Transcription of Gaining Ease #23
Speaker 1: You are listening to the Dr. Lisa Radio Hour and Podcast. Recorded at the studios of Maine Magazine in Portland, Maine and broadcast each Sunday at 11:00 a.m. on WLOB 1310 AM and available streaming on-line at wlobradio.com. Podcasts are available at doctorlisa.org. Thank you for joining us.
Speaker 1: The Dr. Lisa Radio Hour and Podcast is made possible with the support of the following generous sponsors. Maine Magazine, Michael LePage and Beth Franklin at Remax Heritage, Robin Hodgkin at Morgan Stanley, Smith Barney, Dr. John Herzog of Orthopedic Specialists in Falmouth, Maine, Tom Shepard of Shepard Financial, Pierce Atwood, Booth, UNE, The University of New England and Akari.
Lisa: Hello this is Dr. Lisa Belisle and you are listening to the Dr. Lisa Radio Hour and Podcast on Sunday, February 19, 2012. This is show number 23. Our show is called Gaining Ease and actually you may not be listening to it on Sunday, February 19th. You may be listening to it via podcast. We welcome our WLOB radio listeners on 1310 AM. Portland or wlobradio.com streaming. We also welcome our podcast subscribers through iTunes. Today on the Dr. Lisa Radio Hour and Podcast, we are going to speaking with Dr. Michael Totta of the Spine Center at Orthopedic Associates in the Portland area, Dr. Bob Lynch of Lynch Chiropractic Art Center in south Portland and Chris Bicknell, Coordinator of the Teen Center and Lighthouse Shelter at Preble Street, also in Portland. It’s going to be a good show and I have my cohost, Genevieve Morgan sitting across the microphone from me.
Genevieve: Nice to see you Lisa.
Lisa: Good to see you. We’re already to go into our, what we’ve been calling our Deep Dish.
Genevieve: I’m excited about this one; because, I’ve been having a lot of back pain lately. I’m interested in how we’re going to gain ease today in what our guests have to say.
Lisa: This is interesting to me; because, we were going to call this something like Pain. I can’t remember exactly what the show theme was going to be.
Genevieve: It was going to be pain.
Lisa: Yeah, something about pain; because, pain is pain. We do; however, like the notion that there is a possibility of gaining ease through the pain. This is what we are trying to provide people with by bringing on individuals who can talk about gaining ease. We have two people who will speak to gaining ease through pain in the spine, pain in the body. Then we have another individual who talks about gaining ease through finding things like food to eat and a place to sleep.
Genevieve: I think when you are in a state of dis-ease it’s really important to know that it’s not going to last forever, or in most cases not going to last forever. I love this show; because for people who are out there listening who are currently in a state of pain, that there are answers out there and that they aren’t necessarily always going to feel the way they’re feeling right now.
Lisa: Yes, that speaks to something that I believe is very important and that is hope. When I have patients who come into my practice and they have been told, you are the way you are going to be for the rest of your life and whether they’re in pain or whether they’re in a time of great sorrow, grief, loneliness, they don’t want to hear that. I think it’s really wrong of anyone to assume that any other human-being is always going to be the way that they’re going to be. Now if you have lost a limb then clearly you’re not going to regrow your limb, but the fact that we limit ourselves by assuming that we will always continue in the same patterns, on the same path, doing exactly the same thing and have the same types of pain.
I just don’t believe in that and that’s why I believe in hope and that’s why we’re doing this show on Gaining Ease.
Genevieve: Certainly chronic pain is rampant throughout our society and it’s also one of the things that get people on the medical merry go round where they go from doctor to doctor to doctor to doctor to doctor trying to figure out what’s causing their pain. They get all these tests done and there’s no solid diagnosis and I think it leaves people in a really hopeless place; because, most people when they’re in pain do seek help, it’s just often the help doesn’t come back at them. Where does your practice step in?
Lisa: My practice is a unique one in that I often will take on what other providers might consider the “hopeless cases” and they tend to be the cases that believe it or not respond the best. There are some cases yes of chronic issues, structural problems. People will come in and say, I’ve had this for my entire life and I may or may not be able to fix that, but I can often help with sort of the circumstances surrounding that pain. That nidus of infection or that inflammation that’s been so chronic throughout their years. The other thing that my practice offers is a listening ear which often is the biggest problem.
You talk about this medical merry-go-round and if you are a patient who has a problem that hasn’t been solved through surgery or rehabilitation or medication you become the “problem patient.” Most patients who become the problem patient and who have a legitimate concern, that’s a bitter pill to swallow. That all of a sudden; because, they actually have a problem that needs to be solved, they are the problem.
Genevieve: People hear that oh well your pain’s all in your head. Well, okay, so it’s in my head, but it still feels really painful.
Lisa: Yeah, it is still a very legitimate problem. Even if I can do nothing else but this I will listen and this is something that, if you’re a busy medical practice and you’re a medical care provider and you do care about your patients, but you have to see a patient every 10-15 minutes or you have to schedule out six weeks or you have this sort of barricade of front office staff that’s really doing their best to help you. They’re kind of holding out people who need to be seen. You have the frustration of not being able to help your patients. What I am able to do in my office and it’s by virtue of the way that I’ve structured it is I give people the time to come in and tell their stories.
