WI NTER 2 021
HOW
HIDDEN
D’YOU
ANATOMY
WHAT’S
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STORY? STORY ?
KNOW? KNOW ?
THE
SQUEAKY
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FOUNDATION OF
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Editor’s Letter
ello LifeWest! Lifelines Magazine has undergone a number of changes since its last issue. Lifelines will now be published quarterly, and will be made available Week 1. There are several new faces contributing to this issue, and we are keen to further diversify the contributing perspectives in future issues. I have been entrusted with the responsibilities of Lifelines editor for the next 3 quarters, at which time the position will be up for renewal. By way of background, I am from Edmonton, Alberta, Canada. I completed undergraduate and graduate degrees in Kinesiology and Neuroscience from the University of Alberta, and post-doctoral training at the University of Toronto in the field of neuromuscular electrophysiology. Chiropractic has been a long tradition in my family, dating back to 1922 when my great grandfather first started practice. I am currently entering quarter 7 of 12 and self-identify as a “Gondroid, open to Tonal”. Aside from school, my priorities are heavily weighted towards spending quality time with my partner Dana (Quarter 7; @motherchiro), and our 5-year-old son, Winsloe. Together, we enjoy most outdoor activities, like hiking, x-country skiing and camping. Now for a few housekeeping notes. There are 2 “new” recurring segments in Lifelines. The first segment is called, “How d’you know?”, where we deepdive into the nitty-gritty of subluxation analysis with some of our most proficient chiropractic interns. The second segment is called, “What’s your story?”, where we ask students to share how they found chiropractic or, for some, how chiropractic found them. Lastly, for those that were aware of the discussions that were slated for this issue regarding chiropractors prescribing pain medications, those discussions have been postponed to a later issue. The unfolding of 2020 would have been difficult for anyone to predict, and for many it has been equally difficult to navigate. Physical and social distancing measures have left many of us feeling less connected to our friends, family and fellow students. It is my hope that this issue of Lifelines, and all future issues, will contribute at least in a small way to growing our sense of connectedness at LifeWest. To this end, please accept this, my inaugural issue as Lifelines editor. I hope you enjoy! In Gratitude,
Dr. Austin Bergquist, PhD abergquist@college.lifewest.edu IG: @plantedchiro
MEET OUR CONTRIBUTORS
Before attending LifeWest, Alexis studied fine art and art history at Arizona State University, where she developed a passion for historic arts and their anthropological applications and significance throughout time. Her more recent chiropractic education has revealed her fascination for the human body and its functions, leading her to seek out parallels between art history and anatomy and physiology. She is an avid coffee drinker and full-time plant mom, but in her free time she enjoys painting and creating, as well as reading about ancient Greek philosophy, astrophysics, art and classical literature.
ALLIE OLSON (Quarter 7; @allieo34)
Before attending LifeWest, Allie worked as a nurse in Indianapolis, Indiana. It was through working in the neonatal intensive care unit where she developed a passion for working with babies and mothers. After chiropractic school, she plans to go back home to open a family practice with her fiancé and serve pregnant moms, babies, and children with disabilities. In her free time she enjoys camping, cooking, and spending time with her family.
REBEKKA KUZICHEV (Quarter 14; @rebekkakuzichev)
Rebekka found her passion in chiropractic. She reads ~30 books a year because she believes knowledge is power and hopes to empower her patients to take health into their own hands. Rebekka loves sharing what she has learned through the books she reads and her own life experiences. Chiropractic school has taught her so much more than she could have imagined. She has been studying social neurology and the polyvagal theory for the last few years and hopes to make an impact in the world of mental health. Rebekka begins her preceptorship this quarter in Spokane, WA.
SARA PARSONS (Quarter 10; @itsparpartime)
Sara Parsons is devouring every bit of information on chiropractic and the human body/mind/spirit. A self-proclaimed bibliophile, Sara is usually reading 3-4 books during the moments she isn’t studying or running around at rugby practice. Sara is the President of LifeWest TIC Talkers, Vice President and founding member of Alpha Chi Rho, and the Women’s Premier League representative for the Life West Rugby team. She has a bachelor’s degree in Neuroscience from the University of Nevada, Reno, and was blessed with humble beginnings in a small cow town outside of Reno.
SAGI HEBRON (Quarter 10; @sagi.hebron29)
A native of sunny San Diego, Sagi Hebron is part of a Jewish family that has roots in Israel. Sagi came to LifeWest following a three-year stint in the Israeli army, and he’s constantly looking to help people in need. Hebron has undergone chiropractic care since childhood, and was a patient of LifeWest graduate Richard Stein, DC. After seeing and feeling the effects of chiropractic, Sagi made the decision to pursue a career in the field. Upon joining LifeWest, he participated in student council as a class representative and has quickly climbed the ranks, serving now as our student council president. #LIFELINES | 3
CONTRIBUTORS
ALEXIS GRIFFITH (Quarter 7; @aye.lexis)
CONTENTS 06 | Hidden Anatomy
Discover secret messaging in Michalangelo’s iconic representation of the Book of Genesis on the ceiling of the Sistine Chapel.
11| Knowing Who You Are
How would you answer if someone asked you the question...”Who are you?”. -It’s a simple question.
06
14 | What’s Your Story?
We all have our story of how we found chiropractic, or how it found us. -This is Allie Olson’s story.
16 | Foundation of You
Understanding the relationship between our feet and our spine may be key to how well chiropractic adjustments hold for our patients.
18 | The Squeaky Wheel
There is a divide in our profession. Aligning yourself with an association may be the most productive way forward.
14
20 | House & Senate
Review proposed legislations and the respective viewpoints of the American (ACA) International (ICA) Chiropractic Associations.
22| How D’You Know?
Deep dive into the nitty-gritty of subluxation analysis and adjusting technique with some of our most proficient chiropractic interns. 4 | LIFEWEST.EDU/LIFELINES-MAGAZINE/
18
CONTENTS
11
16
20
22
#LIFELINES | 5
| 20-min read |
HIDDEN ANATOMY IN THE WORKS OF MICHELANGELO
DISCOVER SECRET MESSAGING IN ARTIST MICHALANGELO’S ICONIC REPRESENTATION OF THE BOOK OF GENESIS ON THE CEILING OF THE SISTINE CHAPEL. // By Alexis Griffith //
A
B
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D
E
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FIG 1
a few discrepancies among the interpretations of these alleged hidden structures, as we will discuss, but each dissertation can be seen as correct in its own right, and it is ultimately up to the viewer to decide what Michelangelo was trying to communicate.
