The Coming Epidemic: Manifestations of Prenatal Stress – Monika Buerger

Click here to download the transcript.

Now here’s, today’s host

Dr. Monica Berger.

Hello everybody out there in Cairo Facebook land. And to those of you that are not chiropractors. Welcome to look to the children’s show. And again, thank you Kira secure for giving us this platform to get our message out and to keep educating the amazing chiropractic profession I wanted to bring to you today. Something that’s very near and dear to my heart and is so incredibly critical that we as professionals in the chiropractic around really need to understand this material. Whether you look at work with families and children at not, this is, um, information that we are going to be needed to be mindful of from here on out, given the paradigm that we are practicing in now and what is going on in the world and the COVID epidemic or pandemic the consequences of what we’re experiencing. Now, in addition to how the world was before this pandemic, the two combined are, um, essentially leading us up to what I’m referring to as a next epidemic.

And what I’m talking about is not a specific disease or diagnosis or label. It is the effects of prenatal stress. So again, whether you work with preconception care, prenatal care, um, pediatrics, if you work with anybody, this information, um, is a must know, and it’s extremely, extremely profound. So what I’m going to try to do is take you, um, set up a PowerPoint. You can see my slides. I’m going to take you kind of through a mini course, um, from prenatal stress and what that’s going to look like down the road or what that does look like down the road. This is information that is bast. It’s profound from the new world of neuroscience. I’m not making this up. I’m not overstating it. I’m not overexaggerating it. And if we look at, in the depths of neuroscience, this is this information that I’m going to talk to you about today is the foundation.

It is the basis for the neurobiology of disease. I want you to sit with this, the basis of the neurobiology of disease, physical disease, and especially mental disease, mental illnesses. So let’s dig in a little bit again, please, please pass this information on to all of our colleagues. This is such profound information that is, is going to set the foundation for generations to come. No joke here. So this paper came out a few weeks ago in regards to prenatal stress. And it specifically how moms are proceeding stress in this particular time look pretty much probably 99.9% of the global population is experiencing some kind of added stress due to the situation we’re in stress. Anxiety, anxiety has gone drastically up during this time. What does this mean for the pregnant mom? And what does this mean for the offspring? It’s huge pregnant moms right now.

This came out of, I believe Alberta, Canada, but what they showed is pregnant moms. Um, the prenatal period and the early weeks postnatally that they’re pre COVID stress levels would be reported about 15% in the current paradigm, their depression in regards to depression solely Precoa time, 15% current paradigm about 41% depression anxiety. Their prenatal reporting of anxiety is about 29%. And in the current paradigm is about 71%. These are the vast jumps in pre and pregnant mamas experience, depression and anxiety. Okay. They also looked at, which was very interesting is, um, exercise rates. Okay. Um, prenatal activity rates and about 65% of pregnant women report that their exercise levels has gone down during the COVID period. About 15% of said up at about 21% say it’s been staying stagnant. Okay. What does this mean? Why is it a big deal? Again, this information is hands down where, how we’re going to see generations to come.

The program that the premium programming that’s happening now in utero is bast and profound. We know from the neuroscience literature, that when a mom is stressed, the enzyme, the gene that works too as a barrier protective barrier to the fetus, keeping cortisol out of not being able to pass the placental barrier, that enzyme it’s called, um, hydroxy steroid dehydrogenase too. Don’t worry about the name of it. Bottom line is that enzyme is protective to the fetus and it doesn’t allow more than 15 to 20% of cortisol should not pass up the central barrier. More than that passes a placental barrier, a dynamic cascade of neurophysiological consequences. Cause that fetus is exposed to more cortisol, which is neurotoxic. This is very much associated with preterm birth and low birth weight with which those two factors in the world of neuroscience has been shown to be key in the neurobiology of disease, lifelong disease of offspring, especially mental health and a lot of cardiovascular. Okay. So we need to minimize the stress. Bottom line is we needed to minimize the stress on those mamas.

Um, low protein levels also, um, will inhibit that enzyme. The enzyme needs good proteins to work, um, and, uh, B3, niacin my moral, my story for this lecture or for this presentation, I wanted you to understand that wow, stress is altering fetal development. And one is by cortisol, excess cortisol exposure. That is very neurotoxic. So we need to have these mamas under care to help regulate that stress of which we’ll talk about when we finished it at the end of this little presentation, but I want you to understand that prenatal insults maternal stress is one of the biggest ones, psychosocial stress, psychosocial stress is stressors. We all have, especially these days, right? Worried about your job, paying the bills and going out in public. Just those dynamics that pregnant mamas have extra psychosocial stressors that they report that is the fear of giving birth. The concern about being birthed that is magnified in this particular crisis.

