Cupping - The Miracle Revealed

         I escape from work for an extended lunch hour.   It may be a bit irresponsible of me to turn off my pager and silence my phone in the middle of the day, but the reward is decadent - an hour of true relaxation.  Also, I don’t want anything to detract from my cupping experience.  The spa is located in a cozy cottage in the Montford historic district of Asheville.  Without GPS assistance, it would be nearly impossible to find.  As I enter, I am greeted by a diminutive blonde woman who will be my cupper – if that is the appropriate term.  She hands me the requisite form to list why I have come and to give my past medical history.  There is a line to indicate if I have any communicable diseases.  I pause and think of some cool diseases I might write down.  After a bit of contemplation, I decide to write “leprosy” on the line while enjoying a small chuckle.  I also note that I suffer from chronic lower back pain and bilateral shoulder tendonitis.

     When I have finished completing the form, she leads me into a small room with a massage table in the center.  She explains that the session will be an hour in length with some initial deep massage followed by cupping.  She asks what I hope to gain from the session.  I say that I would like to have two fully functional shoulders, relief of my back pain, and at least one Olympic gold medal.  She gives me a sideward glance and says, “Special Olympics maybe.”  She is a funny one.  Doesn’t she realize that humor is my shtick?  She then shows me the cupping machine, which is about the size of a bread box with numerous dials and gauges along with several tubes connected to glass cups.  Basically, it is a small vacuum device.  She says she will step out while I get undressed.  She indicates that I can fully disrobe or leave my underwear on.  I sheepishly opt for wearing my boxers.

       When she returns, I am safely tucked in face down between the warm sheets on the massage table.  For the next hour, my visual field is limited to the shadows and movements which I can see from the hole in the head rest.  She is barefoot with painted toenails – that is about all I know.  She tells me that she may be small, but that she will do her best to give me a good, deep massage.  “Think of me as a hefty Russian woman, rather than a small woman who weighs 100 pounds soaking wet,” she says.  While I lay there waiting to begin, she says, “I see you suffer from Leprosy.”  I laugh, forced to reveal my little joke.

        She dims the lights and turns on some soothing background music.  Then, she gets down to business.  She kneads warm lotion into my back and shoulder muscles.  I am in my happy place.  For the most part, I enter a zone of semi-consciousness.  She thoroughly works me over, from my shoulders down to my upper buttocks.  After about 40 minutes, she pauses and turns on the cupping device.  She applies the vacuum cups to my back and shoulder.  It feels like she only applies one or two at a time, but I am not sure.  The longer the cup is applied, the more intense the pulling sensation.  It feels like a strong vacuum cleaner being applied to my skin.  She alternates between leaving one or two cups in a single place while massaging a different region of my back – using massage as a distraction so that she gets me to relax areas I would otherwise naturally tense up.  She also uses the cups like vacuum cleaners, rubbing them up and down my back and shoulders with intermittent stays for a few seconds in different regions.  The cups create a little discomfort, but nothing too unpleasant.  They do little to jolt me out of my state of relaxation.  After about 20 minutes, she clicks off the machine, and we are done.  Prior to her stepping out the room, she tells me to take my time getting dressed.  She also encourages me to drink a lot of water throughout the rest of the day.  She also says I should expect to get a few stares if I go swimming or participate in group activities without a shirt in the next few days.  I pay 105 dollars, and after a little small talk, I am out the door.

        When I get home, I strip off my shirt and examine my back in the mirror.  I look like Michael Phelps, minus the big shoulders and V-shaped back.  A number of silver dollar sized bruises pepper my back.  I tell my kids I was mugged by a man with a baseball bat on the way home, and I am lucky to be alive.  They almost believe me.  They act concerned, but then I reveal the truth, and they again regard me with typical indifference.  They are used to my kidding.  I do look forward to showing off my marks at the pool. 

        Aside from the new experience, are my shoulders and back better?   Time will tell.  

 

 

Please check out my recently published book on Alternative Medicine.  It makes a great Christmas gift!