THE BIG PICTURE
Before we delve into the individual panels of the Sistine Chapel ceiling, the cumulative panels tell a story, other than the book of Genesis; a story about the development of the human brain. The first four panels (FIG 1), starting from the west end of the chapel, illustrate the days of creation from the book of Genesis, but Michelangelo also snuck in images of brains during different evolutionary developments to show the relative growth of the telencephalon and cerebrum1. In the first panel, The Separation of Light and Darkness (FIG 1D), Michelangelo appears to have inserted the shape of what looks like a primordial fish brain within the contours of God’s throat (FIG 1E)1, representing one of the earliest vertebrate brains. There are, however, other more accurate interpretations of this structure, which we will discuss later. In the next panel, The Creation of the Sun, Moon and Plants (FIG 1C), we see behind the main image of God surrounded by cherubs, an image of what appears to be an amphibious brain, or perhaps a non-primate mammalian brain1. In the subsequent panel, The Separation of Land and Water (FIG 1B), we see a slightly more evolved nonhuman primate brain. Another more likely interpretation of this panel is that Michelangelo is representing a kidney, which we will also discuss later. The last panel in this series is The Creation of Adam (FIG 1A), in
which we see God giving life to the first man. In this image we see God extending out from what appears to be a fully developed human brain (FIG 7), complete with structures suggesting a pituitary stalk, vertebral artery and brainstem2. Ashford et al. believes this linear depiction of an evolving brain suggests the evolutionary growth of the cerebral cortex in humans, representing a progressive increase in brain complexity1. I personally believe this could also be a representation of the fetal brain development, as we know that embryologically our brains grow and develop through similar shapes as those depicted in Michelangelo’s paintings. Allow us now to delve into additional and/or opposing views on hidden structures and their intentions in the individual panels of the Sistine Chapel ceiling.
LIGHT & DARK
The first panel on the west end of the Sistine Chapel is titled The Separation of Light and Darkness, in which God is beginning his creation by first separating light from dark (FIG 1E). This particular panel is located directly above the altar and was undoubtedly intended to portray God in all his glory; so it is interesting that Michelangelo inserted anatomical abnormalities, especially as a master anatomist. One large anatomical error is in God’s throat, which we briefly touched on earlier. While some believe this odd structure to resemble a primordial brain, another more probable interpretation is that it is actually the ventral view of a brainstem (FIG 2), along with perisellar and chiasmic regions2. From proximal to distal, we see the upper cervical portion of the spinal cord, medulla complete with anterior median sulcus, pons, and the sellar region of the brain. The central depression seen in the bottom of #LIFELINES | 7
HIDDEN ANATOMY
M
ichelangelo di Lodovico Buonarroti Simoni, known best simply as Michelangelo, was a painter, sculptor, poet and master anatomist of the Italian Renaissance during the fifteenth and sixteenth centuries. With the Renaissance brought the major intellectual movement called Humanism, in which experimentation and the scientific method began, as well as the effort of artists to perfect their portrayals of the human form1. Among these artistanatomists was Michelangelo, who developed a great understanding of human anatomy from performing countless cadaver dissections. It is speculated that he paid particular attention to understanding gross neuroanatomy by dissecting many brains and spinal cords, and also by trading anatomy studies with his contemporaries, including his rival Leonardo da Vinci. Although responsible for many great works, including the famous Statue of David, Michelangelo’s painted ceiling of the Sistine Chapel in Vatican City is arguably his greatest and most analyzed work. Comprised of nine central panels depicting different scenes from the book of Genesis, including the well-known Creation of Adam, Michelangelo showcases his abilities as a master artist. It wasn’t until recently, however, that art historians began to analyze hidden shapes and messages within these depictions. One major hidden theme of Michelangelo’s Sistine Chapel ceiling appears to be the representation of different anatomic structures, particularly that of neuroanatomy. It is suggested that he incorporated these anatomic structures in order to portray allegorical concepts as well as to communicate personal struggles in his own life. There are
God’s beard can even be compared to the frontal aspect of the medial longitudinal fissure of the cerebrum2. One indicator that this is not merely an accidental error in anatomy, but a purposeful representation, is that there appears to be an irregular light source only on this ventral aspect of God’s throat that is different from the rest of the composition2. We know Michelangelo to be a master painter, especially that of light depiction, indicating that he was attempting to highlight this anomaly. Another indicator is that when comparing God’s throat in this depiction versus others on the Sistine Chapel ceiling, all from the same three-quarter perspective, Michelangelo specifically drew in this much more complicated structure in this portrayal only. It is speculated that he chose to hide the ventral brainstem within God’s throat area due to the similar conical structures as well as the proximity to the correct anatomical location2. While the theory that Michelangelo was attempting to depict a brainstem within God’s irregular throat anatomy is generally accepted, some suggest that he actually intended to depict a goiter3. Suk et al. disregard this opinion, however, since it simply does not look like a hypertrophied thyroid gland, and Michelangelo was actually able to observe this condition closely in the people of the Po River valley in Lombardy, where goiter was an endemic2, so we would expect him to know how to accurately portray it.
chest, which is not seen in any other of his depictions (FIG 3A). We can easily assume that Michelangelo was alluding to a ventral view of the cervicothoracic spinal cord, which is even an offset continuation from the brain stem in God’s neck2. Another odd shape seen in the torso area is a “Y” shape just below the waist (FIG 3B), which some believe alludes to the optic chiasm and optic nerves2. Although we now know that the optic chiasm is more of an “H” shape, anatomists during the Italian Renaissance were still figuring out the exact anatomy, so some depictions from that time show the optic chiasm as the “Y” shape, as is seen here2. We can even imagine the
A
optic nerves traveling superiorly and ending at the two masses that appear in the subcostal region, which could very well be representing eyeballs (FIG 3B). This particular assertion is definitely more of a stretch, but as this panel is depicting the beginning of light and dark, Michelangelo may have been inspired to allude to the organs of vision and their neural structures2. Another interpretation of the four masses that appear on God’s chest, which is my own personal observation, is that they are representing the corpora quadrigemina from the tectum of the dorsal aspect of the midbrain. God’s laterally ascending arms could be seen as the two symmetrical structures
B
C
IRREGULAR ROBE
As we move down from God’s throat to his torso, there are some more abnormalities in the ways that his robe flows and folds. First of all, there is a very obvious tubular structure with a longitudinal cleft traveling down the middle of his 8 | LIFEWEST.EDU/LIFELINES-MAGAZINE/
FIG 2
HIDDEN ANATOMY
that make up the thalamus, which is anatomically located superior to the corpora quadrigemina.
