling is the easiest and most efficient way to accomplish this. I usually recommend cycling, instead of driving, for any trip under 3 miles. In our terrain, you’ll sweat, you’ll pant, and you will get a nice feeling of fatigue, especially if you are not used to physical activity. And if you have to get off the bike and walk up some of those hills, at least initially, that is just fine as well. Before you know it, you’ll be riding them.

And at the same time, you are getting the grocery shopping done, gone to the post office, and picked up the dog food.

Oh, yeah, one other thing — one stop you haven’t made is at the gas station. These days, a couple of missed stops puts some jingle in your pocket. In fact, I calculated that last year, I saved about $6,000 by replacing the truck with the bicycle whenever possible. I tend to slide that little factoid into my sales pitch as well.

Upon arising this morning, I thought to myself that I really should get out for a ride today. But on the other hand, I really wanted to leisurely sip a cup of coffee and read the news. It’s a dilemma faced frequently by anyone who works out on a regular basis, the competition between sloth and fitness.

Then I remembered that we were out of milk and almost out of eggs. Perfect. That means a trip to the farm was in order, a 7-mile round trip that I could easily bounce up to 10 miles by taking a couple of lefts instead of a right, and I could do the milk run at lunchtime.

Problem solved. Instead of having to dredge up the wherewithal to saddle up for an “exercise ride,” all I need to do is a little grocery shopping. And the exercise disappears, replaced by just another chore, but this time enlivened by a swift ride on two wheels, while I save a couple of pennies as well. (Anyone with a child in college is no doubt familiar with my obviously single-minded focus on shaving costs wherever possible).

And when you consider that during the recently overhyped “Carmageddon” in LA, a group of California cyclists managed to beat a jet plane commuting between Burbank and Long Beach, the added time commitment to cycle from A to B is generally miniscule.

Monthly, we are faced by additional research, confirming the already large corpus which demonstrates that regular exercise is the key component in avoiding, managing and curing many chronic diseases. (Yes, FDA, I said cure. Got a problem with that?)

Cycling is one of the best ways to incorporate regular exercise into your daily routines. It is age-appropriate regardless of your age, it is inexpensive, it is effective. It saves you money while reducing your dependence on prescription drugs and even more appropriate therapies such as mine.

I think that I will put a bicycle rack out in front of the Center. Please feel free to use it.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Sometimes lightning strikes at the best of times.

Thursday’s wild storm left the Center for Alternative Medicine without power for a day, and what an unusual day it proved to be! Though my hours were quite fully filled for Friday, I went in that morning with low expectations for the day. I told my ever-suffering office manager, Teresa, to stay home, as I expected that I would easily be able to handle what few patients showed up.

Of course, I had no idea of exactly who that might be, as I converted to entirely digital scheduling and medical records several years ago. In fact, when it comes to solo doctors’ offices, my practice is pretty close to the bleeding edge, technologically speaking. I have set up a highly integrated network of Linux-based servers, desktop systems, laptops and netbooks and even smartphones, all entirely fueled by international-standard FOSS software. In fact, to my knowledge, I am the only doctor in the country whose practice is entirely built around the Ubuntu operating system. We use no Windows or Mac operating systems or applications, from patient charts to accounting.

All of which, of course, was of absolutely no use on Friday. Even a battery-powered laptop was ineffectual, as it needed a functioning router and powered-up server to tell me anything about anything.

So I went into the office Friday morning prepared to amuse myself by engaging in an archeological dig through the junk mail, research journals and meaty tomes on acupuncture which have been serving to hold my desk firmly onto the floor for a few months.

I abandoned that project, mid-pile, when my 9 o’clock patient walked through the door. Then the 9:15 patient showed up. And all of a sudden, in darkened office with windows opened to the breeze, my day came alive. The next time I looked at the clock, it was lunchtime. I took a quick lunch, and was back at it for another 6 hours.