 

https://www.amazon.com/Are-You-Afraid-Snakes-Exploration/product-reviews/1935660268/ref=dp_db_cm_cr_acr_txt?ie=UTF8&showViewpoints=1

Cupping - I want to be like Mike

            Finally, my book on alternative medicine is published!   I tried every alternative therapy there is – or did I?  This past summer, after completing the final version of my book, edits and all, the Summer Olympics come on television.  And what do I see?  None other than the great Michael Phelps, ageless wonder and swimmer extraordinaire, covered with hideous red circles.  Has he been attacked by an army of leeches while swimming in the contaminated waters of Brazil?  No, I learn from the announcers, he is the latest disciple of cupping.  Not only does he go on to win a gold medal in the event I am watching, but he goes on to rewrite the record books as the most decorated Olympian ever.  Certainly, cupping is his secret.  As a result, everyone asks me if I have tried this ancient therapy.  When I say “no,” I can tell I have lost a potential reader.  What kind of alternative medicine book leaves out cupping?  I rationalize that cupping is “alternative” alternative medicine.   Alas, I learn that cupping is not just popular with Mr. Phelps, but that People magazine’s world’s most beautiful woman, Jennifer Aniston, along with Gwyneth Paltrow, Victoria Beckham and even tennis star Andy Murray are devotees of cupping.  Thus, despite having completed my book, my adventures in alternative medicine shall continue – I must try cupping.

            “What is cupping?” you might ask.  Cupping, a form of acupuncture, dates back over 5000 years.  It is reported that as early as 3000 B.C., the ancient Egyptians performed cupping. Hippocrates purportedly used cupping to cure internal disease around 400 B.C.  Later, cupping was embraced by the Chinese, and it continues to be popular in Asian culture even today.  The goal of cupping, which is achieved by creating vacuum pressure in cups applied across your body, is to draw out inflammation by increasing the local blood supply to the underlying muscles and skin, thus allowing toxins to be carried away.  These are two of my favorite alternative medicine themes – “inflammation” and “toxins.”  Reading further, I learn that both acute and chronic conditions can be treated by cupping.  How is cupping done?  There are various methods.  In one, cup-like pneumatic devices which create suctioning like a small vacuum cleaner are applied to the skin, while more traditional methods involve lighting alcohol on fire below a glass cup overlying the skin, creating a vacuum as the oxygen is gobbled up in the chemical reaction.

            Where does one go to get cupped?  A quick internet search finds cupping to be quite common in Asheville -  and I thought the multiple red circles seen on everyone’s back were just strange tattoos.  It just so happens that my wife’s favorite massage parlor, if anyone uses that phrase anymore, offers cupping.  I schedule an appointment for one week from today.  My visit is timely:  my lower back continues to pain me and my shoulder tendonitis has been acting up.  I am eager to see what cupping can do for me. If I can’t be rendered pain-free, perhaps I can at least win Olympic gold - just one will suffice.

Next week . . . my cupping experience.

To read more about my alternative medicine experiences, cupping excepted, check out my book on Amazon and consider making it a Holiday gift.

https://www.amazon.com/Are-You-Afraid-Snakes-Exploration/dp/1935660268/ref=sr_1_1?ie=UTF8&qid=1481243467&sr=8-1&keywords=are+you+afraid+of+snakes

           

Are You Afraid of Snakes - A Doctor's Exploration of Alternative Medicine - The book

I have finally finished recording all of my alternative medicine explorations in my newly published book:  Are You Afraid of Snakes?  - A Doctor's Exploration of Alternative Medicine.


In addition to the many topics I have discussed in my blog I also explore Hot Yoga, Craniosacral Therapy, and more.


Please consider ordering a copy on Amazon at:

<https://www.amazon.com/Are-You-Afraid-Snakes-Exploration/dp/1935660268/ref
=mt_other?_encoding=UTF8&me=>

Thank you for your support.


-Scott Mahan

Chronic Lyme Disease – Alternative Medicine Paradise

                   As I stated in my prior posting, Chronic Lyme Disease (CLD) is a controversial, yet not uncommon, diagnosis.  Generally, CLD refers to persons with symptoms lasting more than 6 months after a diagnosis of Lyme disease.  In reality, CLD has different definitions to different people.  For some, there must be a confirmed original diagnosis of primary Lyme disease while others assume CLD can arise without a prior tick bite, rash, or confirmatory testing.  Confused?  Me too.  Lyme disease has even engendered conspiracy theories.  Some have concluded that Lyme disease is a genetically-modified hybrid of syphilis that our government has weaponized. 

