Or the problem of consistently fainting while eating.

A patient complained that for the last few years she was having enormous difficulty with swallowing. Often during a meal she would ‘pass out’, her record was five times during a meal, literally ‘face planting’ onto her plate. It was very distressing for her and everyone around her. They would hold onto her while she ate waiting for the ‘drop’. Even swallowing her own saliva while walking around could lead to a fall and an injury. On one occasion, she had a fall down a flight of stairs. Driving was a problem as she had to pull over to have a drink of water, prepare herself for an episode of unconsciousness, recover and drive off as if nothing had happened.

Vasovagal Syncope is a very interesting phenomena. Basically the nervous system doesn’t coordinate properly allowing a temporary drop in blood pressure to the brain. It then shuts down leading to unconsciousness. For some inexplicable reason the blood needed to pump up to the brain tends to pool in the legs.

It is known to occur for a variety of common reasons such as:

• Standing still in the hot sun

• Heat exposure

• Seeing blood or having an injection

• Fear

• Straining at the stool

There is a variation of it, called Micturition Syncope where older men ‘pass out’ while urinating. Cough Syncope is another version of it.

Anyway the lady who ‘swallows’ to initiate this phenomena was typical in some ways and very different in others. She had been to multiple physicians without any hope of a treatment. The usual medical advice for this problem is to ‘work around it’ i.e., there isn’t any medication or therapy utilised as ‘best practice’. It is usually a matter of putting up with it.

From another point of view this problem is a lack of fine coordination of the haemodynamics that we all normally have. Basically, the receptors that convey messages of how much pressure the heart must pump in various situations, or the vascular response of the lower limbs, is not working properly, or both. Either way the Nervous System is dysfunctional but not pathologic. Vasovagal Syncope won’t kill someone by itself. Of course, if the environment is dangerous, passing out could end up being fatal!

This patient’s history was unremarkable and did not give any clues as to the source of her issue. A bank of tests to do with her Autonomic Nervous System revealed enough aberrant or unusual findings to start to get an idea as to what might be going on with her.

The Carotid Sinus Reflex was sluggish and largely unresponsive compared to normal. This is a test that requires measurement of the Heart Rate before and after light finger pressure upon the carotid sinuses in the neck. The occulo-cardiac reflex was similar. Gentle pressure upon the closed eyeball also affects the Heart Rate. This also was slow to respond and didn’t vary as much as normal.

More generally the evaluation of Eye Movements using Saccadometry showed a poor cerebellar control.

• Dynamic Visual Acuity Testing showed a poor Vestibulo-occular Reflex.

• Force Plate Analysis also showed ocular deficiency and poor proprioception integration.

Together these findings led to a formulation of a treatment regimen which included:

• Spinal Adjustments which are proven to stimulate the Frontal Cortex of the Brain

• Low Level Electrical Stimulation of the tongue to gently stimulate the Brain Stem

• Sensory-motor integration procedures using Laser Guided Targets and Hand-eye coordination and timing techniques.

• Observing Saccades and Pursuits.

Also home exercises were emphasised utilising:

• Gargling

• Singing loudly

• Standing on one foot while brushing teeth with eyes closed.

• Gaze stabilisation exercise

• Deep Knee Bends (squats)

After 5 consultations in one month we were happy to hear that the problem of fainting with swallowing was completely gone. At a one year follow up phone call the patient said the problem had not returned.

A very interesting presentation.

Mild Concussion — An opportunity to describe the functional approach to health and dis-ease.

The following is not a testimonial or a case study as these are not allowed within Australian licensing guidelines.

AP presented with mild neck discomfort and constant headaches following a motor vehicle accident one week previously.

Aside from the neck pain, AP suffered from insomnia, poor concentration, irritability, a tendency to become easily upset, tearfulness and a feeling of being ‘on edge’.

It seemed to be progressing and she was having recurring thoughts about the accident every day. AP had previously been of very good health and fitness.

Further inquiries about the incident revealed AP did not hit her head but did get violently thrown to the side. Immediately following the motor vehicle accident she felt vague and couldn’t concentrate.

So far her story and presentation sounded like a case of concussion.

Another more accurate name for concussion is mild Traumatic Brain Injury. Recent studies have discovered that the violent trauma that leads to the signs and symptoms of concussion actually occur from damage to the delicate coverings of the nerves within the Central Nervous System; this is the Brain and Spinal Cord.

This type of damage affects the quality of nerve transmission, of impulses to and from many parts of the body which helps explain the diverse range of symptoms of concussion.

