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Advice When Choosing a Functional Medicine Doctor

1/9/2014

3 Comments

 
I think this goes without saying; I think that Functional Medicine is the bomb-diggity dog. It is what medicine should be- patient centered care and focuses on identifying and treating the root cause of the patient's problems.

Functional Medicine is gaining popularity and is starting to be taught in some medical schools and chiropractic schools. This is very exciting, but it also means that there are different "flavors" of functional medicine doctors. Being aware of these specialties and differences will help you in choosing your functional medicine practitioner.

The type of physician you go to will tell you a little bit about their treatment approach. This isn't set in stone, but purely based on their scope of practice this is what you can expect in such offices:
  • Chiropractors pride themselves on being the non-invasive specialists. It is not within our scope of practice to prescribe medications, however many chiropractors do use supplements in their office. A chiropractor who specializes in functional medicine will likely have a much better working knowledge of supplements than your average chiropractor. I find that chiropractors who use functional neurology and functional medicine have the most well-rounded approach and are the brightest in the field. To find a doctor who specializes in functional neurology click here. Keep in mind that the doctors listed here may or may not do functional medicine, too.
  • Medical Doctors and Osteopaths (MD, DO) are largely taught how to treat disease with drugs and surgery. Sadly, generally speaking, medical schools teach very little nutrition. More MDs and DOs are getting into the field of functional medicine, but many of the ones I have interacted with still have a limited working knowledge of nutrition and supplements. However, these guys are sometimes better suited to cases that either require the prescribing of medications or weening off of medications.
  • Acupuncturists are also getting into functional medicine and tend to be very savvy with herbal supplements, since that is such a large part of their acupuncture training. Like chiropractors, acupuncturists can not prescribe medications. More typical treatments with an acupuncturist include acupuncture (duh), herbs, cupping, meditation, and qi gong.
  • Naturopaths (NDs) often offer a little bit of both worlds- they have the ability to prescribe medications in a few states, but tend to be less prescription-happy than MDs and DOs. Much of their ND training is very functional medicine-esque, but they often do different types of tests that I personally don't fully endorse (heavy metal hair analysis, urinary neurotransmitters, IgG sensitivity testing). The big thing to realize with NDs is that they are not licensed in all 50 states- actually, they are only licensed in about 16 states right now. Even if they are licensed, their scope of practice varies a lot state-by-state, so unless you live in Arizona or Oregon you will likely be better off finding another type of physician.

There is no one accrediting body for functional medicine. There are groups and online courses that teach functional medicine (such as the IFM and Functional Medicine University), but know that there are numerous other places where doctors can receive their training. For that matter, being listed on their website doesn't necessarily say that the participant fully understood the material and can put it to good use in a clinical environment. The best way to assess that is by reading about the doctor's credentials and experience, reading their blogs, following them on facebook and twitter, and ultimately talking to them!

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. ​​Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

In health,
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3 Comments

My Approach to Chronic Pain

9/17/2013

2 Comments

 
This is part of a series I call "My Approach Mondays" where I discuss how I approach different symptoms and diseases. I hope you find this information helpful!

Chronic pain affects more Americans than diabetes, heart disease and cancer combined [1]. This means that nearly 1/3 of the people in this country suffer from some form of chronic pain!
Six of the top ten most prescribed drugs in the US in 2005 were pain medications and four of them are used to treat depression [2]. Coincidence? I think not. It's not surprised we're all bummed out- many of these people go to doctor after doctor and never really get an answer. When x-rays and MRIs come back clean the patient almost always gets told that they are fine (translation: I think it's all in your head because on film you look fine) despite being in chronic, often times debilitating pain.

The thing that is absolutely critical for you to understand is that pain is a cortical event- it takes place in the brain. The only thing that needs to happen for you to feel pain is those neurons in your brain that perceive pain need to come to threshold. The thing that makes pain so tricky (and fascinating) is that those neurons can be brought to threshold for a million reasons.
- Receptors in the skin or tissue get activated by tissue damage* or other processes
- Mechanical receptors in the tissues stop firing**, and thus, stop inhibiting pain neurons
- Neurons in the spinal cord that normally inhibit (stop) pain pathways stop firing
- Neurons in the brain stem that normally inhibit pain stop firing
- Neurons in the brain that produce the perception of pain fire
- Neurons in parts of the brain that normally inhibit pain stop firing

*The underlying assumption in almost all conventional methods for diagnosing and treating chronic pain is that there is tissue damage. I would argue, however, that this is often not the case.
**This is why movement in the form of exercise and spinal adjustments are so critical to any pain management protocol.

We could break this list down further and examine reasons why various neurons either stop doing their job or start firing when we don't want them to... but that would make for far too long of a post. Just know that anything that causes inflammation, disease, or imbalance in the body affects every single cell in your body including the neurons involved in pain perception. Examples could include diabetes or blood sugar problems, anemia, hypothyroidism, concussion, leaky gut syndrome, autoimmune disease, food sensitivities, hormonal imbalances, or lack of quality sleep.