                Since doctors and alternative practitioners can’t agree on the definition of CLD, you can bet their approach to treatment will vary widely . . . and so it has.   Those of us who toe the party line of the CDC and the Infectious Disease Society of America disavow the diagnosis altogether.  CLD probably doesn’t exist, and even if it does, we haven’t found an effective treatment.  On the other hand, my colleagues in the Northeast, in the hotbed of Lyme, have often taken a different tack.  They are inundated with patients who have been bitten by ticks, have tested positive for Lyme, and still complain of joint pain, brain fog, and other assorted maladies despite having received the CDC recommended 14-28 days of antibiotics.  What to do with these patients?  Some stick to their guns and refuse treatment.  Others start to experiment.  Perhaps 14 days of antibiotics is not enough.  Maybe a different antibiotic will work better. The result is numerous regimens of long-term intravenous and oral antibiotics based on flimsy science.  What does one do when the patient demands treatment, but nothing is proven to work?  Often, trial and error rules the day. 

                I personally have seen patients diagnosed with CLD, despite never having a confirmed tick bite or having met the CDC definition for primary Lyme disease.  These patients have been placed on year-long courses of intravenous antibiotics, anti-fungals, and anti-tuberculous medications.  Often, the patients must then resort to anti-nausea agents to help them tolerate the complex medical regimen they are taking.  It is frightening.  It is safe to say many patients feel western medicine has failed them . . . so where do they turn?  How about alternative medicine?

                Naturopaths, herbalists, and homeopaths have stepped up their game to help the suffering CLD patients.   Special diets boost your immune system to help you combat the infection.   Diets tailored to boost one’s blood alkalinity have been proposed.  Astragalus drives the pathogens out of the lymph nodes making it easier for the immune system to attack; B-vitamins help damaged nerves heal; colloidal silver electrically zaps the bugs; and, of course, chlorophyll improves our oxygen absorption along with providing a safe amount of copper to make the body more toxic to pathogens.  This is only the beginning.  There are hundreds of herbal and homeopathic remedies to try. 

                The problem is that as crazy as all these remedies sound, I can’t do any better.  I suspect there is some underlying problem in persons diagnosed with CLD.  Perhaps for some, their symptoms are truly related to prior Lyme infection while others are suffering for an entirely different disease.  Until we know for sure, CLD will continue to constitute the Wild West of Medicine.  It is the Donald Trump of medicine . . . in the absence of proof; I can say and do anything I want.

Chronic Lyme Disease - Is it real?

               As an infectious disease doctor, I am constantly being asked about Lyme disease by my patients, acquaintances, and other doctors.  Their interest is well founded.  One only needs to Google “Lyme disease” to see the thousands of divergent opinions and theories, both by the medical establishment and the public.   Even my colleagues are confused.  What constitutes a true diagnosis of Lyme disease?  Can a person be infected by Lyme disease despite having a negative test?  Is chronic Lyme disease real?  I field these questions on a daily basis despite living in North Carolina where Lyme is a rarity according to the Center for Disease Control (CDC) and the N.C. State Health Department.  I am sympathetic to my colleagues in the Northeast where Lyme disease is endemic.  I, for one, will not be volunteering to practice medicine in Lyme, Connecticut.  Despite my relative insulation from the heat of battle,  I am fearful that with global warming and the associated intrusion of new vector borne pathogens into traditionally cooler and less bug infested areas, the Lyme referrals will increase, even here in the N.C. Mountains.  What is a clinician to do?

