The self care challenge and applying a self-care regimen for a long chiropractic career
“Physician, heal thyself: then wilt thou also heal thy patient. Let it be his best cure to see with his eyes him who maketh himself whole.” ― Friedrich Nietzsche, “Thus Spoke Zarathustra” Of course, Nietzsche died, insane, with tertiary syphilis. Like us, he probably needed to heed his own advice. We are in the business of healing, but how much of our knowledge do we apply to a self care challenge for our own careers?
Starting with stress
It is easy to fall into cliched and obvious advice — telling you to strengthen your core, use proper body mechanics, think positively and eat a good diet would make this article much like the lame advice given to consumers about money and health that we see so often on the morning news shows.
Instead, let’s talk about stress. Running a practice can be stressful, both on the business end and the clinical end. On the business end we have the government and insurance companies to deal with. On the clinical end, some of us are so concerned about our patients (especially those who are not getting the desired result) that it affects our own health. There are also two opposite ways we can be stressed out by our practice. You can be stressed because you are so busy that you cannot catch your breath, or you can be stressed because you are so slow that you do not know where the office rent is coming from. Either way, dealing with that stress is a self care challenge that can improve the length and quality of your life.
When the adjusters need adjusting
Do you get adjusted? So many chiropractors don’t.
Not only does it show that you believe in what you do, it can relieve stress. Adjusting relieves stress. Tight back, neck and shoulders are often the result of stress (see the little man above). What happens when you scare or anger a cat? The fur on its back stands on end. Southerners have a term, “Get your back up,” to describe anger. Adjusting breaks what has been called the “safety pin cycle” (am I dating myself?).
Feeling stress causes the muscles to tighten, and in turn, the tight muscles make you feel stress; it’s a feedback loop. That is one of the reasons there is such a feeling of well-being after an adjustment.
George Goodheart, DC, talked extensively about hyperadrenia and hypoadrenia, based on his interpretation of the work of Hans Selye, MD. Research has since provided us with a more nuanced view of stress (check out this article: Cell Mol Neurobiol. 2010; 30(8): 1433–1440. ).
Although archaic, the terms hyperadrenia and hypoadrenia are still a useful way to communicate about stress (you can say sympathetic dominant or parasympathetic dominant, if you prefer). Addressing stress is not simply a matter of adrenal support.
Prolonged stress creates problems
Increased heart rate and blood pressure — If it does not go back to normal, the epithelium of the arterial walls become damaged, and the body lays down plaque to “repair” it. This is the beginning of atherosclerosis and heart disease.
Tight muscles and head held forward — The neck, upper back, gluteals and calf muscles become tight. If this is prolonged it can be the beginning of neck pain, back pain, knee pain or headaches.
Blood leaves the intestines to go to the skeletal muscle — If this is prolonged, it can be the beginning of colitis, leaky gut, immune problems (more than half of your immune system is associated with the GI tract), irritable bowel or ulcers.
Sugar-handling issues — The body wants sugar for fuel so it can survive. If the stress persists it can lead to poor dietary choices. It begins to crave sugar, salt and fat. If the situation is prolonged, insulin insensitivity can develop.
Other issues — Stress makes you hypervigilant (you need to be aware and protect yourself). Prolonged, this can lead to anxiety and even depression. It can also lead to infertility (reproduction is not necessary when you are under attack).
A self care challenge and how to reduce stress
Meditation — Meditation, yoga, Tai Chi or simple deep breathing exercises can help you bring stress under control. Much of the damage that stress does to your health is not due to any external factors, but rather how your mind interprets those factors. Meditation and other techniques help reduce the harm of stress by quieting the mind. You should meditate 30 minutes each day (if you do not have time, you need to meditate for 60 minutes each day).
Sports and hobbies — Meditation and yoga may be a little “new age” for some people. Hobbies are a good solution for these people. Most hobbies are relaxing; your mind has to focus on a simple task rather than on sources of stress.
Exercise — Moderate aerobic exercise is good. This is exercise that uses large muscles repetitively and is mild enough that you can carry on a normal conversation during the activity. Anaerobic exercise (working so hard that you can’t carry on a normal conversation) can be stressful and should be limited while the adrenal glands are recovering.
Address cardiovascular damage — Diet, of course, is much more important than supplementation. Avoid processed foods, sugar, chemicals, GMOs and “funny” fats. Eat foods that reduce inflammation (translation: fresh produce, which should be more than 50% of your diet, by volume). Also, get insulin insensitivity under control (also a product of stress).
Stress causes vasoconstriction and damage to the cardiovascular system. Most of the supplement companies have products that help address blood pressure and cardiac issues. They often combine several nutrients. They use nutrients that have been studied and found to help reduce blood pressure, some by addressing angiotensin, some thorough other mechanisms.
