"I didn't know you could help with high blood pressure," Martha blurted. Of course she really meant to say that she was already taking medication and that it would be absolutely impossible for her to ever quit. Her blood pressure was so-o-o-o bad that they had to hospitalize her once to get it under control.
"Yes, Martha," I said, "your blood pressure is a part of your body's innate signal that you need to adopt a healthier lifestyle; and drugs are not the answer."
"Oh, I take a low dose of blood pressure pills, I watch my salt, and I even eat whole wheat bread," she said. She meant, look buddy, if you bother me much more about my blood pressure, I am going to go somewhere else to get my back popped into place.
Preferring to live dangerously, I continued, "Gee, I see in your chart that you have a high cholesterol. Martha, did you know that most blood pressure medications cause your cholesterol to go up?" (Raven GM: Insulin resistance, hyperinsulinemia, and hypertriglyceridemia, in the etiolgy of hypertension. American Journal of Medicine, Supplement 2A, 90:2A-7S-12S, February 21, 1991.)
"What?" she said, dropping her defenses for a moment.
"Yeah, it's a shame that you are trying so hard to eat right to lower your cholesterol when your medication for high blood pressure is making it go up -- what with you eating whole wheat bread and cutting down on your ice cream and all."
"You mean the blood pressure medication could make it higher?"
"Yes, it appears to be a side effect. Did you know that people who take blood pressure medication have more heart disease than the average American who eats whatever they want?" Now she was thinking -- for once without a medical doctor to save her from the menopausal hysteria of living and eating responsibly.
"So, Martha, if you could lower your blood pressure without raising your cholesterol and increasing your risk of heart disease, would you want to?"
"Well," (she knew that she was going to regret this) "yes, I would."
"There is a diet that will lower your blood pressure better than the drug you are taking." (Moriguchi, et al: Systemic arterial hypertension: results of the change from pharmacological to non-pharmacological therapy. Journal of Cardiovascular Phamacology, Supplement 8, PS72-4, 1990.) Best of all, Martha, you can eat all the food you want."
"But my other chiropractors never told me about this and my medical doctors never told me either," she said as she laid down for the rest of her adjustment.
Health care is two things: a service to people and a business of marketing. Chiropractic has identified itself as the major preventative and drugless healing art while allopathy has identified itself with heroic intervention. This seems clear enough, but there is a curtain of haze that divides chiropractic from true preventative care.
When was the last time your state convention contained a seminar on preventing hypertension, heart disease, or stroke? Funny, isn't it, that the major preventive health profession has no outreach programs to educate not only the public, but its own patients, and for that matter, its own doctors! Odds are that your professional affiliate has no more to do with preventing illness than the insurance industry has with promoting chiropractic.
Sure, there is a plethora of articles dealing with the miraculous benefits of vitamin XYZ in our semiprofessional literature, but isn't it puzzling that there are so few about simple diet and exercise?
Dr. Sid Williams of Life College once wrote a slanted pamphlet titled, "When is a potato a pill?" In this he chastises the profession for using nutritional supplements as pharmaceuticals. He may have been right about one thing, a chiropractor is more likely to sell his patient an unproven bottle of XYZ vitamins to control hypertension than he is to advocate simple lifestyle measures that are actually known to work -- like salt restriction for hypertension.
I would like to propose a pamphlet titled, "When is a chiropractor a potato?" This pamphlet would chastise chiropractors who would claim to improve the human condition without lifting a pisiform to educate the patient about how to implement a diet and exercise program.
What chiropractic student can remember a course in which they were taught to control a patient's food and exercise to restore normal blood pressure? A chiropractor in the great state of Washington called me once and lamented that they could not even take a blood pressure. This is ridiculous when a professional man is unable to figure out that he is not going to go to jail because he took someone's blood pressure! Is it possible that every chiropractor in Washington and other so-called straight states are limiting their preventive care of patients to spinal adjustment only? Well, the chiropractic myopia is not limited to straight states. Think again about when your state association last sponsored a conference on preventing hypertension, heart disease, or for that matter, spinal subluxation.
Even if such a conference were available, who would come? My guess is nobody. So what if nutrition is the major tool to prevent disease? So what if insurance companies would pay for the care? So what?
Fifty-eight million Americans have high blood pressure; only 24 million know it. Out of that 24 million, only 2.4 million actually take high blood pressure pills. Only one-third of those who take high blood pressure pills actually lower their blood pressure; fewer than that follow a simple plan of salt and calorie restriction, coupled with exercise for 20 minutes, three times a week. (Disease of the Month. Year Book Medical Publishers, Chicago, p 138, March 1989.)
Think of it, allopathy unable to correct spinal subluxation and loses to chiropractors in the management of lower back pain. Interesting, but to whom? Chiropractors only. Now add this: allopathic drugs unable to correct hypertension and loses to chiropractors in the management of hypertension. Now who is interested?
Three steps must be taken to put chiropractic at the forefront of preventive health care.
The chiropractic doctors denigrate themselves by concentrating on symptom relief rather than health care. It might be surprising to you that if a patient presents with high blood pressure, the odds of you successfully correcting their spinal subluxation without correcting their blood pressure is zero. Of course, you could adjust them twice a week for a year and get symptomatic relief, not to mention high volume practice. The public can see through this sham form of health care (only if it is performed by a chiropractor).
From out here in the country, it looks to me like the chiropractic profession has been shrink wrapped and pre-packaged to go to market; city-slicked into a white suit and tie to fit into our self-made stereotype. By accepting this stereotype as a necessity for survival, we are denigrating our profession and our education, but the more damning charge is that chiropractic is supporting disease by ignoring true health care.
When you next adjust a patient with high blood pressure (there are two studies that show this alone can lower blood pressure a little bit) face the facts that cardiologists have been facing for almost a decade; preventing illness is possible only through diet, exercise, and relaxation. No adjustment you are going to give could be as important as the diet, exercises, and relaxation training you can give your patient. Sure, the adjustment will help them get well for now, but your health care will help them to stay well in the future.
This Christmas season give yourself and your patients a big present -- tear off the shrink wrap! Merry Christmas.
Martha now has normal blood pressure without blood pressure pills -- against her MD's advice.
Please contact me if you feel strongly enough to do something to make chiropractic the leader in preventative health care:
Willard Bertrand, D.C.
P.O. Box 366
Union, Oregon 97883
(503) 562-6223
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