                First, let me relate what is known about Lyme disease and generally accepted by most clinicians - both western trained and alternative.  Lyme disease is the most common reportable vector born disease in the United States.  Lyme disease is transmitted by certain ixodid ticks and is caused by the spirochete Borrelia burdorferi.  Lyme is also present in other countries where other Borrelia species may be involved.  According to the CDC, over 30,000 cases of Lyme are reported in the U.S. each year, although the true number of cases likely exceeds 300,000 due to underreporting.  Classic early Lyme disease presents as a bull’s-eye rash that appears 1-2 weeks after a tick bite.  For some, the rash is all they get, but others may report fatigue, headache, joint pain, and occasionally, fever.  Early Lyme is treated with antibiotics, usually doxycycline.   Serologic testing at this point is not recommended, as an immune response has often not yet kicked in, leading to falsely negative tests.  Up to this point, there is generally agreement, but with all else Lyme, the consensus breaks down.

                The problem is that despite a clear CDC definition for Lyme disease - a reported tick bite and classic skin lesion for early Lyme disease, and well defined serologic criteria for secondary Lyme disease- there is ambiguity regarding whether people commonly progress to long term symptoms related to Lyme disease despite treatment, an entity referred to as chronic Lyme disease.  Some argue that a person can develop chronic Lyme disease despite never having a distinct tick bite, rash, or serologic evidence of infection.  An expert panel organized by the Infectious Disease Society of America (IDSA), the main association for infectious disease doctors in the U.S., agrees a percentage (upwards of 20%) of persons with confirmed Lyme infection may continue to have persistent complaints lasting beyond 6 months from the original diagnosis despite appropriate treatment, but asserts that the complaints and numbers affected are not significantly greater than the general population as a whole, and are thus not clearly attributable to Lyme disease.  Additionally, the panel has concluded that even if there is such an entity as chronic Lyme disease, which it says there is not, there is no evidence supporting treatment with a longer course of antibiotics or any of the treatments proposed to date.  Here is where the IDSA is at odds with other Lyme advocacy groups and Lyme societies.   The International Lyme and Associated Diseases Society (ILADS) has reviewed the same studies and formed entirely different conclusions.

                What is a clinician to do?  The patients are confused, the doctors are confused, and I am confused.  Something must be going on, but what?  Patients complain of “brain fog,” poor memory, numbness, pain, headaches, and irritability.  It sounds like a bad hangover.  While all this suffering is concerning, it does create enormous opportunity.  Into this knowledge gap, many have entered.  In the Northeast, Lyme Clinics abound.  It really feels like the wild west of medicine.  There are endless remedies proposed and no lack of willing customers.  Cures for chronic Lyme disease are offered by dedicated western trained clinicians, opportunistic western trained clinicians, homeopaths, herbalists, and alternative practitioners of all stripes.  

Stay tuned.  Next post -  Chronic Lyme Disease - Alternative medicine paradise  (The next post will be in 2 weeks – I am gone to Nicaragua for a medical mission in the interim)

Chiropractor- The return visit

A week has passed and it is time for my return to the chiropractor.  I am not so crippled as I was, but my back still feels “weak.”   What do I mean by weak?  I still have a deep uneasiness that stems from my lower back.  It gets sore when I sit or stand too long, and it feels like I am just an awkward bend away from full disability- Medicaid here I come.  Hopefully, today’s visit will help my back regain its stability.

                 Today’s visit has an added bonus.  Included in my $25 co-pay is a 20 minute massage.  I am introduced to a 40 something year-old masseuse who invites me back to his room and massage table.  He has me lie face down  while remaining fully dressed.  I am a bit bummed that he doesn’t at least have me strip off my shirt.  I rightly assume  this means no massage oils, and a limitation to the deep probing.  Despite this he quickly identifies the tight muscles up and down my spine. He spends the allotted 20 minutes probing and massaging my neck and back.  It is quite satisfying. Once I am loosed up to his satisfaction he sends me over to the chiropractor.

The chiropractor wastes no time. After a quick consultation of my x-rays taken last week, and a few perfunctory questions, he gets down to business. Mercifully, he again forgoes cracking my neck (the maneuver which seems most likely to cause paralysis).  Despite my having had a massage, he uses a handheld vibrating machine to tenderize my back muscles a bit further, and then has me lie on my side with my upper leg bent up as he adjusts my back by pushing down quickly on this leg. He elicits a satisfying pop and he is done.  It is a short, but satisfying visit.