It was at some point, while I was blending a custom herbal formula for a new patient by the light of the sun streaming in the laboratory window, that I realized just how independent of technology is the practice of primary care chiropractic. Here I was, with no notes, no power and no machines, treating patients as I would on any other day.

Granted, it wasn’t quite the same. With no water for washing my hands between patients, I resorted to rubbing my hands with alcohol, not a dermatologically comfortable practice when you are doing it 30 or so times. And without power, the bath of hot water in which I store my thermal packs is just a bath of tepid water.

As many of my patients know, I often apply heat prior to myofascial therapy because it makes the process a bit less painful. So a few of my patients on Friday experienced a tad more discomfort than usual, but all managed to take it in stride.

Chiropractic adjustments were similarly easy. I’ve chiropractically examined and adjusted people just about everywhere and on just about everything, from logs deep in a national forest to incubators in a neonatal ICU, so adjusting in natural light with the windows open did not even draw conscious notice on my part.

Acupuncture treatment was a bit trickier. The room in which I usually treat my acupuncture patients is without windows, and is dark as a cave with the lights off. So I re-fitted one of the tables in my other exam room with outriggers to be used as a suitable acupuncture room.

What was more difficult was determining treatment protocols and plans, all of which comprise part of a patients’ chart. For each patient, I note where I am adjusting, and which adjusting techniques are used. And I will often alternate complementary therapies. Acupuncture patients also have an individualized point prescription which I follow for treatment. With none of these available, I was forced to rely on my memory.

Interestingly, I was pretty successful. Fortunately, a chiropractic doctor develops a close enough relationship with his patients that when my memory did falter, people cheerfully volunteered the information, often with a teasing jab at my stumble. It was all good-humored though, and nobody seemed disaffected because they had to remind me of my duties.

And when their treatment was finished, it was “Goodbye, I’ll have Teresa call you about appointments and payments!” Nobody seemed to mind. Everybody likes to leave the doctor’s office without having to pull out their wallet!

Notes were jotted down on pieces of paper and put on the desk for transcription when the power went back on. At 4:30, I walked out of a treatment room, and realized that there were some lights on in the hall. The CL&P linemen had pulled out all the stops in getting the power back up; and I recalled that some time earlier, I had seen a truck hauling a rather oversized transformer up the road. Perhaps a swap had been made.

But by then I had established a rhythm to the day, and I decided not to disturb it. Until hours ended at 6:30, I continued to work the day old-school style, sleeves rolled up, as chiropractic doctors have for generations before me. It was really a very welcome return to my roots.

For a few minutes before I left on Friday, I sat on the bench in the front of the Center and reflected on the day. Though busy, it had proved to be exceedingly pleasant. Without telephones or email to pester me, I was really drawn into the present and the presence of my patients to the exclusion of all else. As I have written before, it is really that relationship, between patient and doctor, that is the source of my joy in my work; to have it enhanced in that way was not only surprising, but also served as a reminder to me. It was a call for me to, professionally speaking, stop and smell the roses. To forget the distractions and to focus on what is truly important:

The healing power of both touch and words. The ability of laughter to pierce through pain. The sincere “thank you,” unblemished by commerce. Those are the things that matter to both my patients and myself, and in turn make my practice as healthy and robust as it is.

Isn’t it funny how a loss of power should actually become its reclamation?

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Clean well water, stored in a glass carboy. Yum!

It was many years ago when the first warnings came out. In fact, a 1999  study found that 22 percent of bottled water brands had at least one sample containing chemical contaminants at levels above strict state health limits. It wasn’t long after that when a study from Goethe University at Frankfurt found that a high percentage of the bottled water contained in plastic containers was polluted with estrogenic chemicals.