We’re under, are they going to be allowed to have a birth partner in the room or not? They’re having to mask the whole time in why they’re in the hospital. Are they going to be separated from the baby? All these extra things. The number one psychosocial stressors that, um, pregnant mamas report is, or pregnant couples report is giving birth to an offspring with, um, developmental challenges. So they have these extra stressors happening. All right, we know that these premial stressors are leading to, to circuit, uh, developmental circuit changes in the brain, prefrontal cortex, amid Dilla, hippocampus, incredibly profound connections, especially between the limbic system and the frontal lobe, which we know from neuroscience, that connection or that misfire, that misconnection between the limbic system and the prefrontal lobe is the basis of mental illness. Okay. This is from the medical literature. And of course, then we’ll get the labels as a result of this at this prenatal stress.

Now we get the labels down the road, add ADHD, autism, et cetera. So it’s really kind of works like this. We use it, it used to be referred to as a two hit model. Now they’re looking at it as a three hit model. We have genetic factors, which actually are epigenetic factors. Okay? So we have these epigenetic loads that are vast right now hit number two is prenatal stressors, psychosocial stressors, depression, anxiety, everything that is up ramped right now with, I mean, globally, the third head is a subsequent hit that can happen up to 20 years later that finally tips the scales. And this is really the basis of most mental illnesses and individuals in mental institutions. And whether it’s a viral load that is especially if, if mama right now has had, COVID why she’s pregnant. That is a viral load that’s that fetus is exposed to.

So we have stress. It leads to enhanced cortisol, passing the placental barrier neurotoxic insult on the developing fetus and the developing nervous system, other genetic predispositions. And now down the road, another key hit can happen. It can be anything, it can be viral, come back bacterial. It can be from inoculations. It can be a poor bonding with mom and dad, whatever. So we know that prenatal stress also alters the microbiome. The mom, I’m just going to brief over this, but this is incredibly incredibly important for us to understand for supportive measures from mama during pregnancy. So a couple of key strains of bacteria have been known to be altered or, or, um, deficient in pregnant mamas under stress. And these particular strains are also coincide with supportive measures, four key areas, the brain like the Olympic system and the frontal lobe. So more of the story is stress wipes out the microbiome wipes out, excuse me, these critical bacteria, which all can alter function of these key areas of the brain.

Okay. Lactobacillus, rhamnosus, and material to those strains abberant um, or, um, deficient microbiome of mom leads to a deficient microbiome of the vaginal microbiome. So next moral the store on next golden Pearl, it doesn’t matter. A lot of people are concerned about, um, seeding of the microbiome or giving probiotics. If a baby is born via a Syrian section, because they say, well, baby, didn’t get a exposure to mom’s bathroom, microbiome. Hello, newsflash. If Michael biome of mom is poor vaginal microbiome, mom is going to be poor, whether they were born vaginally or not, they could still have a dysbiotic offering. The baby can not have a optimal microbiome, even if they’re born vaginally. So we may still need to help support that after birth, because we know a dysbiotic a, a, a non-sufficient microbiome, well also alter, um, an absorption of key nutrients. And these key nutrients are going to be imperative for metabolic function for metabolic demands on the developing brain.

So stress equals altered. Maybe pre stress is very much related to preterm birth and low birth weight altered microbiome of mom altered vaginal biome of mom altered microbiome, but baby lack of absorption of key nutrients needed for metabolic development, metabolic support of the developing brain key structures of the brain. So we have stress or infectious load. It earned again, it, it alters the maternal microbiome. It alters the microbiome, the baby. It is shown in neuroscience that this will change the trajectory of neurodevelopment of the baby. However, early intervention measures chiropractic care. For sure, especially during the prenatal period, trying to deescalate the stress load on that pregnant mom, deescalation of stress on mama is deescalation of stress on the fetus equals a more optimal chance of neurodevelopment.