Over the following week I note continued improvement in my back. Each time I run it causes a bit of a setback, but by and large I get better. No more radiating pain.  I also start to do more stretching.  I read that exercise – of almost any kind- is the best approach for lower back pain.  http://well.blogs.nytimes.com/2016/01/27/to-prevent-back-pain-orthotics-are-out-exercise-is-in/?_r=0

                Regular exercise it will be-  a bit less running, but more swimming, biking, and definitely yoga.  Does chiropractor care make a difference?  The jury is still out.  My prior research certainly did not find overwhelming supportive evidence for chiropractic care. I will probably return when I have flares of my back pain based on the notion that something is better than nothing. 




to see my prior conclusions and evidence review:
http://alternativemeddoc.blogspot.com/2011/07/chiropracter-my-final-analysis.html

Chiropractor- It must be my leg

           It is just three days since my visit to the chiropractor and I must admit my back is considerably better.  I no longer have pain radiating from my lower back down my left buttocks. My mobility is much improved. I am now able to tie my own shoes, much to my wife’s relief.  I am even able to drive my son all the way to Athens, Georgia for an ice hockey tournament.  I am not sure if the improvement in my back is related to my chiropractic visit, or if it is just the fact that is now two days further from the time when I strained it.  Regardless of the reason, I am not complaining.  It does make me eager to see the chiropractor again next week.

                I want to address the root cause of my back problem.  Perhaps it really is due to my left leg being shorter than my right leg. I have been told this by two chiropractors and a physical therapist. Previously, I was prescribed a heal lift which I never picked up. I decide to address the leg length discrepancy myself.  I dig into the inner recesses of my closet to find the orthotics that I was given several years ago for plantar fasciitis.  Rather than place them in both of my shoes as the podiatrist had recommended for plantar fasciitis, I decide to wear one in my left shoe only.  It feels a bit odd at first; like I am a bit cock-eyed, but after a while I adjust my gate.  It is not until around noon that I realize I have put the right foot orthotic in the left shoe. Duh.  A neurosurgeon I am not, of course Ben Carson is a neurosurgeon…Hhmm…  I wear the appropriate orthotic in the left shoe the remainder of the weekend, but by Monday I decide to abandon it  until my legs have been properly measured.   When my wife, Beth, finally helps me measure my legs we find they are the exact same length.  Amazing, my left leg must have had a growth spurt over the weekend.  

On further appraisal of the situation, I think the interpretation of standing films of your back and pelvis is deceiving.  It is not surprising one side of my pelvis might be higher than the other when my back muscles are rigid.  Additionally, most of us don’t stand perfectly straight- hence curvature of your spine and pelvis tilt. This seeds doubt in my mind regarding chiropractors. Nevertheless, I plan to return to tomorrow, and I am looking forward to the visit. The healing of my back appears to have slowed, undoubtedly hindered by my runs with my son, David, over the past couple of days.

Chiropractor- My back brings me back

         I have finished all my planned alternative adventures.  My book is finished and submitted to my agent.   One would guess that I will wipe my hands clean of this whole alternative medicine business and get back to my bread and butter- western medicine.  But no…I am a changed man.  This past Sunday while skiing with my family, I bent over awkwardly to help my 8 year old with his ski bindings and pop went my back.  During the drive home I could tell I was in trouble.  I suffered through work on Monday,  I called in sick on Tuesday, and by Wednesday I knew I needed help.  Where did I turn for help?  The chiropractor. 

                I manage to schedule a visit for Thursday after work.  The office is in a nice section of Asheville located on the second floor of a newer office building.  I am impressed with the office’s display of technology.  First, there is the electronic sign-in via a touch screen computer. Prompts help you illustrate where you have pain.  Everything appears modern- business must be doing well.  I meet my doctor, a short man with close cropped hair.  He s affable and about my age.  He quickly reviews my history and takes a couple of x-rays.  We review the films together and he notes that my left pelvis rides lower than my right- likely due to a shortened left leg.  I have been told this before- now I am beginning to believe. My spine has a normal curvature, but there is narrowing between my L4-L5 vertebra and in my left sacroiliac  joint.  He has me lie on the table and examines my back. It is pretty cool the way he feels around and then finds the point where the pain is most intense. With this knowledge in hand,  he then loosens up my back muscles with a vibrating machine and proceeds to adjustment my lower back.  It takes a few tries, but he eventually elicits a satisfying pop and exclaims that it worked.  I have been spared the high intensity cracking of my neck that I  dread.  I then am taken to a second room where I lie face up on an automated table  which has a roller which pushes up from the table and massages while also stretching the space between each vertebra.   It feels pretty good.