Since then, the research has just kept piling on the fact that water stored in plastic containers simply isn’t safe. Over the past few years, research uncovered the fact that the plastics commonly used for water bottle storage release a chemical called bisphenol-A into the water. Bisphenol-A (aka BPA) is what is known as a “xenoestrogen.” Xenoestrogens are chemicals that act like estrogen in our bodies, fooling us into thinking we have more estrogen inside us than we do. This creates numerous problems, for males and females alike. Estrogen dominance is a frequent cause of perimenopausal health problems, and the presence of too much estrogen-like chemicals in men can cause infertility and unwanted physical changes.

Bottle-makers began switching over to “BPA-free” plastics, and all seemed well and good for a few years, until more recent news came in: A full 33% of all plastics leach toxins into food and water, regardless of whether they were BPA-free or not. In addition to xenoestrogens, other toxins were released into the water in as little as 2-3 days, according to a Swedish study.

This would not have a major effect on products such as reusable water bottles, such as those used by cyclists and runners, as those are emptied within hours, long before toxins or xenoestrogens would be able to leach into the water. Which is why I’m comfortable using BPA-free reusable water bottles as one of the rewards for the members of my DocAltMed Fitness Team.

However, it never sat so well with me that the water coming from the bubbler in the reception room of my office was stored in plastic bottles. Even though I had been assured by my suppliers that the plastic was BPA-free, the most recent studies made it clear that there was little doubt that the water I was supplying to my patients was tainted.

One of the key tenets for me as a doctor is that I must walk the talk. The only way, in my mind, that I could possibly have the authority to tell people to fundamentally alter their lifestyles is to live a healthy lifestyle myself. (Thus the bike (or trike) sitting by the door, where I park it after riding it to work.) And it seemed to me that giving people water which has likely been sullied by toxins was probably not in keeping with my core principles, particularly when you consider the amount of my professional life I spend cajoling people to imbibe the stuff.

But it wasn’t easy to change. I searched high and low for bottled water companies that would deliver in old-style glass carboys. And, in fact, there is one — in Baltimore. The Center, apparently, is outside of their delivery area.

Then again, who needs bottled water, I thought? All I really need is a cooler/bubbler, a glass carboy, and a water source. So I had the well water at the Center tested, and it was clean of all of the contaminants that I could test for. In addition, it is moderately hard, giving the well water a pleasing taste.

So a couple of weeks ago, I fired my bottled water company and we went online with our clean, fresh, local water. After getting everything all set up, Teresa and I noticed an enjoyable side benefit. As you draw water from the tap, and the bubbles pop to the surface of the carboy, they make a pleasant and happy “Ping!”, very unlike the “blurp” of the old plastic bottles, which sounded a bit like an old man’s response to a fatty meal.

So if you would like to sample our very tasty well water, and experience it’s delicious Ping!, stop by the Center for a glassful. You don’t need to be a patient. Just thirsty.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Brazilian model Lea T.

Imagine, for a moment, a disease that affects 1 in 10,000 people. That is a fairly common disorder; about the same number of people that are affected by glaucoma or deafness, and three times more frequent than brain cancer. Add to that image a mortality rate of 41%. That’s a pretty serious disease, isn’t it?

Let’s add a bit to that picture. The treatment for this health problem is not terribly expensive, nor difficult. It requires some common, inexpensive drugs. It also requires some surgery, in the price range of $12,000. None of this treatment is particularly unmanageable or experimental, though as with any medical procedure, research would no doubt find room for improvement, and it does take a certain level of specialization.

What would you say if you found out that there is no insurance coverage for the treatment of this common, deadly disorder? And despite the fact that you may pay thousands of dollars per year for your insurance coverage, if you or a loved one had it, not a single dime will go toward the payment of life saving treatment.

That disorder exists. It’s called Gender Identity Disorder, and though we don’t know the cause of it, we do know how to help people with it. Through the use of hormones such as estrogen and testosterone, and surgery to help people’s bodies reflect their self-identity, we can not only vastly improve someone’s health and quality of life, we can also save their lives. Untreated gender identity disorder is associated with high suicide rates, and very high levels of substance abuse, as people try to self-medicate their pain.