The brain is prevented from getting the usually full complement of information from the tissues that tell it what is going on, both internally and from the world around us. A multitude of sensors (muscle tone, pressure, pain, temperature, ligament and joint, oxygen, blood pressure, movement, sight and sound, taste and smell) feed information into our nervous system to allow the brain to construct a ‘reality’ of what we think is ‘us’.

The brain also sends out signals to match the incoming information. If the input is poor then it follows that the output will be poor. This allows symptoms like loss of concentration, teariness, anxiety, fuzzy head, fogginess, memory loss and muscle weakness etc. to occur.

There are many tests and established protocols for the diagnosis of concussion. Physical examination of AP was fairly straight forward as the diagnosis was already clear. This involved examining her cranial nerves and a spinal exam, testing her muscles, eye movements, reflexes, cognition, balance, memory and coordination. What was interesting was the hyper-reflexia of all her muscle reflexes; they were brisk and exaggerated to an alarming degree. Her muscles were tight, not unlike many presenting conditions, but her reflexes were so abnormal that they could be used as an objective sign to gauge improvement over time.

A brief explanation of the situation.

I explained to AP the likely mechanism of the injury and the reasons for her signs and symptoms; this was followed by my reasoning behind the management of her condition. I suggested she would need quite a bit of time to fully recover but initial rapid improvement would be expected. I explained that damaged nerves need:

1. Stimulation

2. Nutrition and

3. Oxygen.

Her diet was already excellent so I had only to focus on Oxygen and Stimulation. The stimulation of AP’s nervous system was achieved by the restoration of normal spinal mechanics using Chiropractic Adjustments and Yoga exercises.

Adjustments were to be carried out every few days for a week or so and the Yoga Exercises had to be performed a few times each day.

Increasing Oxygenation to the neuronal tissues was to be achieved by simple deep breathing for one minute three times daily.

The profound value of such a simple breathing exercise was demonstrated by connecting AP to a Heart Rate Variability (HRV) Monitor and recording the baseline result followed by the Deep Breathing Exercise for one minute and re-recording the result.

The HRV measurement was initially 47 which jumped to 56 after doing the breathing exercises for only one minute. This was a brilliant result; I was hopeful of a quick recovery due to AP already being very fit and flexible.

A follow-up consultation was to be held in three days; unfortunately AP stated she had only marginally improved. The hyperreflexia was unchanged which was very disappointing. Initially, I found this result very confusing.

Upon further enquiry it transpired AP did not do the breathing or the yoga stretching exercises. I had to read ‘the riot act’ to her about this and again explained the reasons for the exercises. With her head feeling as if in a fog she didn’t really take in what she was told on the previous visit. No matter, she received Adjustments and encouragement.

The next visit was markedly different. AP was happier, brighter and more responsive. She stated she did the exercises precisely as she was told and as a result felt much better for having done so. Upon re-examination the hyperreflexia was much less. Adjustments were made and encouragement given and the next visit showed the reflexes were normal. AP felt she had recovered. This was a good result.

WHAT was going on with AP’s Brain and Spinal Cord?

Clearly the accident had upset her nervous system. Exactly how, modern neuroscience is not sure. It appears the excessive energy of the impact caused a disruption to the vastly interconnected but delicate neurological matrix, thereby, producing an inefficiency of some of the neuronal circuits. It appears logical that this reduced or aberrant signalling was the reason for the signs and symptoms discussed.

As a general principle, the background to our nervous system is hard-wired to be in a constant state of excitatory activity. We overlay this with more precise inhibitory controls effectively calming it down to allow fine control.

For example: The grasp reflex of a newborn baby is a wonderful phenomenon. It occurs when you put your finger across the palm of a newborn baby’s hand, it will close and not let go. This ‘grasp reflex’ is hard-wired before birth and as the little one’s nervous system develops he/she gains control over opening and closing its hand at will by inhibiting the reflex. This usually takes five to six months.

This same process is replicated in thousands of circuits as we develop. The young child will say what it thinks until, with increasing neuronal maturity, they learn to suppress or inhibit those urges, like saying, ‘Mummy is fat and grandpa stinks’!

Learning to juggle is another example. Initially the act of juggling is difficult as the movements needed are too gross to perform quickly and accurately. With only a small amount of repetition, our senses of sight and touch feed back to us the ability to increase the fine control of our muscles by further inhibition to their gross movements allowing the control needed to be able to juggle.