I walk out of the office feeling better, but not cured.  I wish I would have that eureka moment that others describe where a maneuver is performed and then as if by miracle all the pain is gone.  The next day at work I still have lower back pain, but perhaps not as bad.  Is it the adjustment or just another 24 hours of healing?

Craniosacral Therapy- The results

I have just completed a session of craniosacral therapy (CST). I have been told that as a result of the therapy my cerebrospinal fluid pulsations have returned to normal.

I get up slowly.  I am very relaxed.  I should be hurrying out of the office to pick up Thayer, my youngest son, and take him to his in-line hockey game.  Despite my normal Type A’ness, I am too calm to be rushed.  First, I must pay the bill.  The session costs $75 payable by credit card.   As I exit the office I again appreciate how blissfully calm I am. A pretty impressive short-term result: remember, I am a tiger dad.  I conclude I should have a pretty good next couple of days to weeks now that my CSF rhythms have been restored to normal.   I wonder why my CSF rhythm was so irregular to begin with.  I give my dad a call. Perhaps he can tell me about the conditions of my undoubtedly traumatic birth which must have led to my abnormal CSF pulsations.  Ideally my mom, the true eyewitness, would have related my birth experience to me, but she passed away four years ago, so my dad will have to do.  He is a retired obstetrician and should be fairly reliable.  Contrary to my assumption that my birth was a difficult one, he says it was fast and easy: no nuchal cord around my neck, no need to use forceps to extract me from the birth canal, no extended labor.   I guess it must be those lifelong hardships which have thrown me out of whack - exactly what those hardships are I am not sure.

A week after the CST session, I assess my general condition.  I have a bit of a headache, and my lower back discomfort is unchanged.  Reestablishing my CSF rhythm seems to have had no measurable impact.  Perhaps I need to go back for another session.  Maybe the plumbing of my cerebral system is out of whack again.  I did watch the Republican debates this week, a traumatic experience or perhaps more of a comedic one.  Could that have set me askew once again?  No, I think I am done for the time being. 

As I research the published scientific literature about CST, I come upon several articles regarding the use of CST for Autism Spectrum Disorder (ASD).  This is a topic which hits home for me.  My oldest son has Asperger’s syndrome, more recently renamed as high functioning autism.  Due to my obvious skepticism of CST, I am surprised to see the Autism Research Institute, a reputable group, included CST in their list of therapies to treat autism in 2011.[1]  CST is also included in a book on Cutting-edge Therapies for Autism published in 2010.[2]  Wanveer, a certified instructor for The Upledger Institute, was asked by Dr. John Upledger (yes, the very same founding father of modern CST), to address the benefits of CST for Autism.  Wanveer hypothesized that persons with autism have increased pro-inflammatory cytokines, neuroglial activation, and inflammatory changes in their cerebral spinal fluid.  The inflamed spinal fluid leads to loss of flexibility and likely inflammation of the membrane layers surrounding the brain. These can result in hampering of the brain function.  He claims that CST is able to “decrease the abnormal and often enormous strain the brain has been under” and thereby help the ASD person “come to newfound levels of tolerance, understanding, and response within themselves and with the world around them.” [3] 

Once again, I am skeptical.  Should my autistic son really receive CST?  Connor is a brilliant child.  He will want to see proof that CST really works before he gives it a try.  I log onto the Autism Research Institute site to confirm they still recommend CST for the treatment of Autism in 2015.[4]  What do I find?  Nothing.  All references to CST have been wiped clean from the site.  Apparently, they have had a change of heart.  I too am ready to move on.