Talk about their sort of social and family and emotional ramifications of whatever problem that they have. Then we can start to untangle things a little bit. It is so multilayered. Pain is so multilayered, just like psychological things.
Genevieve: Chinese medicine takes that global view of everything, but also of pain and so does Ayurvedic medicine that pain is not just a mechanical problem, it’s a mind/body problem, but it’s individual to every person. Is that right?
Lisa: Yes, there are certain patterns that have been observed in Chinese medicine over the thousands of years that it’s been out there. It’s interesting to study Chinese medicine; because, people think, how easy is it? You study and stick a few needles in people at various places. There are volumes and volumes of texts out there that discuss pulse diagnosis or tongue diagnosis or skin diagnosis. In Chinese medicine similar to Ayurvedic medicine they’ve been practicing observational medicine forever. This is the benefit that we have. We can individualize it.
It’s not as simple as “Oh, you have hypertension take this medication.” We can get down to very specific reasons for hypertension. Very specific reasons for back pain, neck pain.
Genevieve: You can have two patients come in in the morning that each have the same disk herniation, an L5 disk herniation but their root of their pain is completely individual and different and the treatment will be completely different.
Lisa: That’s right.
Genevieve: Well, that’s really encouraging; because, it means that if you’re sitting there in pain right now, that you are the instrument of your own healing.
Lisa: That is very true. I know that Chris Bicknell is going to talk about this and even Bob Lynch is going to talk about this, the fact that you make choices. You choose to continue to seek healing. You choose to continue to show up and this is again a theme that goes over and over and over again. We talk about it. Show up, show up, show up, keep showing up. Don’t give up. Show up. In our Daily Tread, the book that we read from on occasion to benefit safe passage. The quote from Martin Luther King, Jr. is one that really rings true. “The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy.”
Now Martin Luther King, Jr. is talking about this from more of a societal standpoint, but it’s also where you stand in your life when you are undergoing troubles or when you have pain. If you have decided that okay, I’m going to accept the label that everybody has given me, that I’m a hopeless case, that I’m a problem. Then you’re going to feel very differently than if you’ve decided that, you know what I’m going to look at this as an opportunity, as Susan Connelly did in a show a few weeks ago. She had breast cancer. She was living in China with her husband and her two sons. This was an opportunity for her to live a bigger life.
Genevieve: That’s true and when you’re in pain it’s hard to see that, but I think small changes and small choices just get you further down the path and as you’ve said before that you show up for the small change and that it makes it easier to make the next change. I know in my case with my back pain one of the changes that I’ve made is that I’m not driving as much; because, when I drive my back really hurts. For the time being I’m just not going to drive which means I’m walking more. That one small change then starts to help.
Lisa: These small changes that start to help can also give you a chance to look at something that might be going on that’s deeper in your life. What might be causing some of this pain, whether it’s psychological pain that’s impacting physical or physical pain that’s causing psychological pain. You and I have talked about Ayurvedic medicine and the different chakras and that your first few chakras are sort of the foundational chakras. This is sort of the need for food, safety, all of the things that keep you just foundationally secure. In Ayurvedic medicine which evolved actually from Chinese medicine there is this notion that if you can’t get the foundation solid then everything above it is going to be shaky.
Genevieve: Well, I brought in this great book by Karol Truman called Feelings Buried Alive Never Die and can I tell you what she writes about back pain?
Lisa: Sure.
Genevieve: Back problems are feelings of no support. Having difficulty coping with emotional difficulty, feeling burdened emotionally, feelings of frustration and wanting to get someone or something off your back. That’s exactly what we’re talking about. You have a mechanical problem but you may also have unconsciously some of these deeper rooted things. I’m trying to figure out what I have against my car, but clearly there’s something related to that.
Lisa: Well, if it’s something as simple as your car then you’re pretty golden. When I do acupuncture on people, there’s the meridians that run up and down the back and actually in the core of the body are again very foundational. In fact the ones that run up and down the back themselves are the bladder meridians. We talked about the kidney meridian and that’s your very sort of inborn chi, your inborn energy. The bladder and the kidney are related.
Genevieve: What are the bladder meridians?
Lisa: This is again, it goes back to there’s five elements and the kidney and the bladder are associated with the element of water and that’s the winter and the emotion associated with it is fear. It’s also wisdom. If you’re feeling secure then you feel more wise. If you’re not feeling secure you feel fear. I do see this. Actually the knees are another thing that are associated with this particular set of meridians, the bladder and the kidney meridian. If your foundation isn’t secure, your knees want to buckle underneath you. You just aren’t able to kind of keep holding up this life of yours that you’ve entered into. I think there’s a lot of crossover between all the things that you’re describing.
Genevieve: When you mention the chakra the first, second and third chakras that go from the seat of your spine, up to the third is about the center of your belly. They’re about survival, creation and power.
Lisa: That is why we have the show every week is so that we can inspire people to not only survive but create and gain power in their own lives. This show we’re very excited about gaining ease. As I said we’ll speak with Dr. Michael Totta, Dr. Bob Lynch and Chris Bicknell. We know that people will not only gain ease but also be inspired.
Genevieve: I’m looking forward to it. I’d love to gain some ease.