Vitamin D, for example, is associated with lowering levels of angiotensin1,2. Magnesium is necessary for vitamin D to be active3 and is important for the health of the vascular endothelium.4,5,6,7,8,9 Low magnesium is associated with increased angiotensin, arterial calcification and fibrogenesis.10,11,12,13,14
Niacin has been shown to have cardiovascular benefits.15 It improves lipid profiles, especially for those with insulin insensitivity.16,17,18 Niacin also has been shown to reduce inflammation of the vascular lining.20 Poor riboflavin status is a risk factor for stroke.15,19 Menauinone-7 (vitamin K2) helps prevent calcification of arteries and reduces their stiffness.22,23,24,25,26
Insulin insensitivity — This goes hand-in-hand with stress and can cause vascular disease. It encompasses three conditions: metabolic syndrome (sometimes called Syndrome X), adult-onset diabetes and obesity. Sugar and insulin are highly inflammatory. They are involved with high blood pressure, high cholesterol, high triglycerides, Type 2 diabetes, menstrual problems, heart disease, pain, inflammation, depression and polycystic ovaries. Half of all patients with high blood pressure have insulin insensitivity. If you are a man with a waist larger than 40” or a woman with a waist larger than 35”, you should initiate a self care challenge and address insulin insensitivity (whether or not the labs say so). Here are some ideas to help bring insulin insensitivity under control:
Do not eat foods with a glycemic load greater than 10. Another choice is the Roadmap to Health diet, which addresses not only glycemic index, but inflammation and digestive issues as well.
Do light exercise (heavy workouts increase cortisol production). There are literally hundreds of scientific studies showing the benefits of exercise for diabetics. There are too many to list here. They consistently show a lowering of A1C scores for diabetics who begin an exercise regimen. Light exercise is best, and it should be done daily.
Take magnesium for bowel tolerance, on an empty stomach. Stress depletes magnesium. Magnesium and its role in blood sugar control have been extensively studied. Insulin insensitivity and the overproduction of insulin found in Type 2 diabetes may actually interfere with magnesium absorption.27 The best form of magnesium for people with high blood pressure is magnesium taurinate. The best form for those with cardiac issues is magnesium orotate.
Intermittent fasting is a well-researched way to get insulin insensitivity under control and to lose weight. You have an eight-hour window to eat. There needs to be 16 hours between dinner and breakfast the next morning. If you eat dinner at 5 p.m., breakfast is at 9 a.m. the next morning. It works because when you fast you produce glucagon, which is a hormone that helps break down fat.28,29 Also, avoid snacking between meals.
Berberine has been well-researched and shown to reduce blood sugar and A1C. Studies have shown that berberine can help and performs similarly to metformin. Subjects have had significant decreases in A1C, fasting blood glucose, postprandial blood glucose, and plasma triglycerides.30,31,32,33,34
Essential fatty acids: Insulin is highly inflammatory, so insulin insensitivity can cause inflammation. It is part of the reason so many diseases are associated with it, like heart disease. The chemicals that create and suppress inflammation are oil soluble. The type of fat in the diet can either promote or suppress inflammation. Avoid hydrogenated oils, trans fats, and highly refined vegetable oils. Use extra virgin olive oil for cooking and for salads. Studies have shown that taking vegetable-sourced omega-3 fatty acids, like linolenic acid from flax seeds, will reduce inflammation as well as improve blood sugar control.35,36,37,38,39,40,41,42,43 Use a vegetable source; long-term use of fish oil is not a good idea.
Other supplements: Most supplement companies make a multiple with Krebs cycle factors and other constituents to bring insulin insensitivity under control. There are supplements to thin bile, which will address biliary insufficiency and fatty liver; both are associated with insulin insensitivity. They either have a beet base or an artichoke base (choose artichoke because beets are high in oxalates).
Emotional stress, structural stress and chemical stress all affect the body the same way. Your adrenal glands do not know the difference between an IRS audit, an argument or excessive sugar consumption. If you initiate a self care challenge to reduce the stress you can control, stressful situations will not have as much of a physical effect on you.
Take charge of your outer diet and inner dialogue
Try to focus on the positive areas of your life and not the one or two things that really stress you out. Take charge of your internal dialog. Say only positive things to yourself. This is not to get you to deny any negativity in your life, but if you cannot do anything about a negative situation, put it out of your mind. Also, take steps to undo the structural and chemical damage that stress has caused.
PAUL VARNAS, DC, DACBN, is a graduate of the National College of Chiropractic and has had a functional medicine practice for 34 years. He is the author of several books and has taught nutrition at the National University of Health Sciences. For a free PDF of “Instantly Have a Functional Medicine Practice,” email him at [email protected]m.