---

[1] Zane T. A Review of Craniosacral Therapy- Science, Fads, and Applied Behavior Analysis. The Current Repertoire, Fall 2011, Newsletter of the Cambridge Center for Behavioral Studies.

[2] Siri K, Lyons T. Cutting-edge therapies for autism: 2010-2011. New York, NY: Skyhorse Publishing, 2010.

[3] Wanveer T. Autism spectrum disorder: How craniosacral therapy can help. Massage Today. 2007; 7(7), 1-4.

[4] http://www.autism.com/ accessed 12/22/2015.

Cranial Sacral Therapy- The visit

My appointment finally comes around.   The office is located on a trendy street in North Asheville not far from the Grove Park Inn, a famous resort.  The massage therapist’s office is in an older single story cottage.  I am met at the door by the therapist, a middle aged woman with a warm smile.  After exchanging pleasantries, she escorts me into the outer vestibule.  Here, I take a seat and fill out the requisite forms - who am I, what is my profession, next of kin, how did I hear of them, and what am I here for today.  Throughout my exploration of alternative medicine, I often waffle on how to answer this second question - what is my profession?  I don’t like to lie, but I also don’t want to be too truthful.  Perhaps if they know I am a medical doctor, they treat me differently and cheat me out of some of the alternative experience.  I signify that I am a “writer” hoping this will not lead to a host of difficult questions:  “what have you authored?”  “Have I read any of your works?”  Fortunately, when reading the form, she says “a writer, hmm . . . you must be hunched over a computer quite a lot,” to which I say, “yes.”  And then, she moves on to other things.  My alias is not blown.  I tell her about my headaches and back pain, and she smiles and tells me that CST should be just the thing to help me feel better.

Next, the therapist leads me into an octagonal room with a massage table in the center.  It smells of incense (the calling card of alternative practitioners).  The room has carpeted floors and dark wood walls.  There is a lava lamp - yes, they still do exist - sitting on a side table.  There is a framed illustration of a man and a woman with their muscles and skeleton exposed.  Also included on the diagram are labeled acupoints and lines of meridian - another commonality that spans several alternative disciplines including massage, crystal therapy, and acupuncture.   Soothing music plays in the background; it sounds like a didgeridoo from Australia.  I succumb to the moment.  Let the healing begin.

I remain fully dressed and lie face up on the massage table.  The therapist’s hands meticulously feel along my scalp, apparently palpating the suture lines between my cranial bones.  I wonder if she can feel subtle movements of my cranial bones or perhaps even deeper movements in my brain.  She then places her hands at the base of my skull in the back of my neck where I imagine she is feeling for cerebrospinal fluid (CSF) pulsations.  She jams her thumbs into this area at the base of my skull while encouraging me to relax my head back.  It is not the most relaxing position, but I try to channel my inner Buddha.  After a few minutes, she moves to the foot of the table and pulls gently on my feet and applies pressure with her hands over my knees, thighs, pelvis, chest, and shoulders.  She then returns to the base of my skull for a while.  During the course of the visit, she spends time pressing gently along my skull, ears and face.  Fortunately, she does not enter my nose - I have had enough of the inner nose manipulation by my Rolfer.  Periodically, she reassesses the rhythm of my CSF by probing the base of my skull.  I close my eyes throughout most of the session.  The combination of her warm hands on my scalp, the background music, and the dim light put me in a near comatose state.  It would be even better if she were massaging my scalp, but just having someone manipulate and probe your scalp is pretty soothing in its own right.  I lose track of time. I am surprised when she turns up the light and announces that the session is complete.  Where did the hour go?  I tell her how relaxing the session was, and that I normally have a hard time letting go – in line with my Type A personality.  My admission of being Type A surprises her, probably because I am wearing my most hippie appearing clothes, I am unshaven, and I claim to be an author.  She comments that when she first was feeling my CSF pulsations, they were very frenetic and irregular, but now at the end of the session, they are nice and rhythmic.

Next Post: Do my rhythmic CSF pulsations translate into results?