Lisa: We at the Dr. Lisa Radio Hour on Podcast are pleased to have a segment we call Wellness Innovations which is sponsored by the University of New England. Today’s wellness innovation comes from Psychology Today and may be found on the Dr. Lisa website. This is called Chronic Pain Versus The Brain. How does a person become a chronic pain patient? Researchers used magnetic resonance imaging MRI to demonstrate that individuals with chronic back pain had alterations in the functional connectivity of the cortical regions compared to those individuals not suffering from chronic pain.
Interestingly, these areas of the brain are unrelated to pain. This altered brain function leads to additional and unwelcome diagnoses such as depression, anxiety, sleep disturbances and decision-making difficulties. In the healthy brain all the regions exist in a state of equilibrium. When one region is active the others become quiet. In contrast those with chronic pain experience continued activity in the frontal part of the cortex of the brain associated with emotion. These are disturbances of the brain not directly associated with the sensation of pain.
For more information on pain and the brain go to doctorlisa.org. For information on the University of New England go to UNE.edu.
Speaker 1: This portion of the Dr. Lisa Radio Hour and Podcast has been brought to you by the University of New England, UNE, an innovative health sciences university grounded in the liberal arts. UNE is the number one educator of health professionals in Maine. Learn more about the University of New England at UNE.edu.
Lisa: This week’s show we’ve called gaining ease. Show number 23. We were going to call it something like Pain, but we thought let’s think positive and in a positive vein we have Dr. Michael Totta, who’s going to come in here and talk to us about back pain. Thanks for coming in Dr. Totta.
Dr. Totta: Good morning. Thanks for having me.
Lisa: We have Genevieve Morgan who is sitting next to me.
Genevieve: Hi, Dr. Totta.
Dr. Totta: Good morning.
Lisa: I should say before we start that it’s always interesting when worlds collide, that you and I have had children in the Yarmouth School System. Well we used to. Now they’re all graduated. Our sons play baseball together and your daughter graduated with my son and we even have a Safe Passage, Our Daily Tread relationship. So it’s very interesting to have you in as an expert and you’re truly an expert in this field, but also have this whole back story. This whole Yarmouth thing. It’s a small world. Maine is a whole big small town.
Genevieve: I like that back story.
Dr. Totta: It is a very small world.
Lisa: It is a good back story and it is a back story, oh gosh. Oh my gosh, did we just do a huge pun? Thank you for that Genevieve. All right, clearly this is the first interview of the morning. You have a very impressive background. What I’m interested in is this physical medicine and rehabilitation residency that you did at Temple. You worked as the Medical Director at the Orthopedic Associates Spine Center and one might think you were a surgeon, but you’re not.
Dr. Totta: Correct, no. I’m the Medical Director and I play a role in directing the medical therapy for spine problems, of which there are a lot of folks who need more medical therapy than surgical therapy, so we’re very busy.
Lisa: You are very busy. I know that to actually get into your practice, there’s a process. There’s faxing things over and referrals. You have so many people that have back issues that want to see you that it has to be triaged.
Dr. Totta: Back problems are very common, extremely common and nonsurgical back problems are extremely common. There’s a saying among nonsurgical spine physicians, that if you have a friend that you want to refer for a back problem, you send them to a doctor with a really long waiting list; because, that way they get better on their own and they don’t need anything done. We think that we’re doing the community a service by keeping people on a long waiting list. I’m joking. I’m not serious.
Lisa: That’s good to know. It is an interesting truth is that a lot of back things will get better on their own.
Dr. Totta: A vast majority. Yes, it’s sort of an interesting concept that I’m based in a surgical practice, despite the fact that spine problems are predominantly a nonsurgical problem.
Genevieve: Aren’t people’s thresholds for pain different?
Dr. Totta: Oh, unquestionably. Every now and then a patient will stay in my office and say to me, exasperated, Doctor, it’s not all in my head is it? Of course, I look at them with a concerned look in my eye and say, “Oh course not.” In my brain I’m saying, yeah it is. Sure it is. Pain is a perception. Pain is something you feel in the upper most thought process of your brain. The most developed area of your brain. In essence it is all in your head. All pain is “psychological.” It’s influenced by psychological things. You know of course if I light your foot on fire, that’s real pain that’s caused by what we call a nociceptor or a neurological source.
What’s interesting is now it’s very clear that there’s pain that’s generated and the perception of pain that’s changed by neurological processing. Essentially things that are in your head and not so much in your body.
Lisa: I see this a lot in people who have had pain issues for a while that when they start to do things, when their lives start to sort themselves out and they sort of get busy doing something else and this is not everybody. Some people have real anatomic problems and real physiologic pain, but there are some people who have some low lying something and once they start to sort things out the pain kind of goes away. Do you see that?
Dr. Totta: Oh Lord yes. There are two really brilliant thinkers in my field. One is Dr. Waddell who medical students and you may know this yourself, he’s an orthopedist from Scotland. He developed some physical exam maneuvers as well as some historical information databases that show that there’s certain ways that people communicate what he calls psychological distress. I think that’s kind of what you’re dancing around in your comment. Psychological distress is essentially, it’s not that people are crazy. It’s defined as an acceptable way of communicating psychological unrest through physical symptoms.
Another word that we use is somatization, okay or mental issues creating physical manifestations. That is so real.
Genevieve: For example, if you really don’t like your job, all of a sudden you might, every time you sit down at your chair in front of your desk, feel back pain. Is that sort of what you’re, for the people listening out there, that might be what you’re saying?