LAND AND WATER
Moving a couple panels east on the Sistine Chapel ceiling is the third painting titled The Separation of Land and Water, which some believe has a more intimate connection with Michelangelo’s life. It is documented that Michelangelo suffered from nephrolithiasis, with recurring bouts his entire life, as well as subsequent obstructive uropathy and urinary tract infections4. This caused him immense suffering that he has documented himself in correspondences, poetry and, of course, his paintings. Based on Michelangelo’s personal interest in kidneys and urinary function, the structure behind God in this panel, that we previously discussed as appearing as a non-human primate brain, is alternatively thought to be a bisected right kidney (FIG 4)4. We can even imagine that where God is emerging is the renal pelvis, while the bunched robes and fabric hanging down represent the ureter and renal vasculature. In addition to this theory, we can analyze one of the four male figures that border the main image of God. This figure in the bottom left corner with his back turned to the viewer appears to be surrounded by two kidney shapes created by bunches in the fabric directly in front of and behind him (FIG 5), which coincidently correspond to a right and a left kidney. This figure also appears to be grimacing and arching their back in such a distinct way as to allude to suffering, specifically from kidney pain4. The costovertebral angle on his back is also quite pronounced, which we know is generally where the kidneys are located from a dorsal orientation. What makes the connection of this depiction with
FIG 3
A
B
Michelangelo’s experience with kidney stones truly interesting is that this painting is literally showing the separation of land and water during God’s creation. During Renaissance Italy, much of what was known about kidney function was from the ancient Roman physician Galen, who taught that the kidneys are the organs that separate solid from liquid in our bodies5. This idea makes an astounding parallel with the theme of this particular panel on the Sistine Chapel ceiling.
that the large structure that God is emerging from is a brain (FIG 6), which corresponds with the previous theme of evolving brains6. This midsagittal view of the cerebrum is even complete with shapes that allude to a pituitary stalk, vertebral artery and brainstem, and the flowing appendage coming off from the upper right aspect of the brain is said to represent the meninges1. While we know that this painting is depicting God giving life to the first man, Michelangelo’s choice to show God emerging from a brain also suggests that he is endowing him with intelligence as well6. An opposing, yet equally perceivable theory is that this structure is actually representing a postpartum uterus7. Just as with the brain theory, there are quite a few parallels between this image and an anatomically accurate postpartum uterus. First off, the way in which the structure is
CREATION OF ADAM
Lastly, we will discuss the arguably most famous work of Michelangelo’s, The Creation of Adam, which is the fourth panel from the west side of the ceiling. Now, there are two main theories on what Michelangelo was attempting to portray in the hidden imagery of this painting. Firstly, some argue
FIG 4
A
B #LIFELINES | 9
painted appears as if Michelangelo was trying to depict a hollow organ. What appear to be folds inside this structure can represent the folds of the mucosa in a postpartum uterus. We know that under normal conditions these aren’t present, but are only apparent after delivery due to the subsequent retraction of the uterine muscle. The fissure that we see in the lower left aspect of the structure has been identified as the uterine cervix as it bends towards the inner part of the structure7. The flowing appendage in the upper right corner, which was previously identified as part of the meninges of a brain, is seemingly more accurately compared to a uterine tube in this theory. A great compliment to the suggestion that God is emerging from a postpartum uterus is the imagery in the lower left aspect of the panel where Adam is laying. He appears to be resting on a rock, and the concept of rock is historically symbolic of the “generating mother”, as many mythological divinities across many cultures arose from rock7. Behind Adam and the rock is a blue outline that appears as a silhouette of a woman’s body, with the breast and nipple located just above Adam’s head. Some believe this idea of God emerging from a postpartum uterus, together with the allusion of the generating rock and female body, correspond better with the title and concept of life-bearing in this particular painting. As we discuss the possible symbolism of allegorical imagery, we must take caution in our interpretations. Michelangelo, along with most historic artists, did not write a guide to his paintings, and accurately interpreting historical works is challenging with our contemporary viewpoints and biases. The art historian and neuroanatomist
FIG 5 Michael Salcman cautions us that these modern parallels that we draw from historic works could simply be the result of “cultural ideation superimposed on otherwise non-descriptive images”8. There is a well-known phenomenon is psychology in which one suddenly perceives an item in a complex field which they were unable to see before. This psychological effect combined with experiences from our own lives can be an attribute of these double entendres that are characteristic of historic art. While there is controversy as to whether or not the images that are perceived as anatomical structures were used intentionally by Michelangelo, the
FIG 6
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similarities between his paintings and anatomical structures are too similar to be left to chance, and we know that as a master painter and anatomist he is very unlikely to make such incompetent mistakes. This aside, the beauty of art is that it can be highly subjective, allowing individual viewers to see and take from it what they want, without being right or wrong. One could say that this is why Michelangelo blurred the lines between biblical themes, anatomical themes and maybe even other themes that have yet to be realized, in order to cater to the perspectives of all that would view his masterpieces. §
| 10-min read | KNOWING WHO YOU ARE
Knowing Who You Are
HOW WOULD YOU ANSWER IF SOMEONE ASKED YOU THE QUESTION...”WHO ARE YOU?”. IT’S A SIMPLE QUESTION. // By Rebekka Kuzichev //
#LIFELINES | 11
T