Craniosacral Therapy- Molding the Mind

           It was my wife’s reaction to reading about craniosacral therapy in Andrew Weil’s book that spurred me to begin my exploration of alternative medicine.  Beth had read to me the account of a craniosacral practitioner feeling the movement of the skull bones to diagnoses and treat problems. I was in disbelief, “the movements of the skull bones?!”   Beth on the other hand thought the explanation was reasonable.  Despite my skepticism, who was I to contradict the author’s testimony.  Even though I was a physician I had never tried craniosacral therapy myself, nor did I have any proof that it didn’t work.  It just sounded kooky.  This led me to thinking about alternative medicine as a whole.  My western training told me it was all kooky, but I realized my opinion was based on biases formed in my training in traditional western medicine.  Rather than disparage alternative medicine while being uninformed I was going give it a try and develop my own educated opinion.  So it here I am five years into my alternative education and finally I will be giving craniosacral therapy a try.  I am certainly much more open minded, but I still have a hard time imaging my free floating skull bones.

I had assumed finding a craniosacral therapist would be difficult, but once again Asheville’s deep well of alternative medicine practitioners comes through.  In fact, the craniosacral therapy business appears to be booming- I have multiple options to choose from.   Craniosacral therapy is performed by massage therapists, practitioners of holistic healing, chiropractors, and others; although the massage therapists seem to be the most numerous.  I choose a husband –wife combination who are both licensed massage therapists.  In addition to craniosacral therapy they offer reflexology and more traditional forms of massage.  The craniosacral system is defined as consisting of the protective membranes surrounding the brain, the lining of the cranium, and the covering of the spinal column and the cerebrospinal fluid which ebbs and flows at a rate of 8-12 seconds per cycle. It represents the body’s hydraulic system as well as supporting the entire nervous system. Events ranging from a traumatic birth to other physical and emotional traumas occurring later in life can upset these rhythms.  

Craniosacral therapy follows a gentle, light-pressure protocol, to enhance the body’s natural ability to heal, improve brain and spinal cord function, and restore immune system response.  According to the website some of the maladies which craniosacral therapy claims to heal are: migraine headaches, TMJ (Temporomandibular Joint pain), chronic neck and shoulder pain, fibromyalgia, emotional difficulties, learning disabilities, and joint and muscle pain.  This seems perfect for me; despite my recent rolfing experience I still have lower back pain, and I am prone to frequent headaches. 

My alternative medicine bible reiterates the claimed benefits of craniosacral therapy touted by the website.  In fact, it expands the range of problems that can be addressed to include respiratory conditions, digestive disorders, and even Downs syndrome.  A cranial therapist is trained to feel the motion of the craniosacral system and locate critical points of restriction which can then be manipulated to re-establish a normal rhythm.  There are three primary approaches to CST: the sutural approach, the meningeal approach, and the reflex approach.  The pioneers of craniosacral therapy were Dr. William Sutherland in the early 20^th century and later Dr. John Upledger in the 1970’s, both osteopathic physicians.  Sutherland popularized the sutural approach in which he manipulated the sutures (where the cranial bones meet) to increase the mobility of the cranial bones. An interesting description, but one of which I am instantly skeptical. I was taught early in my medical training to palpate the cranium of infants for their fontanelles or “soft spots” during the first year of life as a possible indication of their volume status (level of hydration).  There are two main soft spots, one at the front of the skull and one near the back.  When an infant is dehydrate or sick the fontanelles may be sunken in.  These spots represent the areas where the cranial sutures have yet to fuse.  Early on the cranial bones remain unfused to allow the brain room to grow.  By 12-18 months of age the cranial bones have fused- the lines of fusion are suture lines.  Once the cranial bones have fused I would doubt much movement could be appreciated.  When I remember back to my first year of medical school and dissecting a cadaver I remember palpating these very same suture lines and the appearance of the skull as a single fused structure.    Dr. Upledger built upon Sutherland’s approach and pioneered   the meningeal approach was which he claimed was very successful for treating chronic, severe headaches.  His approach, which happens to be the approach followed by the massage therapist I will be seeing, works on releasing the restrictions of the cranial tissues and underlying membranes while monitoring the rhythmic movement of the craniosacral system via changes in cerebrospinal fluid pressure. He reported an 85% success rate in curing headaches.  My headaches are feeling better already.  I book a visit for the following week.

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