Dr. Totta: Absolutely, absolutely. The second guy who’s a brilliant thinker is a guy by the name of John Sarno who’s a physical medicine doctor from NYU. I think he’s still alive. He must be in his mid 80’s. I’ve never met the man personally, but I’ve read several of his books. He is way out on the far end extreme of thinking about back pain and disability related to spine as being predominantly psychological. What Sarno believes is that some people; because, it’s not socially acceptable to go out on the street and then start ranting and raving, that people communicate their rage through physical problems.
Lisa: Well, Sarno brings up a good point that in the 50’s everybody had ulcers. You know stress was expressed as ulcers, but now in the 21st Century it seems to be back pain.
Genevieve: Ulcers have gone . . .
Dr. Totta: Taken a dive, yeah, yeah. It’s not; because, we’re drinking less coffee or whatever else you think is going on with ulcers, but yeah it’s an interesting phenomenon. The disease of the decade. The most prescribed drug in the United States right now is Vicodin, hydrocodone, which is a narcotic pain medicine. The most prescribed drug in the 1970’s when I was in high school was Valium. Okay, momma’s, was it a Beetles song or something. Momma’s little pill.
Lisa: Mother’s little helper, yeah.
Dr. Totta: Mother’s little helper, right, right.
Genevieve: Rolling Stones.
Dr. Totta: Well, it was, okay, sorry, yeah, yeah. Sorry, I’m not a rock historian. These are sort of reality manifestations of again the psychology. The genetics of human-beings have not appreciably changed since the 1970’s. It’s a cultural issue.
Genevieve: What are some of the nonsurgical, aside from getting a prescription for Vicodin; because, some of the treatment for back pain is sort of counter-intuitive. You’re in a lot of pain and you don’t want to move, but actually in our conversations moving seems to be the thing that helps.
Dr. Totta: Correct. When I went to medical school. It was just starting to change from the old culture of the 50’s and 60’s where if you had back pain, I mean literally just back pain, you could be admitted to the hospital and put in traction for a week. Those were the days before HMO’s and cost concerns. What they found was that didn’t really help people. There’s an awful lot of what’s done in spine that is artistic. Lisa will tell there’s something that doctors hide behind. I’m probably going to lose my medical card. I’ll be out of the fraternity for saying this. Doctors say oh, it’s part of the art of the practice of medicine.
All right, that sounds really good, doesn’t it. It’s like that’s a beautiful thing. You’re an artist, okay. What that really means is we don’t have scientific information to base what we’re doing this on, but we think it works. Let’s just do it that way. This is my art. This is my practice. Really medicine is supposed to be science. All right, there’s a big push these days for something called, I’m blanking on the word.
Dr. Lisa: Evidence-based medicine.
Dr. Totta: Yes, evidence based medicine is sort of the new catchphrase. Basically, what that implies is that you have a scientific basis for what you’re doing. What they did was they studied the concept of spine pain and activity. They found very clearly that when patients were more active, as a population, as a scientific study, not as individuals, okay but as a population. People were better off being active than sedentary when they had spine problems.
Lisa: Why do you think that is?
Dr. Totta: Well, on the same vein of evidence based medicine there are things that I know scientifically and there are things that I believe. When I give lectures, I actually have a slide of doctor, or not doctor, Guido Sarducci, you remember the priest on Saturday Night Live; because, half the things I say maybe half the things are science and the other half are religion. It’s what we believe. I think what you’re asking me what I believe, right. I don’t know this for sure, but my suspicion is that activity does two things. One is it improves blood flow to the spine, all right. The spine is a passive area of the body.
Disks and bones and joints can’t do anything by themselves, alright? They are victims in a drive by shooting to muscle function, tendon function and neurological coordination. I believe that activity number one improves blood flow and we know when there’s structural damage anywhere in the body. The body’s ability to heal is related to the blood flow. That’s why your skin heals really well but maybe ligaments and tendons don’t heal as well. Things that have very poor circulation in them like disks heal extremely slowly. That’s the issue. You want to get nutrition.
Secondly, I think that exercise does a little bit of what you talked about earlier as far as getting active. There’s all this neurological feedback that goes to our brains. This whole area that processes pain. When you’re active you get a completely different type of sort of sensory bombardment to that area. I think it actually inhibits pain. The same way when you hit your thumb with a hammer and you rub it. It inhibits pain.
Lisa: Perhaps there’s some sort of serotonergic, some sort of neuro-chemical, something that’s sort of bathing the neurons in a way.
Dr. Totta: Absolutely. Again, we visualize the brain as being some sort of magical thing. There’s magic going on and a friend of ours, actually from Yarmouth, Kent Pierce who is an author. I love the way that he looks at things he doesn’t understand and he just says, it’s magic. Okay, and yeah it’s probably magic in the brain, but it’s based in chemistry. It’s based in electricity. The concept of nerve signals. I’m becoming less of a believer in magic, but more of a believer in realizing I don’t understand it.
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Dr. Totta: A vast majority of spine pain could be explainable with science if we had the tools to measure what the variable is. I think a mentor of mine once said that evidence-based medicine and randomized control trials which is the fancy scientific name for good science studies on medical things, are easy to do if you want them to turn out negative. If you want to find out that nothing works. It’s really easy to prove that nothing works. What’s hard to prove is when things do work, but you don’t completely understand why. That becomes much more difficult; because, human-beings aren’t like a physics lab.