his year started on the heels of what kind of chiropractor I would be. Right off the bat in my first and an amazing and rejuvenating If someone were to ask: “who second quarters, people started to retreat in Costa Rica. I was a are you?” How would you describe tell me exactly who I needed to be in little burnt out from a heavy yourself? I think a lot of people order to be a successful chiropractor. quarter and felt renewed with love are sleep walking through life and Most of them meant well, but no and confidence and was excited don’t really know who they are. one ever told me it was ok to be to share what I had learned at the When it comes to answering this my authentic self and then to grow HERstory seminar in October. question, people answer in a way that. They told me what I lacked, not And then COVID happened that is in relation to another thing. how to expand on my strengths and and I think we can all agree that Maybe the first thing you thought of nurture my weaknesses. those were not an easy six months. was: “I’m a chiropractor.” Are you People would tell me: “you It dredged up a lot of past trauma nothing without chiropractic? That’s a have to join this club, you have to that hadn’t fully healed. Even though dangerous way to think. do this amount of screenings, you I had done so much growth during My identity does not solely have to gain mass, you have to stop my time in Costa Rica it felt like I went lie in Chiropractic. Before I am a focusing on academics, you have to two steps forward and then 30 steps chiropractor I am Bekka. But when be more outgoing, you have to be back. It felt as if I wasn’t worthy of I first started chiropractic school, I extroverted, you have to be more being a speaker anymore because didn’t really know who I was. And friendly.” I was back in a place that I had when you don’t know who you are I didn’t really fit into the “mold” been before. But I had come to the people will tell you who you are, and of the stereotypical life west student realization that this is exactly how who you need to be in order to make (and yes there is a stereotype). What we empower each other. By making them comfortable. And I’m not just we don’t know about ourselves can sure we create a space that it’s OK to talking about the surface stuff like, hurt us. And I spent the first 2 years be imperfect in, or to of school trying to be still be healing from someone I wasn’t, just “When we understand ourselves better, something. We help because everyone each other by being we understand others better and expand told me that who I real with where we’re was wasn’t good our capacity to love and serve them. at. That’s how we enough. Without grow together. I don’t self-awareness think we see enough stories that are “oh I am from such and such place I of how we see the world and the in the middle part, in the midst of a grew up here I went to school here.” wounds and beliefs that have shaped struggle. A lot of speakers talk about I’m talking about what are my fears who we are, we become prisoners the endings and how they started and dreams? What are my strengths of our history. The main message I at a rock bottom in the beginning, and weaknesses? What is my received from some of the people struggled in the middle and are now motivation? Why do I do the things around me was that I wouldn’t be a where they want to be. And their I do? What coping mechanisms successful chiropractor if I continued message usually consists of “you can do I still use that aren’t serving me to focus on my classes. There was be here too!” This isn’t necessarily a anymore? I know that a lot of these an attitude at school that celebrated bad thing, but I don’t think we see sound like very simple questions but people who did the best adjustments, enough stories that are in the middle once you dig to a deeper level there had the fastest learning curve and of the struggle, and honestly that’s are a lot of layers that we have to got the loudest cavitations. I tried where I’m at. So, I wanted to share sift through, because a lot of things to become like those people and a little bit more about the middle are covered up by trying to avoid viewed my thirst for knowledge as a of my story. It has a lot to do with pain. My question to you is: are weakness, and something that stood discovering who I was as a person. you paying attention? My biggest in the way of becoming that “great And I know it sounds very cliché, I struggle when I started school was chiropractor” everyone would talk get it, I hate clichés but probably my not the classes or the adjusting, it was about. biggest lesson in school was having getting out of my own way, so I could Here’s the thing, if any of you to know who I was in order to know grow into who I was created to be. know about the enneagram, I am
”
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KNOWING WHO YOU ARE
a type 5 and a thirst for gaining knowledge and wisdom is a part of who I am. I was told to be different in order to be accepted, and I tried to get rid of that part of me. I love to learn, and I love to share what I learn so it took a big part of the joy out of school. I felt like I didn’t belong in the chiropractic profession, even though I loved everything about it. I thought about quitting 3rd quarter, and then 5th quarter, and even this quarter. I wasn’t aware of my strengths and became hyperaware of my weaknesses that were thrust upon me without my consent. Let me say that again: people will put limitations on you without your consent. Most of the time we will believe something if we are afraid it is true. Even though I got the repeated message to get my nose out of the books and focus on something “more important”, I dove into finding out more about my unhealthy coping mechanisms, my actual weaknesses, my motivation, and my strengths. I learned that my main motivation at the time stemmed from fear. I had a few interpersonal traumas in the years before starting school and I was afraid to connect with people again. Any of my classmates from the beginning of school (if they noticed that is), would know me as a completely different person. My first few quarters I experienced so much anxiety and depression that I
hardly spoke to anyone beyond what was necessary. I was in a perpetual state of my mind being disconnected from my body and if you know about the polyvagal theory, it completely inhibited the neurology that we use to socialize with one another. I was determined to grow and heal without needing people and without having to be vulnerable and develop deeper connections with people, even though that is ultimately what I wanted. Out of all the research I did for several months and about 19 books later, I had my answer. People. Every single book I read on the subject of healing, self-discovery, or growth had the same message: you have to have a safe and supportive community in order to grow. Great. I even read the book that literally had the title How to win friends and influence people. The problem was, I didn’t feel like I had a safe community to support me, to accept my failures, struggles, and weaknesses and to help me discover more of who I was so I could grow. Which brings me to the Costa Rica retreat. I signed up reluctantly because I had been burned mostly by women in my past, so going on an all-female sounded like a nightmare. I remember being in the final leg of my flight and worrying more about meeting people at the airport than being in a foreign country. That week changed my life. On their promotion posts Dr. Mo and
Dr. Mac had said, “give us a week and we’ll change your life”. And they did not disappoint. They were the first and only chiropractors who celebrated me for who I was, but also desired to help me grow, and that changed everything for me. It was a huge turning point in my own self-awareness of what I needed to grow and accept the parts of me that seemed like everyone was trying to get rid of. Growth and healing are rarely linear, so fast forward to today and I am in the midst of a struggle still, and that’s ok. The main concepts I want you to take away from this is: don’t be afraid to discover yourself more. In fact, I want you to set apart one hour to dive into who you really are: strengths, weaknesses, and that includes separating out things people have told you that may not be true, and what your greatest gifts are. Most of all, learn how to ask questions. Curiosity propelled me on my journey of self-discovery. Whenever I had a certain reaction to a situation that really didn’t serve me or those around me, I’d ask myself, “why?”. Not to judge, just to understand. When we understand ourselves better, we understand others better and expand our capacity to love and serve them. It’s time to start paying attention. §
#LIFELINES | 13
| 4-min read |
What’s Your
Story?