My general approach with chronic pain is simply:
1. Evaluate weather or not the pain is coming from actual tissue damage through the use of orthopedic testing, X-ray or MRI
2. Take a holistic approach to finding the root cause(s) of imbalance or inflammation (such as those above) in that person and address those issues using as holistic and non-invasive approach as possible
3. Share in that person's joy when their pain magically gets better as their body gets healthier (often-times)

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

Yours in health,
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2 Comments

Functional Neurology

7/4/2013

0 Comments

 
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Chiropractors have been boasting for years that we are neurology specialists- that we treat the spine, and therefore the nervous system. One classic explanation for this is because an important part of the central nervous system, the spinal cord, lies within the spinal canal that goes through each vertebrae. Another commonly used explanation for this is that subluxation, that "bone out of place" that chiropractors adjust, can put pressure on the spinal nerves and obstructs nerve flow or vital force that goes to each target organ. And while both of those theories may be true to some extent, there seems to be a better explanation.

More recently (since about the 80s or 90s) as our understanding of neurology has advanced, so has our understanding of chiropractic's affect on the nervous system. Simply put, adjustments are felt by the patient, which means that they are sensed and interpreted by the brain. Depending on the location of the adjustment, the type of adjustment, or the timing of the treatment, the brain will interpret that information a different way. This also calls attention to the very real, but all too forgotten reality that everything in our lives provides different stimulation to our brains. Whether it be the food we eat, the sensory information from our feet, or the thoughts we think, everything is perceived by the big guy upstairs- whether we are consciously aware of it or not. Furthermore, the brain has the remarkable ability to adapt to the stimulation it receives- or as we in the biz call it, neuroplasticity. This is the basis for neurological stimulation such as what we use in functional neurology. As the weak circuitry is stimulated, the pathways are strengthened and allowed to operate more smoothly.

As a clinician who wants to help the more "complicated" patients out there, I find it will be especially important for me to know not only how the body affects the brain, but how the brain affects the rest of the body. This is why I have chosen to study chiropractic neurology (also called functional neurology). Functional neurologist take extensive classwork in addition to their chiropractic degree coursework to further understand the nervous system. To get a diplomate in functional neurology one must complete a minimum of 300 hours of additional coursework in neurology and pass a rigorous clinically oriented test. Many chiropractic neurologists are also well versed in functional medicine- another critically important skill set when treating the so called "complicated" patients that are becoming increasingly common now.

Chiropractic neurology has received a lot of press in the last few months, mostly because of Dr. Ted Carrick's work treating hockey star Syd Crosby. Since then, Carrick and functional neurology has seen a lot of positive press, as well as a lot of skepticism. For example, one particularly rude reader commented on an article about Crosby that "last he knew, concussion was not caused by a subluxation"... And I agree, but we never claimed that it was! When applied in a specific way that is unique to the patient's neurological needs, chiropractic adjustments can be a very powerful and effective way to stimulate the brain. Furthermore, functional neurologists such as Carrick use a variety of treatments in conjunction with their adjustments including eye exercises, as well as balance and coordination exercises. That poster's comment not only reveals a clear lack of understanding of basic neurology and neuroplasticity, but an unawareness of what chiropractic neurology is all about!

Chiropractic neurology helps the brain function at it's very best. Certainly anybody could benefit from chiropractic neurology, but it is particularly great for people with neurological disease or symptoms. If you know of someone who's brain is not functioning at it's best, finding a qualified chiropractor near you may make a world of difference in that person's life. I encourage you to go on the American Chiropractic Neurology board's website and find a chiropractic neurologist near you!

If you or somebody you know is interested in working with a functional medicine doctor please call my office at (919) 238-4094 and see if we are the right fit for you. Infinity Holistic Healthcare is located in Chapel Hill, North Carolina, part of the Raleigh-Durham "triangle" area.

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Resources:
Doctor locator-
http://acnb.org/doctor-locator
*note, I am not on the doctor locator because I haven't taken my diplomate exam yet.

More on Crosby and Carrick-
http://video.ca.msn.com/watch/video/inside-hockey-sidney-crosby/16atihz31
http://prohockeytalk.nbcsports.com/2012/01/16/crosby-to-see-chiropractic-neurology-specialist/

More about Functional Neurology in the press-
http://vimeo.com/47787677 (Carrick on ABC's nightline)

Trailer and information about the functional neurology movie  Hope Restored-
http://www.myhoperestored.com/

A fun read on neuroplasticity and changing your thoughts for the better-
http://www.mysticmusingsandmeditations.com/2010/03/is-it-really-possible-to-rewire-your-brain-7-days-to-a-new-positive-you/
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    Nicole DiNezza

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