You can’t control all the variables and that’s the problem. You can say that I absolutely have to do everything based on science, but then you’re facing a patient in your office and you need to do something for that patient today.
Lisa: When a patient is in your office though complaining of pain regardless of the origin. You have to find ways to ease that pain. What is the protocol?
Dr. Totta: The first protocol, because I’m a medical doctor, I’m going to look for a medical or anatomic source of pain. Oftentimes when a patient gives you a history their problem is fairly evident just from what they’re telling you. Just from the experience of seeing thousands of people, you know when someone complains of a certain thing it’s more likely to be one thing or another. We first get a history. First get the information that helps to lead us. Then we’ll do a physical examination. Physical examination for spine problems is frequently overrated. There really aren’t a lot of things you can find that really mean very much, but there are certainly some things.
Numbness, weakness, movement problems, either; because, of pain or; because, of the physical blockage of movement. That’s all data that you can put together with their history. Then being in the modern era where we have x-rays and fancy stuff like MRIs you get imaging data. You can see inside people. You put those three things together to come up with a tentative diagnosis.
Lisa: Then once you have an anatomical problem, your solutions are far more towards therapy, activity, rest and activity as opposed to any kind of intervention, surgical intervention.
Dr. Totta: Most of the time the first thing that you do is you modify activity and by modify I don’t mean either turn it on or turn it off, but sometimes change it; because, again we believe, all right here’s the religious thing again, that there are certain types of activity that promote good spine health. There’s certain types of activity that may not. That can be an individual thing depending on what the problem is with the spine and what the predisposition is that someone has genetically. Their posture, their muscularity, etc. etc.
Lisa: It seems to me that one of the reasons, you may have come to this way of practicing medicine is perhaps from your background. You were training with the US National Rowing Team and you were selected for the 1983 Pan American Games team, so you have a very personal interest in the physical.
Dr. Totta: Oh I do, very much and I had back problems. In fact most rowers have back problems at one point or another, but I actually had to stop rowing right after I moved to Maine. Looking back on it now it may have had to do with the psychological distress of having two young children and a busy job, I don’t know, maybe. That’s what actually piqued my interest in spine problems; because, I looked for help for my spine problem and the help that was out there was essentially surgical and so you either needed surgery or you didn’t. In fact, I went down to Boston, this was in 1992 and saw the son of one of the most famous orthopedic spine doctors in history.
Basically, the guy who discovered disk herniations, which is an amazing thing. It was cool to meet the guy. He looked at my x-rays. At the time I was 34-years-old which I consider remarkably young now, where I’m sitting. He looked at my MRI and then he looked at me and this is frankly even before he said hello. It was also a lesson in etiquette for me. He said, “Well, if you were playing for the Boston Red Sox, your career would be just about over by now.” I’m looking at the guy going okay, this may not work out so well. He said, “Well, you know, what you really need to find is a physical therapist, good luck.”
He could give me no information. There was no communication between my relative ignorance and this need for extreme procedure like surgery. There’s this big void in the middle. That’s the void that I fill in my practice who people do what I do fill.
Lisa: You’ve talked about the need for physical activity when one has a back problem, but it sounds like your back problem might have come from excessive physical activity, is that true? Is there too much that goes on with this?
Dr. Totta: Yeah, and I wouldn’t probably use the term that too much activity caused my back problem. It’s sort of like if someone took a hammer and broke your leg, all right and then you stood up and walked, well that would hurt like hell. Every time you walked it hurt and you could go to someone and say doctor, every time I walk it hurts and the doctor would say, well walking caused your problem, but in fact it obviously did not. I think in general spine problems are not caused by activity. They’re aggravated by excessive activity or incorrect activity.
Genevieve: How do you take care of your own back now? Give us some tools.
Dr. Totta: Stretching, strengthening exercises, postural awareness and activity. There’s absolutely no question than when I spend time inactive, long car trips, a few days of traveling somewhere, where I’m kind of off my obsessive exercise routine. My back hurts more. Is that psychological distress from being out of my routine? Maybe, I don’t know. It’s a combination of things. It’s rare that someone can put their finger on a single thing that makes their back problem better, but ultimately you have to address, I believe most patients have to address their genetic predisposition to back problems.
Obviously you can’t change your genes, but what you can do is you can work very hard at modifying the things that put you at risk and that tends to be activity and exercise.
Lisa: How can people find out more about your practice and the Orthopedic Associates Spine Center?
Dr. Totta: Well, we’re on the Internet, orthoassociates.com. We have a fairly good referral relationship with most of the primary care physicians around town, so if you go through some of the basic measures that any good primary care physician will use to help your spine problem and things aren’t going well, you may end up referred to us. We’re happy to answer people’s questions if they contact us directly.
Lisa: Well, it’s been very interesting to speak with you today. We’ve been talking with Dr. Michael Totta who is the Medical Director of the OA Spine Center here in the Portland area. We appreciate your coming in.
Dr. Totta: Thank you very much.
