Editor's note: This is part 1 of a two-part series.
When I opened my integrated clinic many years ago, I set out to do something different and approach chiropractic and health care as a whole in a way that many hadn't yet done. Prevention health care was still a fairly unknown concept to both patients and many mainstream health practitioners, and an interdisciplinary clinic orchestrated by a DC, was also not that common. Looking back, never in my wildest dreams did I think this road would lead me to sleep wellness.
My approach to patient care has always been functional-based. From diagnosing and resolving a simple cervical spine sprain strain to working with chronic pain caused by insomnia, my goal is to find the root cause of disease and dysfunction, correct it and assist in helping my patients build up their health from there. Whether a patient suffers from an auto-immune disorder or is being seen for well care, my clinical approach takes into account five core principles. These principles are drawn from our basic needs to support the body and help achieve viable and abundant health. Those five basics (and I stress "basics") are:
Deficiency in any of these areas makes the body susceptible to breakdown, so I want to identify and correct these deficiencies if any are noted.
Background
Like many DCs have experienced, my clinic has expanded and contracted over the years. At one time, I had 18 different practitioners, all with their own specialty, working with me. Today, my clinic consists of myself, a DO, an acupuncturist, a massage therapist and a superior staff that makes my clinic hum without effort.
I have what most would call a boutique practice, built strictly on referrals, with a 90 percent patient retention rate. Although mostly sports-injury oriented with a functional medicine foundation, I cater to all people and they share the common thread of wanting to stay healthy and fit. Sixty-seven percent of my practice is self-pay and I'm not an inexpensive visit. The percentage remaining is private-pay insurance, with a small portion of personal injury.
My patients know that they always will get my undivided attention, a total-body approach, with my care; health advocacy if they have illnesses or injuries out of my scope of practice; and most importantly, practical, useful information – tools and products to help them better their overall health when they are away from my clinic. I have a great practice filled with like-minded patients who look to me as their trusted compass through the health care system. They know that I walk my talk and only endorse things I believe in and use in my own life.
Problem Sleep
As I gained experience in practice, I easily incorporated resources to aid in assisting my patients with those five core principles vital to abundant health: breathing, hydration, sleeping, nutrients and exercise. I was able to successfully master all areas with ease, with the exception of sleep. I was acutely aware of sleep being a health issue, especially when it came to pain, early on in my training as a DC. I recognized that those who suffered from insomnia due to pain tended to heal much slower than those who were able to obtain a decent night's sleep. And after several years in practice, I saw an increase in what I thought to be diseases linked to environmental / toxic exposure factors, an increase in complaints of insomnia and, sadly, an increase in those taking prescription drugs for insomnia-related issues. What I was observing in my practice gave me a deep sense that something fundamentally wrong was happening with the way we sleep in the modern world, but I just couldn't put my finger on it.
[pb]I also recognized that what my patients were sleeping on structurally was not working. All too often, I identified that my patient's spinal issues had to do with inferiority of the mattress and/or pillows they were sleeping on. In addition, one of my patients had the simple complaint that, for unknown reasons, he wasn't sleeping.
My daily frustration quickly grew into a struggle in helping my patients find solutions and resources to help them sleep better. My not knowing what to recommend, combined with my need to understand how to recommend, fueled a fury of research. And after more than a decade, I've found the information sources that explained what's really happening. I've connected the dots, and what I've concluded is startling.
Startling Sleep Facts
To begin with, what we don't know about sleep is having a profound effect on our health and wellness, both personally and professionally. Sleep issues have become a major health concern in the United States. Surprisingly, the products we're sleeping on here are not regulated for material safety. Furthermore, mattress manufacturers are not required to list all the materials. It was in the 1950s when mattress manufacturers moved away from using cotton for comfort to synthetic foams. These foams off-gas noxious fumes, many of which are known carcinogens and quickly degrade, which leads to failure in providing proper alignment support for the back.
In 2007, the federal government mandated that all mattress manufacturers use a fire retardant. The downfall to this requirement is that the most cost-effective fire retardants / fire blockers are liquid sprays that often contain boric acid and PCDEs, which are both known carcinogens. And most people in the U.S. sleep on these materials every night for six to eight hours. I often question if this exposure is linked to the increase in diseases that are environmentally linked.
The facts make it clear that there is a major health problem regarding sleep:
In doing this research, I have concluded that patients are frequently confused about sleep and that the health care system fails to provide a "go to" resource (aka, a health practitioner). MDs prescribe sleep medication or even recommend that patients participate in overnight sleep studies, some of which lead to a CPAP machine. Neither encourages deep, healing or REM-level sleep, both of which are vital to good health.
I made the decision that between my years of research, my growing understanding of sleep and the critical importance of achieving quality sleep, and the lack of resources available to my patients with insomnia-related pain or unexplained insomnia issues, that I should add sleep wellness care to my practice. Here's how I went about it.
Research and Facts
Adding sleep wellness care to my clinic was more difficult than it appeared. The retail mattress companies don't share much information about what materials their products are made with and which fire blocker they are using. And although there is general agreement that sleep is important, the resources aren't as ample as one might expect. After a lot of searching, I was finally able to find information sources for these and other important sleep issues. This is a more complex topic than one would think, and there's a tremendous amount to learn when it comes to all of the dimensions of healthy, deep-healing sleep.
[pb]Educate Patients
I began advising patients about sleep wellness issues, especially as they relate to proper spinal support; the value of deep, healing sleep; toxic ramifications from the off-gassing of toxic fumes given off by many mattress, pillow foams and fire retardants; and finally, which products I recommend and prescribe. The first step was to add sleep wellness questions to my new-patient forms (see below).
Next month: Learn how to establish a sleep wellness room in your clinic.
Sleep Information Sources
Other valuable sources of sleep information are:
Continuing to impress the advertising and marketing world, The Foundation for Chiropractic Progress (F4CP) has again been recognized by industry organizations for its excellence in educating consumers on the benefits of chiropractic, this time through social media, newsletters, and demonstrating thought leadership by promoting holistic well-being.
Dr. Louis Sportelli received the Lee-Homewood Chiropractic Heritage Award during the annual conference of the Association for the History of Chiropractic (AHC). During his nearly 60-year career, Dr. Sportelli has embodied the spirit of the award, given to “living individuals who have made outstanding contributions to the chiropractic profession.”
Presently there is no consensus on the best treatment for Achilles tendon rupture; and its management is still controversial. The treatment options are conservative treatment and surgical repair. With either treatment, be it conservative or surgical, Achilles tendon tears necessitate prolonged recovery and rehabilitative management.
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