WE ALL HAVE OUR STORY OF HOW WE FOUND CHIROPRACTIC, OR HOW IT FOUND US. THIS IS MY STORY. // By Allie Olson //
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“It’s not too late, you can still go to chiropractic school.”
One day Broc invited me to shadow him at work so I could see what his days were like. That day I shadowed him, he took care of three patients that I will never forget, a pregnant mother, a baby, and an 11-year-old boy with disabilities that kept him in a wheelchair. I saw the joy Broc brought them and the connection he made with them. I saw the pregnant mother walk out with no pain or discomfort despite her changing body. I saw the colicky and constipated baby stop crying and poop and the look of relief on the mother’s face when that happened. I heard the wonderful laughter from the 11-year-old when Broc talked to him and the appreciation in his mother’s smile. Broc made such a profound difference in all their lives and I felt so grateful to have witnessed that. Later that night Broc asked me what I thought about the day. I told him that if I could do it all over again, I would have gone to chiropractic school. With a serious face Broc said, “It’s not too late, you can still go to chiropractic school”. I laughed at him. I simply thought that it wasn’t possible, our life was in Indianapolis and he already had a huge patient base. Broc responded, “If you want to go to chiropractic school, I will follow you”. And so here I am. One year into chiropractic school in Hayward, California. Oh, and also, Broc and I just welcomed our baby girl Sedona into the world on November 4th of 2020. Totally unplanned. It turns out that my OB was wrong, all I needed was an adjustment. § #LIFELINES | 15
WHAT’S YOUR STORY?
M
y chiropractic story starts with a dating app called Hinge. You see, back in 2018 I was a neonatal intensive care unit nurse in Indianapolis, IN. I decided that I was ready to date so I downloaded the app and shortly after that I met, my now fiancé, Dr. Broc Sheets. He was a chiropractor of course. At the time I knew almost nothing about chiropractic. My mom had been in a car collision awhile back and I remembered that she went to the chiropractor for her whiplash. That was the extent of my knowledge of chiropractic. Broc would offer to adjust me in the first couple weeks of dating and I would always tell him that I felt fine and I hadn’t had any trauma to need an adjustment (lol!). Around that time, I was having extremely irregular periods, which I had for the previous 10 years. They were so irregular that my obstetrician (OB) told me that I would most likely have an extremely difficult time conceiving children and would probably need in vitro fertilization. Well, after I finally let Broc adjust me, my periods started to become regular which was something I had never experienced before. Other than chiropractic, I knew that nothing else had changed in my life, so I became a full-on believer.
| 4-min read |
FOUNDATION OF
YOU UNDERSTANDING THE RELATIONSHIP BETWEEN OUR FEET AND OUR SPINE MAY BE KEY TO HOW WELL ADJUSTMENTS HOLD FOR OUR PATIENTS.
//By Rebekka Kuzichev//
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normal gait. Is it important for people to get their feet checked? Absolutely. Even though taking care of feet is not everyone’s cup of tea, it’s important to be knowledgeable about the influential factor the 26 bones and 33 joints of the feet have on the rest of the spine. The second most important thing to understand about the feet is the current crisis in poor footwear. Most shoes are narrow and come to a point for a flattering look, but this leads to loss of control and activation of the intrinsic muscles of the feet which makes the extrinsic muscles of the feet work harder to stabilize.1 Most shoes also have what’s called a positive heel which means the heel sits higher than the rest of the foot. This shifts our entire center of gravity forward from the heel to the ball of the foot. As a result, the pelvis tips forward into an anterior tilt, creating a hyperlordosis in the lumbar spine and a compensation to bring the upper torso posterior and the head forward. See a pattern here? Once we change the natural alignment of the feet, whether it is with footwear or with gait, it has a global effect. Not everyone will want to adjust feet. After all they are feet. However, every single chiropractor should understand the compensation patterns foot dysfunction and improper footwear can have on a spine. Taking care of the spine takes precedence above all. However, if a person has repeated subluxations that aren’t holding, or compensations and imbalances that won’t go away, try taking a look at the very foundation on which we stand. §
FOUNDATION OF YOU
F
oundations is a blanket term that gets thrown around often. What do you think the foundation of you is? In this case, I am talking structurally. What is the second most important structural component of the body? The spine being first of course, it does protect your life source after all. This structure ties into the foundation of our entire skeleton. Your feet. Outside of the spine, our feet create the connection with which we travel in this world. Imagine for a second that children were given tight leather mittens to wear over their hands from the time they were still an infant. Would their hands be able to function the way they should? With any familiarity about neuroplasticity, the answer should be, “no”. The brain is so intelligent that it will get rid of wasting energy on anything our body neglects to use. Did you know you were supposed to be able to spread your toes the way you spread your fingers?1 What would happen if your fingers were unable to move individually and instead moved as a unit? As a runner, I am very familiar with foot injuries, but I didn’t know they were so common in the general and sedentary population. There is an epidemic of chronic foot dysfunction that sets off an abundance of problems up the chain Foot dysfunction causes gait dysfunction, which causes hip dysfunction, which creates pelvic distortion, which can lead to a stressed spinal column all the way to the occiput and atlas articulation. For example, if the metatarsal phalangeal joint of the big toe became functionally or structurally rigid, the foot would need to turn inward in order to toe off. This would rotate the entire leg internally, collapse the knee inward and distort the pelvis in a different way than a
“Once we change the natural alignment of the feet, whether it is with footwear or with gait, it has a global effect.”
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| 8-min read |
Associations & The Squeaky Wheel THERE IS A DIVIDE IN OUR PROFESSION THAT DATES BACK NEARLY TO ITS INCEPTION. ALIGNING YOURSELF WITH AN ASSOCIATION AND BECOMING AN ADVOCATE MAY BE THE MOST PRODUCTIVE WAY FORWARD.