Lisa: One of the ways in which I find ease in my life is to write on a fairly regular basis. It’s become part of my hopefulness. Part of my ability to be a physician and a parent and live in this world. I share my writing on the Bountiful Blog which is available on bountiful-blog.com. This week’s post is a uniquely personal one and one that does speak to the core message of gaining ease. It’s called Friends I Never Knew I Had and it is from January 28th, 2012. It is uniquely concerning to receive a text from one’s child describing potentially life threatening illness symptoms. Headache, stiff neck, fever, lethargy, vomiting. These are not a good constellation of descriptors, especially when one is a physician who has both treated and seen the aftermath of meningitis, the illness often associated with the constellation of the aforementioned descriptors.
Now, add in the fact that one’s child is roughly 2334 miles away in a third world Central American country and that one’s child is barely 18-years-old. As you might have guessed I received just such a text. The past 48 hours have been interesting to say the least. My child is currently in a Guatemalan hospital awaiting the final results of his spinal tap. Fortunately, preliminary results were negative for meningitis and he’s scheduled to be released today. The presumed diagnosis sinusitis is much less severe and more easily treatable than the one I had feared.
To know that my baby was far away and I was completely unable to help him certainly gave me pause. What also gave me pause was that both his roommate’s mother Jan and his roommate Nico contacted me via Facebook to give me updates on my son’s condition. Both offered up Nico’s contact phone number. Nico told me he was taking time off from work to make sure that my son was okay. Keep in mind that I’ve never met Jan, and spent only brief moments of time with Nico during my visit to Guatemala last Thanksgiving. But these kinds souls become in my moments of parental concern the friends I needed.
They were friends I didn’t realize I had. We should all be so fortunate as to be loved by those who owe us nothing. Our lives even when seemingly threatened often reveal themselves to be surprisingly powerfully blessed. Read this post and others like it at bountiful-blog.com.
Speaker 1: This segment of the Dr. Lisa Radio Hour and Podcast is brought to you by the following generous sponsors. Mike LePage and Beth Franklin of Remax Heritage in Yarmouth, Maine. Honesty and integrity can take you home. With Remax Heritage it’s your move. Learn more at ourheritage.com and by Tom Shepard of Shepard Financial with offices in Yarmouth, Maine, the Shepard financial team is there to help you evolve with your money. For more information on Shepard Financials refreshing perspective on investing, please e-mail [email protected].
Lisa: We’re going from one means of gaining ease to another. We spoke with Dr. Michael Totta of the Orthopedic Associates Spine Center and now we’re heading into our Maine Magazine Minutes with Genevieve Morgan and she will be speaking to a very different sort of healer. Genevieve.
Genevieve: Thanks, Lisa. In the studio today we have Bob Lynch who is a second generation chiropractor, who’s been in practice in South Portland, Maine since 1976 when he joined his father in practice. His practice has been a full service chiropractic office and he tries to live the philosophy of his profession which is the body has the unique wisdom to heal itself if given the opportunity, which is very much what Dr. Totta was talking about. Welcome, Dr. Lynch.
Dr. Lynch: Thank you.
Genevieve: Who needs to seek out chiropractic care?
Dr. Lynch: I would think anybody with a spine.
Genevieve: Or vertebrae.
Dr. Lynch: The philosophy of chiropractic is that your structure affects your function and that if your structure isn’t in proper balance then you’re going to have some functional disorders that can manifest themselves.
Genevieve: Dr. Lynch, give me a little background on chiropractic medicine.
Dr. Lynch: Well the practice of chiropractic is a little over hundred years old. What we do, manipulations has been done for generations in Europe and Egypt. The whole concept and philosophy of chiropractic where you treat the body without drugs and surgery if possible is really, we’re the first green medicine. If you use green as being environmental. It’s a very clean way of treating the body.
Genevieve: Now you’ve been doing this for 34 years?
Dr. Lynch: Yes.
Genevieve: You’ve seen a lot of spines.
Dr. Lynch: A lot of spines. I think, we were trying to figure it out, we’re somewhere close to 20,000 different patients.
Genevieve: Have you been able to mark significant pain relief in your patients?
Dr. Lynch: A long time ago I had a patient come in and he goes to me, this is the first time I’ve ever left a doctor’s office feeling better. Usually you’ve got to go home. You got to run to the pharmacy, go home, take the pill, wait for it to work. Being a son of a chiropractor I virtually haven’t had any medication. I think I’ve had one or two prescriptions in my life, it was usually for a toothache.
Genevieve: That’s interesting, explain that. Chiropractors don’t use medication to treat their patients.
Dr. Lynch: We’re not licensed to. If somebody needs medication then we refer them to the appropriate provider. There’s enough people that can prescribe the appropriate drugs. We will prescribe nutritional supplements, diet, exercise, things that they can do naturally to enhance their health care condition.
Genevieve: Is there a psychological link do you think between pain and its ultimate manifestation?
Dr. Lynch: Absolutely. You can’t separate the mind from the body.
Genevieve: Tell me what that has looked like in your practice.
Dr. Lynch: A couple weeks ago a woman comes in, very, very upset. She’s got all this pain in her right upper back. Just seeing her, she wasn’t breathing, very, very shallow breathing. I evaluated her. I gave her a chiropractic adjustment, then we treated her. She felt better and then I asked a question. All right, what’s really going on? Okay, so something else was going on that manifested it. You may seem this to sound funny, but I actually tried to teach her how to breathe. How to do diaphragmatic breathing, so that she’s deep breathing. You’ve got be in balance. Your heads got to be solid emotionally. When you really break it down, we’re just energy. If you’re energy is off then it can lead to disease.