When we look at fetal development, we have to look at autonomic nervous system development and bagel tone development, which that critical window of neuro-development is in the end, the second, and into the entire third trimester of birth, absolutely even more critical weeks, 35 on what we’re seeing in this COVID world is an increase of C-sections. Whether that’s because of stress or not, um, an increase around 37 weeks, this is a critical, critical message because we also know that the microbiome of baby, um, if deliberate, if, if born before 37 weeks, um, has a higher chance of what we call this necrotizing enterocolitis, okay. Inflammation in the gut, which is going to be another, um, another factor in their neurodevelopmental trajectory. This is bagel tone. Um, so prenatal stress lowers, heart rate variability and mom and baby mom and baby, which this equals abberant, um, development of the ans autonomic nervous system and bagel tone decreases the function of a culinary trick anti-inflammatory pathway. That is Vegas that’s bagels, baby, that’s his pathway call energetic anti-inflammatory call energetic anti-inflammatory pathway. This is the big kahuna to downregulate inflammation and upregulate the immune system.

When this is down-regulated this thing called zonulin, that that functions it, uh, it controls the, the tight junctions in the gut. Not allowing them to say open and end up with a leaky gut or gut permeability. So you see the, see the picture I’m painting right now. This is incredibly important to understand, because this is the basis of neurodevelopment. We also know that heart rate, variability, vehicle tone, and mom, the baby’s going to mimic the big tone of the mom. Baby is going to be born. It’s called fetal programming with mom’s stress response. The way mom is perceiving her environment, perceiving her stress and adapting, neurally, adapting. We all talk in our, in the chiropractic profession about neural adaptation. The nervous system has to adapt to our stressors the way that mom is perceiving her stress, her environment, and the way she’s responding to it will be Feedly programmed that fetus and that offspring will adopt her stress reactions and her stress patterns. And that will alter their vehicle tone, their heart rate variability and their ability to distress it, to adapt, to stress their ability, to calm their ability to digest their ability to be an eLearning Grossberg. So we also know that prenatal stress is, um, very much so tied to a neuromuscular development.

So it is tied to, um, sensory modulation, how they perceive their world through the 10 sensory systems, sight smell, sound, touch taste from the outside world and our inner interoceptive inner sensations, which are the Stabler proprioceptive, um, sensations coming from the viscera from the immune system, the immune cells and from the microbiome. So all of these can be dysregulated average, sensory modulation or input to the CNS is going to lead to Averitt, neuromuscular output pre and neuromuscular output. Motor output will then alter sensory input. It’s a loop, but we also see that prenatal stress is very much associated with neuromuscular tone and neuromuscular development in the offspring neural muscle motor tone, motor motor control core pastoral control is associated with things like asthma allergies, dyslexia, ADHD, scoliosis.

So what happens prenatally and how that fetus is preprogrammed by mom’s stress response, and mind you that study. I decided that we just got in regards to the COVID crisis, a vast increase in reported depression and anxiety in pregnant mamas. They also reported lower exercise about 65% reported decrease in their exercise regime. We also know from neuroscience literature, that prenatal exercise during the prenatal period enhances a vagal tone in the offspring. So if you look at the entire picture, that dynamic what’s happening right now, we must be mindful. We must be knowledgeable. We must be educated at a little higher level because what we’re going to see downstream, it may be two years in these offspring. It may be in six months, it may be in their twenties. It may be when they start to go to school and they get slapped with the label of ADHD. Cause they can’t sit still because they have poor postural tone. We must understand that what we lay the foundation of as now is going to have a profound effect on generations to come. And we got, we need to be able to acknowledge it to, to be recognized these red flags in practice.

We, we look at. So if you have an older child coming in, you need, you should look at the history. When were they born? What time period, what was the prenatal stress exposure, but also be mindful that if you’re seeing pregnant women, right during this time period, neuroscience research also shows that even if, when, when these stressors have been resolved, they’ve done a lot of work looking at, um, disasters and, and the, the am longterm effects on offspring during Nat, during when moms are experiencing national disaster, like, um, earthquakes, like even the Holocaust, like, um, one big one is called project ice storm. It was regarding an ice storm up at Canada. And the stress that prenatal stress on mom was then, um, nine 11, all these hallmark disasters, floods. They looked at the implications on the ops spring, and they all show a, uh, uh, post traumatic stress disorder, response, higher anxiety, higher depression levels, um, cardio increased risk of cardiovascular disease.