Our nervous system strengthens and develops inhibitory pathways to fine tune and control our behaviour throughout our lives. Our brain uses the information from our senses of sight, sound, smell, taste, touch and proprioception to modulate or regulate the balance between excitation and inhibition within our nervous system.

AP had hyperreflexia because the trauma of the accident partially disrupted the inhibition to that part of her nervous system which controls muscle tone. Possibly, the trauma disturbed a part of the Basal Ganglia, Brain Stem or Cerebellum within her brain which would normally help control the muscle tone.

As there were a lot of symptoms involving many parts of her brain it is probable that the trauma affected a large number of regions, but only mildly. After all, she was still a functioning human being, just not doing so well.

The correction of her spinal subluxations initially would have been a stimulus to her brain to force extra processing of her sensory signals. This was then followed by more sensory input from the now normal joint movement.

Neurons like stimulation. It’s what keeps them alive. The adjustments both initially stimulate the nervous system and restore normal movement to the spinal joints. This allows the brain to get its expected amount of sensory information which it then utilises to control itself.

The same principle applies to the anxiety and tearfulness etc., that AP experienced. The trauma disrupted the normally well connected components of her Limbic System and Frontal Cortex which controls our social and emotional behaviour. The deep breathing exercises increase the oxygen content of the blood for those damaged neurons. Even doing the exercise is stimulating.

Neurons need oxygen. It keeps them alive.

As mentioned AP had an excellent diet and was previously very fit and flexible. She had everything going for her to enable her recovery.

That’s an impossible question. 

Most people with complex health problems show a measurable improvement within 15 visits. Some less, some more.

Sometimes their presenting complaint is corrected sometimes they are just improved and to varying degrees. 

There is a lot to discuss with this aspect of care.

Often when a patient presents with a condition, there are other complaints that are significant but not the main concern.

For example.

An intractable Migraineur will present with wanting their Migraine headaches stopped. Fair enough. However there are always associated problems that pale by comparison. Perhaps dizziness, vertigo with cold hands and feet also exist. These symptoms are nothing compared to the misery of Migraine, but they show that there is a lot going on with the nervous system of that patient.

In treating the patient, we look at everything possible and design a program specific to that patient’s test results. 

With the example above, as we progress with treatment, we may find that the dizziness and vertigo will go away and the migraines improve, but the cold hands and feet may persist. It would be our intention to correct all the signs and symptoms which represent a dysfunctional nervous system and in doing so the chief complaint being migraine will hopefully be fixed along with the other symptoms.

‘You can't make a silk purse out of a pigs ear’.

By this, I mean that the tyranny of age and the accumulation of injuries over time may mean that we can help somebody but not cure them. All of this will be discussed in detail before commencing treatment and as you proceed through the program.

Some conditions are relentless, such as the autoimmune conditions, they can't be stopped, but their effects can often be lessened.

Some people, at a very deep level, don’t actually want help. They don’t recognise this and would scoff at the very idea of it. However, read on!

Here we must consider our ‘self concept’.

Do you see yourself as a sick or damaged ‘you’? Or do you see yourself as the ‘you’ that has always been but that you have sustained some illness or damage.

If your answer was that you primarily see yourself as a sick or damaged person then you will have changed your ‘self concept’ to being an unwell person. This will require a lot more consideration than otherwise.

The simple reason is that as you improve your health you will have to rethink who you are. You may not want to change your self concept as that is all you know. This is serious stuff and a huge barrier to getting better for some.

Self-concept is a broad term referring to an individual's perception of "self," encompassing beliefs, attitudes, and perceptions one holds about oneself. It includes aspects such as self-awareness, self-esteem, and self-image. Self-concept shapes how individuals see themselves, influencing their behaviours, attitudes, and interactions with others. It is formed through experiences, social interactions, and self-reflection, and can evolve over time. Self-concept is crucial for personal identity and psychological well-being.

There are layers of understanding to becoming well again.

A story of Betty

Betty had been in a really bad way for 4-5 years. Her particular health problems were complex and debilitating. Multiple doctors and others made little difference. She could not easily leave the house, couldn’t have visitors and suffered considerable pain and misery both during the day and at night. she found herself in hospital every 10 weeks or so from particularly bad episodes of her affliction. She could not be the person, mother or wife that she desired. She became involved in the Facebook & Instagram groups associated with her condition and was active with those. Blogging and sharing information and advice. This was her world. It wasn’t much but it was something.