Lisa: That doesn’t seem funny to me at all. In my practice I teach all of my patients how to breathe, so I stick needles in them. Then I almost force them to learn how to breathe. You and I are definitely on the same page on this one and the energy piece.
Speaker 1: We’ll return to our interview after acknowledging the following generous sponsors. Pierce Atwood, part of the Portland legal community for 120 years. Clients turn to Pierce Atwood for help with important deals and critical disputes. For creative solutions and sound advice about legal or business or strategy, for peace of mind. For more information on Pierce Atwood go to www.pierceatwood.com and by Dr. John Herzog of Orthopedic Specialists in Falmouth, Maine. Makers of Dr. John’s granola cereal. Find them on the web at orthopedicspecialistsme.com.
Dr. Lynch: It’s interesting so many people could use the services that we provide, but they don’t know it.
Genevieve: You don’t have to be in pain to come. There’s a preventative aspect to what you do as well.
Dr. Lynch: I think that’s the biggest benefit to chiropractic; because, if we can take, well an example, my friend down in Miami. He works for the University of Miami Hurricane football team. The team finally has gotten it after all these years that we want the kids to be treated first so they can avoid the injuries and not just wait until they get hurt and get care. The profession and what we do has a huge potential for people.
Genevieve: How do people get in touch with you?
Dr. Lynch: They can call us by phone. We have a website.
Genevieve: What’s the phone number?
Dr. Lynch: 799-2263. Website is drlynch.com. E-mail is really simple it’s [email protected].
Lisa: Well that sounds great and I think that all of us listening to you can see by your example that chiropractic can help live a little less painful life and can gain ease.
Genevieve: Yes, thanks so much for coming in.
Dr. Lynch: My pleasure.
Lisa: Dr. Lynch is one of many practitioners in our state that deals with energy and healing energy. In the October 2011, issue of Maine Magazine, I wrote a column called good vibrations that talks about the philosophy behind energy medicine. To subscribe to Maine Magazine go to the mainemag.com or pick up an issue at a local news stand near you.
Speaker 1: Our bodies are often the first indicators that something isn’t quite working. Are you having difficulty sleeping, anxiety or chronic pain issues? Maybe you’ve had a job loss, divorce or recent empty nest. Dr. Lisa specializes in helping people through times of change and inspiring individuals to create joyful, sustainable lives. Visit doctorlisa.org for more information on her Yarmouth, Maine medical practice and schedule your office visit or phone consult today.
Lisa: As part of our gaining ease show we thought we would bring in an individual who has something to do with gaining ease in a slightly unique way. Earlier on in the Dr. Lisa Radio Hour and Podcast we interviewed Mark Swan from Preble Street and today we’re bringing in Chris Bicknell who is from the Light House and Teen Center at Preble Street. Nice to see you Chris.
Chris: Hi.
Lisa: This is of course a part of Preble Street itself.
Chris: Absolutely, yeah. It’s a teen services combined together.
Lisa: One of the reasons we were interested in bringing you back in is; because, we talked about gaining ease with our other guests as being you have a pain in your body. You need to deal with the pain so that you can live your life. But even if you don’t have a pain in your body you might have a pain in your life.
Chris: Absolutely.
Lisa: What types of things do you see with these teens that are coming in? What types of pain in their lives are they experiencing?
Chris: We see a whole range of different things that youth are coming to us with. Mostly we see young people who have been struggling with a bunch of different things throughout their lives. It’s never usually just one thing. We see a lot of hunger, a lot of poverty. We see kids who are struggling. They’ve been in foster care placements and residential placements, hospitalizations, those kinds of things. There’s either mental health issues for themselves or mental health issues in their family. There’s possibly some criminal involvement. Lots of different things that can happen with young people who are living in unstable situations.
Unfortunately, there’s trauma throughout the population that we work with, whether that’s physical trauma, emotional trauma or sexual trauma. We see a lot of that. Our goal is to create safety for young people who have not felt safe in their lives either in their homes or in the community. Try and give them the opportunity to make some different choices and changes in their lives so that they can move forward as opposed to being where they’re at and struggling continuously.
Lisa: What are the services that the Light House Shelter provides?
Chris: The Light House Shelter and the Teen Center together provide a whole group of services that are aimed at creating safety for youth and getting them off the street and finding permanency in their lives. The Light House Shelter is open from 8:00 p.m. to 8:00 a.m. It is a safe place for youth ages 12-20 to sleep at night. If somebody shows up in the middle of the night and they’re hungry, there’s food there for them. It’s a warm, welcoming environment that’s designed to help young people who really have nothing else in their lives and no place to go to be safe.
Then during the day the Teen Center is open from noon to 8:00 p.m. and that provides two hot meals a day, lunch and dinner. We really think that food is a way to connect to people. In my life and in everybody’s life that I know, when you sit down at a meal you talk, you share, you get connected. When youth come into our programs, we eat with them. We talk about what’s going on in their lives and they share with us. We don’t ask them, do you need this? Do you need that? What do you want? We let them tell us; because, most of the time we’re working with youth who have been told what to do by people, by adults, by programs and by systems.
