I attended a relicensing seminar via Zoom last weekend focused on the basic standard of care issues and how to document everything in an appropriate history and exam. One of the topics that came up repeatedly was wellness care. Both presenters were extolling the value of a wellness care type practice. This has been the focus of the newsletters I have been writing every week for the last ten years, but inside my office, most of my time is spent on acute pain care. Over the years I have been to various seminars that have talked about wellness care, but what that meant in the context of the seminar was generally convincing patients that weekly Chiropractic visits would free up any nerve interference and improve their health. While the concept is true to some degree, I have never been convinced that ‘the bang was worth the buck’ for most people. Someone who has chronic joint instabilities due to degenerative arthritic joint changes would feel a significant benefit from such care, as well as someone under a lot of physical or mental stress dealing with chronic muscle tension. But for myself personally, I don’t have much going on that needs relieving. I guess if I don’t feel a problem, I’m not motivated to pay somebody to fix what I can’t feel.
Now don’t get me wrong. I am really big on health maintenance and doing whatever it takes to stay healthy. I am just not big on having someone else guide me through that process. I am very do-it-yourself with everything. But what I was appreciating during this seminar is that not everyone has my do-it-yourself focus of interest on health. My newsletters provide a ton of guidance for understanding what needs to be done to be healthy, and how to do it. But I have been leaving it entirely up to each person to decide what they feel attracted to doing based on personal interest.
I still believe this is the best way to approach health care, but the big picture understanding of what is most important and when to start dealing with it is missing in this paradigm. Usually, we are attracted to putting out the fire at the moment – fix what hurts. That makes perfect sense. What is missing is grasping that most problems are the tip of an iceberg with years of building up to the symptomatic expression. This does not apply to a traumatic accident injury of course (usually). But most other pain issues usually have a long history of subclinical unbalances building up to the eventual symptom. This is where wellness care might have an appropriate use in my book. In some ways, wellness is considered preventative care, but in reality, so many things are always going wrong in our bodies that we never know about because the results of the problem don’t produce pain. Take diabetes as an example. Most people have absolutely no idea they are becoming diabetic until a blood test says so. There is nothing to feel until things are so destroyed that it is almost impossible to reverse the damage. So many degenerative processes in the body act like this and could be stopped before it is too late. Pain is a late-stage symptom. Wellness would be looking to correct patterns way before the pain stage.
Wellness has to be a personal quest because the modern medical insurance system is not built to look for wellness. It is a buzzword that health insurance companies are using in their marketing literature because the public is waking up to this idea. But sadly their idea of wellness is getting your flu shot and taking meds for just about everything. They give lip service to diet and exercise, but they haven’t a clue. They still follow the outdated medical models from 50 years ago. What that means in plain English is that you have to pay out of pocket for wellness care. They won’t pay for special lab work or supplements or exercise equipment. Their contractual obligation is to take care of you after you have gotten sick enough to need serious medical intervention, not before. For them, prevention is low salt, low cholesterol, and immunizations. Wellness is so much more than that.
So what is wellness? I did a google search on the term wellness – interesting. From the first page, there are apparently four, or ten, or eight, or maybe twelve dimensions to wellness. The diversity of answers to ‘what is wellness’ tells me that everyone is making it up as they go along. Why not? It does create confusion when you are looking for specific actionable steps towards wellness when there is no consensus as to what wellness even is. So we will have to make up our own meaning. We grasp that wellness is a lot more than simply not being sick, but how much more? Are there standards? Is it enough to be able to use your body effectively to do what you want and need to do, or do you have to be able to run a marathon, lift 500 pounds, and balance on a tight rope to be considered well? I like the first half of the previous statement more. While fitness is certainly a part of being well, excessive performance goals often actually inhibit wellness. Wellness involves an integrated balance between many aspects of your existing experience. Most wellness gurus promote this balance between the physical, emotional, mental, and spiritual aspects of life. I see all of these play out as different aspects of the body. Each shows up in the body in different ways. Other gurus add in bonus areas to the mix like social, environmental, financial, family, and a variety of psychological things. Many of these feel more like individuals just promoting their agendas by tagging it to the wellness buzz.
As a doctor, my focus is on wellness as it shows up in the body. Imbalances in our body can usually be detected through symptoms other than just pain, as well as various lab tests, neurological tests, orthopedic tests, provocation testing, and so on. Physical, emotional, mental, and spiritual imbalances all show up in the body if you know how to look for the impacts and patterns. This is really what the foundation of Chiropractic was built on. The original principle in Chiropractic is that life flows from the top-down and the inside out. At that time the only known physical system that operated that way was the nervous system, so Chiropractors focused on that. Now we know that the hormone system and the immune system also operate this way, which opened up the field of psychoneuroimmunology. Boy is that a mouthful! We now know that what we think and feel directly affects not only our nerves but our immune system and our hormones. These are the control mechanisms that run everything in our bodies. Put simply, everything affects everything. That makes wellness incredibly complex, organic, and interconnected. Fortunately, we have millions of years of biological wisdom running this show and engaging wellness is all about aligning our actions to be alignment with this innate wisdom.
So how do we do this? If we want to do something a little more specific than just taking up yoga and eating organic, what do we do? The first step is to start looking at all the little life symptoms that are telling us things are not exactly ideal and see if we can divine any pattern to them to give us direction. Simply engaging in “healthy” behaviors is very valuable. Most of my newsletters give just such advice. But we usually find that there are some things in our life that need more individualized attention. Generic good stuff doesn’t seem to be enough.
Six years ago I put together information and diagnostic questions from many sources into one massive health questionnaire. It makes a good first step in the quest for wellness. Of particular interest is how the questionnaire is laid out in a priority framework. What that means is that the most important things to address are tested first. This questionnaire is available on my website here.
Everything in the body affects everything else, but not equally. Everything exists as a priority. For instance, getting oxygen to the brain is the top priority. If that is not happening efficiently, nothing else works. If it is impaired even a little bit it affects everything else. Your hormones might be all messed up and neurotransmitters all out of balance, but that is of minor importance compared to oxygen to the brain. Number two is getting energy production happening in the brain. This usually means good blood sugar levels in the brain. This is commonly compromised and is why going on a keto diet is so powerful for most people because it replaces sugar with ketones as an energy source for the brain. Ketones are a much more stable energy source for the brain and much less inflammatory.
So where is all this thought process going? Essentially, I have already created the systems necessary to serve my patients who wish to build wellness into their lives. I have been teaching it forever in person and through my newsletters. I created Heartflow and Gracework to address the mental/ emotional/ spiritual aspects of wellness and then taught it to Ellen as it takes more time involvement than I have available. I have the backdoor access to Lab Corp lab tests that gives me about a 70% discount on tests for my patients. (A really thorough workup can be had for only about $300 that would normally cost more like $1200.) I even have a book published on Amazon that addresses a lot of these issues. Although I am quite happy with my simple acute care practice, I am available for those of you that want to engage the wellness journey.
If you are interested, the first proactive step would be to fill out a Health Assessment Questionnaire. It is available on my website and in a more condensed 5-page form at my office. Wellness is a life-long process. It is not a goal, but a journey. If you wish guidance in this process, I am available.
Take care,
David