She heard of our clinic and arrived exhausted from the short car trip. We did the things we do and she started to improve. Her daytime misery was largely gone, she didn’t end up in hospital any more and she could even have visitors to her home. The kids and husband were very pleased. She was not. She stopped coming for treatment. When questioned about this she said it was too hard to travel for treatment and that was that.

Actually, what was really happening was that her ‘self concept’ was rapidly being destroyed and she couldn’t cope with it. It was better, to her way of thinking, to stop the challenge to her ‘self concept’ and to accept the now reduced misery she suffered nightly. She refused all attempts to get counselling about this, no doubt, for the same reasons. Three years later she told me nothing has changed. She does not want further treatment from anyone despite the obvious possibility of further improvement. Perhaps, in time, her self concept will alter enough to allow her to seek help somewhere.

To further understand this dilemma we should consider an Anthropological Theory: The Special Theory of Specialness’.

That being, we all have an innate desire to be ‘special’. There is a very good reason for this. It is simply that if we did not have it within to be the very best, then it would be a disservice to humanity to propagate and fulfil the primal drive to reproduce the species.

Evolution of the human species occurs from interbreeding the genetics of two people with the expectation of producing an improved version of those parents. Over time the species progresses.

It is hardwired within each of us in order to advance the species i.e. evolve. A parent will give up their life for their child for the same reason. The idea that a child will ‘jump off its parents shoulders’ is similar.

Children don’t mask this need to be ‘special’, they will readily say they want to be the best in the world at this or that.

Adults soon realise that they can’t be the best tennis player in the world or the fastest runner or the best in anything. The desire is there but we have to reconcile it in a way that keeps us satisfied. So we strive to be the best at something that is achievable and we don’t usually make a scene about it as it is a tenuous stance easily and often lost by time and circumstances.   

When the attainment is obvious we look like a ‘high achiever’. But everybody is sub-consciously working away at this impossible goal. Unknowingly driven to improve the species.

How does this relate to improving your health.

Take Betty, she sub-consciously considers herself to be the best at being her version of sick. She is online often, connecting to other sufferers, giving advice, listening to others, and being useful, it gives her a purpose to stay involved. In this way she fulfils the need to consider herself special and satisfies the drive for this relentless need. If she was well she would no longer be able to identify as a fellow sufferer.

In practical terms, Betty overtly wants to be well and have a good life. However, her self concept is holding her to ransom. She also wants to be special.

Being unwell with her particular condition is fulfilling her need to be ‘the only one’ with her situation.

And getting effective treatment leading to a rapid change in her circumstances was a bit scary and so she steered away from challenging her  ‘self concept’. Consequently she rejected further treatment despite its obvious effectiveness.

A little more on 'The Special Theory of Specialness’.

Why people believe weird stuff. Have you heard of the tunnels under the ocean linking the continents where children are kept and farmed for whatever reason I don’t remember. There are those amongst us who have very extreme views that clearly are beyond the normally accepted boundaries of reality. Denial of the Moon landing, the Holocaust. The existence of wee people, fairies, gods, superstition, ghosts, sprits, demons, luck, conspiracy theories, it goes on and on. Many have ‘beliefs’ that they are prepared to die for!

Why do so many people think this way?

For the vast majority the experience of adult life has shown us time and time again that we cannot be the best in the world in something obvious like being the smartest, fastest, funniest, slowest, greatest, wealthiest, but the drive to be ‘special’ is eating away at us.

Inadvertently we see appeal in believing some weird thing as it makes us the special person that knows something that no one else does. When someone claims to have been abducted by aliens you can be sure that the unconscious drive for this is to fulfil the need to be ‘special’. 

What to do with this.

Be the best individual that you can be.

You are the best at being you. That means you are a unique combination of attributes of varying degrees of competence, none are a world first, but in combination you and only you have the particular mix of attributes that you have. No one can be better at being you because you are uniquely a ‘one off’.

Whew, you can now relax and stop striving. Unless you were trying to be the best at not striving!

Likewise you can look at your behaviours and consider if they are serving you or a previously unconscious desire to be the best. 

Often, if you say to yourself, I’m no good at …..… then that’s you saying I’m working on being the best at being no good at ……… 

Of course this is occurring at a sub conscious level. You are not normally aware of it.

Basically we need to understand why we are not the world’s best, but it doesn’t define us. Collectively we each have no match.

What’s important is the knowledge that there is a subconscious drive towards specialness and to hold it in check is to allow acceptance of who we are so we can direct our drive in ways that matter to us. Rather than be out of control of our life’s direction.