All too often, GID (also known as gender dysphoria) is tossed off as a problem of morals, as if it were rectifiable by the application of religion, or as a manipulative version of homophobia. Even in the psychological community, there have been attempts made to reclassify gender dysphoria as an oddball variant of homosexuality.

In particular, there is the claim that male-to-female transsexuals are simply gay men who cannot admit their attraction for other men; or, alternatively, that this same group is  sexually aroused by the image of themselves as females, and thus turn to drugs and surgery to fulfill their autoeroticism. Not only do these half-baked theories fail to explain those seeking to transition from female to male, it also fails to take into account the full range of sexual expression, as transgender people may be gay, straight, bi or uninterested, just like everybody else.

The more likely explanation — and the one that has objective research supporting it — is that the vast majority of people who would prefer living as the opposite gender are simply responding to the way their brain is wired.

That’s right. The preponderance of the evidence these days points to the idea that for some people, during fetal development, their brain growth follows one gender track while their bodies follow another. The mismatch may be noted as early as mid-childhood, though for others the problem does not become evident until puberty, as the genders further differentiate, and as one transsexual person said, “it was all wrong!”

Even so, many people will continue to live with this precarious disconnect between their bodies and their brains because they feel they have no alternative. Afraid of the discrimination and out-and-out violence that is directed toward transgender people, even within the medical community, they suffer quietly. And their suffering takes its toll, in very high rates of depression and its end result, suicide; in drug abuse and alcoholism, as they try to manage their anguish by becoming oblivious; in unemployment and poverty, as their depression and anxiety makes it difficult to hold a job, or even worse, being fired after their condition becomes known to their employer.

The argument that transgenderism is “just” a boy who likes girls’ clothing or a tomboy gone too far is like calling a melanoma “just” a skin blemish. Gender identity disorder is serious, often deadly, and levies an awful toll on both the individual and society.

Which makes the denial of coverage for this disorder little short of heinous, particularly because the solutions we have at hand are relatively successful and not particularly experimental. Unfortunately, even for those people with health insurance, denial of coverage for surgical transition is the norm, via a “Transsexual Exclusion Clause” which excludes all medical procedures related to a person’s transgender status.

With the combination of hormones and surgery, medical doctors can create an internal and external state where one’s body more closely parallels one’s gender self-identity. No, it’s not a perfect answer; few medical responses to chronic conditions are perfect. Nor is surgery the right answer for all transgender people. But for many, the surgical answer is literally life-saving.

Enter the Jim Collins Foundation:

The mission of the Jim Collins Foundation is to provide financial
assistance to transgender people for gender-confirming surgeries. The
Jim Collins Foundation recognizes that not every transgender person
needs or wants surgery to achieve a healthy transition. But for those
who do, gender-confirming surgeries are an important step in their
transition to being their true selves.

Last week, the Foundation awarded its first grant to Drew Lodi. “The Jim Collins Foundation for me is a miracle,” Drew said. “They helped me to stay motivated to live each day purposefully…I improved my life, mind, body, relationships, and faith. To know that people are out there who do NOT have to be helping–but are–makes me motivated to do everything I can…”

The Foundation awards grants based on a combination of financial need and preparedness. And it aims to be more than just deep pockets for people in need. The Foundation strives to empower people to find creative means of financing surgery for themselves, at least partially. Drew, for example, began funding his surgery by collecting bottles and cans for their deposits.

Having firsthand seen the results of the life-saving surgeries which the Jim Collins Foundation funds, I cannot think of a more worthy, or necessary organization deserving of your support and donations.

I know that money is tight for everyone, as this country slowly claws its way out of the Great Recession. But to the extent that you can consider a charity at all, I hope you will consider making a donation to the Jim Collins Foundation.

Gender dysphoria is the disorder that nobody wants to talk about, but that affects millions of Americans just the same.  The cost of treating every person who needs the life-transforming surgery amounts to 5 cents per American citizen. Do you think you could spare a dime to save a life?

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.