Even if the mom conceived two years after that disaster had dissipated. So my message to you is we need to be mindful of the potential that we’re going to see down the road, preterm natal, prenatal stress, higher risk of preterm births, um, or assisted bursts higher. I’m getting pinged on social media all the time about, um, increased risk of breach presentations. That’s going to happen. Breach presentations, um, are, can be, there’s a tie between thyroid dysfunction and the mom and a breech presentation. When mom is under all the stress and the adrenals are compromised. It’s going to compromise the thyroid. You can’t stabilize a thyroid unless you stabilize adrenal function. So it stands to reason we’re going to see more of these breech presentations. Plus mom is much more physiologically, stressed out, much more tense. Um, so we may see more assisted birth, more [inaudible] section, which we’re tending to see on babies being delivered during this Cub of time.

Um, more assisted deliveries. Maybe I have not that statistic yet in regards to, um, section of forceps, but these all play a huge role in the trajectory of neural development down the road. We’re going to see more. We’re ready. We ready before this cupboard crisis have seen a vast increase in babies presenting with more agitation, colic difficulty with feeding difficulties sleeping. This is the pattern you’re going to start seeing more and more of. Then we lead because their, their nervous system is so tapped out and their immune system is compromised. They can’t nearly adapt increased in infectious load, higher risk of chance of antibiotics early in life. One dose of antibiotics wipes up the microbiome for life. It alters the microbiome for life. It can never reestablish back to its original microbiome. After one dose of antibiotics, we may see hyper or hypo more chances of hypo muscle tone because of the neural muscular, um, mal adaptive development, more developmental motor delays, um, or development delays in general.

And this is going to up even more. So our rates of labels of autism add ADHD, oppositional defiant disorder, developmental coordination disorder, whatever label you want to put forth. So my message to you is early intervention chiropractic care is going to be incredibly important for pregnant mom and that baby. But remember, they’re going to be born into this world are ready with difficulty in neuro adaptation. Less is more for these little fiddle farts children that are born and they’re stressed and they’re colicky and they’re hard to console and so forth. It’s harder to bond. And that, that leads to a less maturation of the social engagement portion of the Vegas. Another story for another time, the microbiome, I understand that many of you may not be comfortable or may not wish to venture in supporting the microbiome, but I can tell you that this is absolutely a critical key, important point that you need to understand.

And if you don’t feel comfortable, maybe reach out to a colleague that feels comfortable helping support that microbiome. The adjustment’s going to do that, but in this day and age, we need to look bigger and deeper. I know we need to understand how to foster optimal sensory motor development, get yourself in a program, take classes, but we need to be able to recognize these red flags because the sooner we can intervene, the better the chances for that little fiddle fart, longterm. And again, I thank you. You know, when we should start thinking about how we’re going to articulate our message, going forward from a pain based, you know, to a brain based model. And hopefully this information helps give you some, some nuggets to think about and to investigate and to further study and learn and understand because we are going to need this information and we’re going to need to get this out to the world because this crisis has changed generations to come that have not even been born yet.

Um, so I’ll leave you with sit with that. Um, here is there’s. I have many classes that you can go to and I have one and one coming soon just on the effects of prenatal stress and what we need to think about. So I’m going to close with that, with that said again, thank you Kira secure for being an amazing vehicle for us to get this information out and more than ever, we are needed, um, to guide the world and help in truth and knowledge and education of how we can change the trajectory for generations to come. Um, I will see you next month with an incredible surprise, amazing guests, um, and you can be with dr. Eric Kowalski the first Thursday of August until then keeping amazing and keep being out there and changing lives.

Empowering Women in Chiropractic – Unmasking Social Engagement in Children – Dr. Monika Buerger

Click here to download the transcript.

Now here’s today’s host, Dr. Monika Buerger.

Hello, everybody, and welcome to ChiroSecure’s Look to the Children Show. I am your host for today, Dr. Monika Buerger. And once again I want to thank ChiroSecure for giving the chiropractic profession this amazing platform to help educate and inform all of you amazing chiropractors. So today, I want to touch on a very concerning topic that I’m getting a lot of text messages, emails, pings on Facebook, what do we need to think of in regards to our little fiddle farts returning back to school in the Fall? So I want to broach a couple of key topics here and concerns that we have over the COVID classroom. So I put together a few slides. We’re going to kind of go over those and let’s dig in and talk about some of those concerns that we are well aware of but maybe our patients, our parents, and our principals and powers to be aren’t so knowledgeable about.