// By Sara Parsons //
B
etween juggling a loaded became what we still call it today, health and human potential through class schedule, clubs, clinic, the International Chiropractors specific and scientific chiropractic 1 and for many of us a partAssociation (ICA) . It is the oldest care”3. The Mission of the ICA also time job, imagine throwing international association to make it to supports the philosophical values; in the mix researching position and 2020, and was developed with the “to protect and promote chiropractic political advocacy articles from aim of “advancing the profession of throughout the world as a distinct multiple chiropractic association chiropractic through advocacy and health care profession predicated 2 websites. Even the best clowns would development” . upon its unique philosophy, have trouble keeping science, and art of all those knives in the subluxation detection air. and correction”3. It is “It is important to figure out However difficult, apparent from these your vision of the future of it is important for statements that the ICA students to keep a philosophical Chiropractic, find the association has our chiropractic foundation, views index fingers on chiropractic as a that has the same vision, join the associations unique profession that association, and fight for the that represent our unlike any other, and profession. I present supports the theory chiropractic you think is best.” in the following of subluxation as the paragraphs a few cause of all disease. players in the game; The ICA lists its the International Chiropractors The ICA, as one might have objectives under its ‘about’ section Association (ICA), the American guessed based on the individual of their website, and atop that list is Chiropractic Association (ACA), that founded it, is an association the goal to “maintain and promote the International Federation of that champions vitalistic chiropractic chiropractic’s unique identity as Chiropractors and Organizations and aims to support and protect the a vitalistic non-therapeutic, non(IFCO), and the World Federation of philosophy of chiropractic as the allopathic, drugless and surgicalChiropractic (WFC). keystone that supports our profession. free health science, based on The ICA vision statement reflects its fundamental principles and ICA this much like a still mountain lake philosophy”3. The rest of the list In 1926, B.J. Palmer founded reflects the sky, the clouds and the includes spreading licensure and the Chiropractic Health Bureau trees that surround it with impeccable regulation of chiropractic to every (CHB). The organization held on accuracy. The vision is to “empower nation, working with other nations to that name until 1941, when it humanity to optimal life expression, “in a global humanitarian effort”3 18 | LIFEWEST.EDU/LIFELINES-MAGAZINE/
CLOSING REMARKS
to spread chiropractic around the globe, to raise the standard of professionalism and technical development, fight for medical freedom and choice, and demand non-discrimination for chiropractic in health care3. As mentioned above, the ICA is active in advocating for the profession and is currently tackling issues surrounding payment, coverage, and opt-out issues for Medicare beneficiaries, coverage for veterans through Tri-care, and fighting for chiropractic to remain drug free2. (For those interested in learning more about current bills presented to Congress, see my article “Senate & State” on page 20).
ACA
There have been three separate chiropractic groups to call themselves the American Chiropractic Association. The first time the name was used was by the first known chiropractic organization, formed
in 1905, disbanded in 1918. The second time the name was used was in 1922, when the ACA was formed in Chicago in direct opposition to the Universal Chiropractors Association found in 1906 by B.J. Palmer (he later left the UCA in 1926 when he lost the election for secretary of the UCA, and formed the ICA as described above). When B.J. left, the UCA and ACA joined to become the National Chiropractic Association (NCA) which in turn became what we know today as the ACA in 19631. The ACA is currently the largest professional chiropractic organization in the United States. Their mission is “to inspire and empower our members to elevate the health and wellness of their communities”4 with a vision to “[lead] a modern movement of chiropractic care based on higher standards and focus on patient outcomes”5. They state their values as patient centered, focused on evidence-based care, service in the best interest of public
There is a divide in our profession that has existed since the early 1900s. On one hand there are those that think the profession should keep at its center the philosophy upon which it was developed, that our profession is separate and distinct as long as we keep it by hand only, focused on the detection and removal of subluxation. On the other hand there are those who believe we the best way to progress and develop the profession is to use chiropractic only for what modern science has shown it is effective in treating, and incorporate chiropractic into the already established health care field working alongside others in an integrative way to reduce neck and low back pain. It is important to figure out your vision of the future of Chiropractic, find the association that has the same vision, join that association, and fight for the chiropractic you think is best. The squeaky wheel gets greased, and the only way to make a change is to stand up and say something. § #LIFELINES | 19
THE SQUEAKY WHEEL
health, and focus on collaboration and integration with other professions in the health care community5. The ACA’s focus is on evidence based care, patient outcomes, and public health initiatives. The ACA is heavily involved with lobbying, supporting research, and creating networks with other health professions to best serve patients. Remember those bills mentioned above currently being presented to the House and the Senate with regards to (shout out Dr. Straub) Medicare, Tri-care, and the question of prescription drugs being integrated under the Chiropractic scope of practice? You guessed it, the ACA is heavily involved with lobbying on all three topics.
| 8-min read |
&
House Senate KEEP UP WITH CHIROPRACTIC POLITICS. HERE ARE THE CURRENT PROPOSED LEGISLATIONS PRESENTED TO CONGRESS, AND THE RESPECTIVE VIEWPOINTS OF THE AMERICAN (ACA) AND INTERNATIONAL (ICA) CHIROPRACTIC ASOCIATIONS.
// By Sara Parsons // BILL H.R. 3654
The Chiropractic Medicare Coverage Modernization Act of 2019 was introduced to the House on July 9th, 2019. Currently, Medicare only covers spinal manipulation to remove subluxation and does not pay for any other physician services that are within a chiropractor’s scope under their state license1. Examples of other physician services are ordering x-rays, clinical labs, and other diagnostic procedures. The Medicare program started allowing coverage for chiropractic care in 1972 by accepting and paying for one service; “the manual manipulation of the spine to correct a subluxation”1.
ACA POSITION
The ACA is in support of this bill passing through the house. They believe that as portal-of-entry doctors, chiropractors should be reimbursed for physician services they can legally perform under their state license including the examination, diagnosis, treatment and, when necessary, the referral of patients to the appropriate providers.