As soon as me as an authority figure comes in and says you need to do this, their initial reaction is no, I don’t need to do anything. I can walk out of here and we’ll say yeah, you can. Tell us what you need and then we’ll provide that. All the other services are relationally based and kids refer themselves to that. After food, we have all the basic needs are met. Shelter, clothing, kids can take showers, do their laundry, use our phones. They can use us as a mailing address. They can also from there access other services, mental health counseling, substance abuse counseling.
We do a lot of work around housing and finding places other than the shelter for kids to live. We have educational services available through adult education so kids can either work on their GED, get referred back to school if that’s an option for them, or if they only have one or two credits to finish to get a diploma, they can do that right on our site. We have an employment training program where kids can do a four week classroom component. Kind of learn what are employability skills. What are the expectations of employers? How do you talk to people at work? Those kinds of things.
Then we’ll place a youth in a job site and we’ll pay a stipend to them so that the employer really knows it’s a training opportunity and we can provide some staffing to support that kid through kind of the struggles of their first job. We also have nursing onsite five days a week so kids can get their medical needs met and get a referral to a primary care physician if that’s possible. We have psychiatry services that are offered once a week so if youth who are on the street need medication or medication management we can do that. There’s a lot available right on site that we do.
Lisa: You alluded to the fact that you had a difficult growing up in your own life, do you believe this has made you more resilient as an adult?
Chris: I do, yeah, absolutely. I was faced with challenges that I either had to find my way past or suffer with and I chose to find my way past them. I didn’t have a place like the Teen Center to do that so I had to utilize my own internal kind of workings to make that happen as opposed to having someone offer it to me. One of the reasons I continue to do this work is because, I see young people are struggling the way that I did and I want to be able to say, you know what, you don’t have to do it alone. There are resources there. People who care. You can make it out in the world.
Lisa: You have a capital campaign?
Chris: Yes.
Lisa: What is your goal with that?
Chris: Well, our capital campaign, currently the Light House Shelter is a 16 bed program. It’s in an old rundown building that was not designed to be a shelter and so we are purchasing and renovating a building to be specifically designed as a youth shelter with the youth in mind and to increase the capacity. Right now two out of three nights a week we’re turning away young people from our shelter that should be sleeping in our shelter. They either have to go the adult shelter, sleep out on the street somewhere or sell their body for a bed that night. That’s just untenable to us.
We’re going to expand the capacity from 16 to 24. We’re going to design a program that really meets youth needs as opposed to kind of fitting it into an old structure; because, environment says a lot about how you’re cared for. The capital campaign is to raise the money to renovate that building.
Genevieve: Where can people go to donate?
Chris: They can go to preblestreet.org. There’s a button right on the web page or they can call 775-0026.
Lisa: Do you also have need for volunteers?
Chris: Yes, we always have need for volunteers. That’s also on the website. You can fill out an on-line application for volunteers. In the range of volunteer things that we need are really broad. There’s a lot that’s available to do.
Lisa: Thank you for helping the youth of the Portland area gain ease. We appreciate you coming in and talking to us today, Chris Bicknell.
Chris: Thanks, your welcome. I’m happy to do it.
Lisa: Thank you for joining us on our gaining ease show where we discussed this topic Dr. Michael Totta of the Spine Center at Orthopedic Associates, Dr. Bob Lynch of Lynch Chiropractic Arts Center and Chris Bicknell of the Teen Center and Life House Shelter at Preble Street. It was interesting to have conversations with two individuals who spend quite a bit of time working on the spine and gaining ease as far as back pain is concerned and then to sort of marry it with the conversation of gaining ease in a different way. Bringing food and shelter and security to a group of individuals who are often forgotten, the teens of the city.
As we said at the beginning of the show our hope is always to provide hope to enable people to be inspired to live their lives in a way that not only helps them gain ease, but to continue to live in a way that is more than just full of ease. It is also full of joy. We hope you’ve enjoyed the show. We encourage you to join us for next week’s show called Creature Comfort which will be airing on February 26th, 2012. For this show and all other past shows you may go to doctorlisa, d-o-c-t-o-rlisa.org and listen to the MP3. Subscribe to the podcast through iTunes. Get regular updates through our Dr. Lisa Facebook page, or contact our office through our website and receive our regular newsletter.
This is Dr. Lisa Belisle. Thank you for being a part of our world. May you have a bountiful life.
Speaker 1: The Dr. Lisa Radio Hour and Podcast is made possible with the support of the following generous sponsors. Maine Magazine, Mike LePage and Beth Franklin at Remax Heritage, Robin Hodgskin at Morgan Stanley, Smith Barney, Dr. John Herzog of Orthopedic Specialists in Falmouth, Maine, Tom Shepard of Shepard Financial, Pierce Atwood, Booth, UNE, the University of New England and Akari. The Dr. Lisa Radio and Podcast is recorded in downtown Portland at the offices of Maine Magazine on 75 Market Street. It is produced by Kevin Thomas and Dr. Lisa Belisle.
Editorial content produced by Chris Kast and Genevieve Morgan. Audio production and original music by John C. McCain. Our assistant producer is Jane Pate. For more information on our hosts, production team, Maine Magazine or any of the guests featured here today, visit us at doctorlisa.org. Tune in every Sunday at 11:00 a.m. for the Dr. Lisa Radio Hour on WLOB Portland, Maine, 1310 AM or streaming wlobradio.com. Podcasts are available at doctorlisa.org.