Because of the current law, patients that have Medicare coverage and need physician services other than a manual manipulation will have to go to another provider to get a diagnosis likely to then be referred out again for necessary lab or diagnostic procedures. The ACA also argues that this system funnels patients into the medical paradigm where providers rely on more invasive standards of
claims passing this bill has the potential of removing barriers to care for the patient, reducing costs to the Medicare system, and acts in the best interest of the Medicare patients2.
ICA POSITION
While the ICA wants to expand Medicare coverage to include payment for examinations and x-rays and believe this specific bill
“The ACA and ICA are actors at
play on Capitol Hill, and work diligently to push through policy changes that will shape the chiropractic profession.”
care like prescribing drugs, spinal injections and surgery. They state that research shows chiropractic care is less invasive, more economical, and more effective in reducing pain syndromes than the above allopathic interventions. Therefore, the ACA 20 | LIFEWEST.EDU/LIFELINES-MAGAZINE/
will remove select barriers to care, namely that patients will visit their chiropractor more if it is covered by their insurance, the ICA is not endorsing this bill because it does not include changes to the “optout” policy. The “opt-out” policy of
HOUSE & SENATE
Medicare allows patients to choose to privately contract with a certain group of health care professionals who are allowed to opt-out of Medicare coverage, and chiropractic is not one of them. Without the ability to opt-out, chiropractors must work under the Medicare umbrella, and will only get reimbursed for what Medicare decides is covered. The ICA states that they won’t back a bill unless it addresses this issue, and issue they view as discriminatory against our profession3.
the Department of Defense health care system, active-duty military members are eligible for chiropractic care through the Chiropractic Health Care Program. Once active members retire or are discharged, their TriCare insurance does not cover chiropractic care. This bill presented to the House on January 8, 2019 would direct the Department of Defense to include chiropractic care under TriCare covered benefits for retired military personnel, national guard and the reserves1.
BILL H.R. 2883
ACA POSITION
Both the ACA and ICA are in support of this Bill, introduced to the house May 21, 2019, which aims to amend the same section XVIII of the social security act as H.R. 3654 to include chiropractors in the definition of authorized physicians. This would allow chiropractors to make private contracts with Medicare beneficiaries and opt-out of working with Medicare3. 3
BILL H.R.344
The Chiropractic Health Parity for Military Beneficiaries Act. Under
The ACA is in support of this bill and points out that musculoskeletal complaints are common among retired military service members, especially when they are at the point of retiring. Soldiers that have been receiving chiropractic care throughout their career are suddenly faced with having to pay for care out of pocket or go without. TriCare does cover prescription drugs, so many retired service members turn to drugs to handle their pain. The ACA claims this bill will help add a drug free option for those who wish to take
a less invasive route to avoid opioid pain management2.
ICA POSITION
The ICA is also in support of this bill because they say it will make chiropractic care a permanent benefit under TriCare health insurance, will mandate that only chiropractors can perform the chiropractic adjustment, and it will allow direct access to chiropractic care to TriCare beneficiaries3. There has been a bill presented to the Senate (S.30) as well3. In order for bills to become law, they must first pass through the house and the senate then be signed off by the president. The ACA and ICA are actors at play on Capitol Hill and work diligently to push through policy changes that will shape the chiropractic profession. To dig into more policies and keep tabs on the future of chiropractic, join an association! You can also find the specific bills and exact language on congress.gov. §
#LIFELINES | 21
| 7-min read |
HOW D’YOU KNOW? EXPLORING SAGI HEBRON’S ANALYSIS TECHNIQUES MAY LEAVE YOU EMBRACING HIS “TRACKSUITWEARING” WAYS.
// By Sagi Hebron & Austin Bergquist //
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HOW D’YOU KNOW?
Can you walk me through your system to asses a patient for subluxations? First, I would have the patient sit in the cervical chair. I would just kind of palpate their upper thoracics, my hands are on their shoulders, letting them know I am here, and gathering information with my hands on their back. This helps to put the patient at ease. Then I begin with the cervicals. I start at the top of the spine and I work my way down. The same with my adjustments. Top down. I know a lot of doctors say to start at the pelvis, because it’s the base, but I like the system of having the patient first sit in the chair to check their neck, then they go on a table face down and I check their thoracics and their pelvis, and I adjust. It’s just the system that I like. In practice, you are not going to do a full scan, write listings, get signed off, and then deliver adjustments. You’re going to find your listing and adjust right away and then move the patient to the next position. So [in practice] I am going to adjust their neck as I feel it during the analysis. When I palpate the neck, I stand on the side of the patient and I’ll have a knife edge contact on the top of their forehead. Very minimal contact. I don’t want to touch makeup or hair. I barely want to touch their head [with the stabilization hand]. I want them to be comfortable. I palpate with my thumb and middle finger, the chiropractic index finger. I go right off the mastoids to the [transvers processes; TPs] and check lateral motion, and move down each segment and feed [posterior to anterior; P-A] in neutral [head] position. Then I palpate [each segment] in rotation [Sagi uses the same hand to check left and right rotation]. As I palpate in rotation, I’m palpating the pillars, checking for differences in muscle tone and texture and I’m also looking for limited rotation of the neck. I’m really paying attention to how far they can look, and feeling if the segment I’m contacting is restricted. Often the rotation restriction is upper cervical, but sometimes it comes from one or two segments in the lower cervicals. Once I have decided that a segment should be adjusted, I make my contact, tuck the chin always, laterally flex toward and rotate away from my contact and “boom”. #LIFELINES | 23
“Motion palpation is gold. ”
“I’ve found that correcting posteriority is the most important, over rotation. Hitting the high points down. If you correct posteriority, you’re going to help a lot of people. ”
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After cervicals, I ask [the patient] to go facedown [on the adjusting table]. To start, I just put my hands on their back to feel for spinous posteriority, muscle tonicity, and I’m feeling for things that are not expected. I also move the pelvis around a bit to help relax the patient. Then I use a cross-pisi position for my main assessment. That’s the position that I adjust in, and that’s the position that I palpate in. I’m thinking about practice. I palpate in that position, the second I find it, “boom”. What’s great about cross-pisi is that I can palpate the spinous, I can palpate the TPs, and I can palpate ribs. I usually start T8 and move up, then I go to T12 and up to T8, then I check the pelvis and move up the lumbars. I assess in sections because there’s a lot of space and it’s easy to get lost. When I adjust the thoracics, I don’t usually give breathing instructions, because I can see and feel when they are breathing. Often, breathing instructions will lead them to brace for the adjustment, instead of relaxing, and I don’t want that.
“Boom. ” When I assess the sacroiliac joints, I first feel their location, whether one is higher or lower [superior or inferior], then I do [general] P-A compression on left and right to feel for restriction. I’ll also compress [specifically] in the direction of a potential listing [e.g. restriction S-I, L-M for anterior-superior ilium]. Then I move to the sacrum and place my thumbs in the sacral alas to sense for any rotation. I don’t use leg checks because there are number of factors that can throw it off. After sacrum, I roll off the sacrum onto L5 and check for posteriority and lateral movement, and move up from there. That’s it. That’s all I do.
Do you adjust everything you find? It’s challenging because, as the patient, you want to feel like you are getting your moneys worth, but often less is more. I don’t adjust everything I find. I have areas that I will focus on. Sacrum and L5 adjustments can change someone’s life. I adjust sacrum over ilium every time, if I find it. If I find a [sacroiliac joint; SIs] and an upper lumbar, I will adjust both, but I won’t adjust SIs and lower lumbars. If I find four restricted segments in thoracics, I’ll adjust one or two, focusing on transitional segments. I’ve found that correcting posteriority is the most important, over rotation. Hitting the high points down. If you correct posteriority, you’re going to help a lot of people.
“I don’t adjust everything I find. I have areas that I will focus on. Sacrum and L5 adjustments can change someone’s life. ”
Let’s say you find 3 segments to adjust in the neck, how do you decide which to address? I usually will not adjust the same side twice. Unless there are no findings on the other side, and the segments are far apart. I normally would not adjust C2 and C4 that are both on the right, I would just adjust C4. Sometimes my decision will have a lot to do with range of motion. If their range of motion is pretty low, I might choose to adjust both segments. No more than 2 cervical adjustments. If there is something else, I’ll let them know that we will get that next visit. When I find a few segments together that are all stuck [e.g. C3-5], I’ll choose to adjust the lowest segment. I find this can often release all of the segments. §
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HOW D’YOU KNOW?
I concentrate on being as soft as I can be, so that it doesn’t feel like a “setup” and so it is comfortable for the patient. I plan to adjust all my patients in the cervical chair, but some patients are nervous and have even had past trauma from other chiropractors. In those cases, I usually adjust them supine first, because [for some people] its more comfortable and they can relax. Also, some people can be adjusted regularly in the cervical chair, but some days they don’t want or can’t seem to relax. I’ll use distractors… “drop your shoulder, look to the right, wiggle your toes…”. I’ll use everything, but nothing works, so I’ll adjust them supine as well.
POLICY Lifelines is the official quarterly magazine of the LifeWest student body, and is funded by Student Council. Any articles published herein do not necessarily reflect the opinions or beliefs of Life Chiropractic College West. EDITOR/DESIGNER/PHOTOS Dr. Austin Bergquist, PhD FACULTY ADVISOR Dani Lorta, MA PRINTING Michael Poss CONTACT lwlifelines@gmail.com ARTICLE SUBMISSION Would you like to write for Lifelines magazine? We look for chiropractic articles that inspire & challange. Email CONTACT for more information. PHOTOGRAPHIC SUBMISSIONS Do you have amazing chiropractic photos that you would like showcased in Lifelines magazine? By sending your photos, you agree that you have the right to distribute the image, and maintain that all people depicted agree to have their image published. Email CONTACT for more information. CREDITS Cover: Marg’s Draw, Sedona, AZ of Dr. Broc Sheets/@drbrocsheets & Allie Olson/@allieo34 by @plantedchiro; 2-3: Contributors Baker Beach, San Francisco, CA of Dr. Austin Bergquist by @motherchiro; Alexis Griffith/@aye.lexis; Allie Olson/@allieo34;
Rebekka Kuzichev/@rebekkakuzichev; Sara Parsons/@coffeeandchiropractic; Sagi Hebron/@sagi.hebron29; 4-5: Contents Creation of Man/Suk & Tamarago (2010) Neurosurgery; Allie selfie by @allieo34; Foot, Oil Can, Capitol Hill by Pixabay; Sagi & Austin by @plantedchiro; 6-10: Hidden Anatomy 1 Ashford et al (2020) Neurocase; 2 Suk & Tamarago (2010) Neurosurgery; 3 Bondeson & Bondeson (2003) JRSM; 4 Eknoyan (2000) Kidney International; 5 Eknoyan (1989)Am J of Nephrol; 6 Meshberger (1990) JAMA; 7 Di Bella et al (2015) Mayo Clin Pro; 8 Salcman (2006) Neurosurgery; 11-13: Knowing Who You Are Rebekka Kuzichev by @prettymanmedia; Faces by Pixabay; 14-15: What’s Your Story? Allie selfieby @allieo34; Broc, Allie & Sedona by @plantedchiro; 16-17: Foundation of You Foot by Pixabay; 1Bowman, K. (2016); 18-19: The Squeaky Wheel Oil can by Pixabay; 1 https://www.acatoday.org/ Portals/60/Research/ACA_50th_anni. pdf; 2 https://www.chiropractic.org/ advocacy-2/; 3 https://www.chiropractic.org/about/; 4 https://www.acatoday.org/About; 5 https://www.acatoday.org/About/ Mission-Vision; 20-21: House & Senate: Congress logos by Pixabay; 1 https://www.congress.gov/116/bills/ hr3654/BILLS-116hr3654ih.pdf; 2 https://cqrcengage.com/aca/action?4; 3 https://www.chiropractic.org/ medicare/; 22-25: How D’You Know Sagi tracksuit, Austin tracksuit, Sagi & Austin by @plantedchiro; 26-27: Credits Simran Chawla/@simi10125 by @plantedchiro; Back Cover: Cathedral Rock, Sedona, AZ by @plantedchiro.
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CREDITS
LIFE LIN
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There are far
better things ahead
than any we leave behind.
C.S.Lewis