So here we go. Concerns over the COVID classroom. Let’s think about this. First of all, I really want you to understand the neurological basis that we are finding ourselves in and our children in. Where is that coming from? What does that manifest? What does it look like? The world, for a large part, is in what I call a frontal lobe flip. Frontal lobe is our executive functioning part of our brain. It’s our reasoning part of our brain. It’s our rational part of our brain. It allows us to have impulse control. It is what makes us human. It is going to have regulation over our emotions. So hold onto that as we go through these slides. And it’s going to be our source of consciousness. So when we don’t have control over our executive functioning part of our brain, we can’t be reasonable, rational, impulse control, our memory, our social engagement system, our ability to initiate tasks and sustain tasks, stay on task in classroom. And how do we get there? How do we get plugged in or stuck in that fearmonger, that amygdala? It’s in situations that we know are unpredictable.

Most of us have lived the last three months plus or so in unpredictable circumstances, and that just doesn’t mean us adults, that means our little fiddle farts as well. Their schooling in the Spring was abruptly halted. They couldn’t predict that. They were transitioned to a homeschool format. Things that they were not used to. They weren’t able to see their friends or family members, and life became a very big upheaval. The next factor, there’s three factors that kind of drive us into this amygdala, is uncontrollable situations. Again, especially for the little fiddle farts, their life has been one uncontrollable ball of mass. They were pulled from school. They can’t see their friends, their family members, do the activities they were used to doing, from baseball to dance to whatever. And they had no control over it.

And the third thing is when something becomes sustainable. So we’ve pretty much been living there in that three complex dynamic, and this drives us into that fearmonger, into living into our emotional center, their limbic system, the amygdala, and it flips off our frontal lobe. So, thus, we’re all walking around in a very temperamental, a low threshold, flip mode. And you’ll notice that with your patients that come in, you just look at them wrong or say the wrong word, or maybe not your patients but their family members and society as a whole. So this leads us into anxiety, stress, worry, fear. We cannot be in a rest and digest growth and development learning phase if we’re stuck in our fearmonger. So this is going to be very applicable to our kiddos when they return to school in the Fall.

All right. Now, one thing I’d like to get you all thinking about is this is a very temperamental issue right now. I’m working with a lot of teachers and school districts in my particular area and doing some education on this. And I am first handedly seeing the two sides of the coin, because one side is going to be in frontal lobe flip, they have been driven into a very fear based mode in regards to, “Oh my gosh. If we get this virus, we’re all going to die.” So they are stuck in that fear based mode. And then you have the other side that may be very passionate and emotional about not wearing masks, being okay with allowing their body to be healthy. So you’re getting these two opposing sides of the coin. So my message to you is, what I have found is when you walk into a room or a conversation in regards to masks or no mask, in particular, today, I’m going to really just go over to the proposals that have been set forth by the CDC for starting school in the Fall.

And that is wearing masks and inhibiting things like recess, like lunch. They’re proposing eat lunch in the classroom. So that’s going to be lack of movement. So those are the only two things I’m going to have time to cover today. But, again, you’re going to see these opposing sides to the coin, and you might have an emotional stance towards one side or the other, which is fine, but understand, when you go into a conversation, the other person may be on the other end of you. So if you’re going in there to fight fire with fire, if you’re going to run into, if your office building is burning down, it’s on fire, are you going to go in there carrying a torch to try to put that fire out? It’s not going to put that fire out. So be mindful of that emotional tie to this very sensitive topic.

And I want to give you some strategies of conversation to build, and it just may be dropping some pearls of information to temper that fire down in the opposing person, the opposing party, and just get them thinking about some things. And for yourself, before you go into a conversation of this, it would very behoove you to get your vagal tone in balance, do some deep breathing, calm down, get out of your amygdala, get your prefrontal cortex online, get adjusted, because we know that, that helps to regulate somatic sensory information to the prefrontal cortex, bringing your prefrontal cortex online, getting you out of your amygdala. And go in there with a strategy of serving and giving information rather than trying to get them, sway them, your way. It’s like going into a relationship where you think you can get that person you’re going into a relationship to change. Don’t go in with that mindset. That’s what I found is not helpful. So let’s think about this. Let’s regard form of masks.

We have the issue of hypoxia. One of the things you may be confronted with is that studies supposedly show that they’re safe hypoxia isn’t necessarily an issue unless the levels of CO2 get too high, and that is very hard to happen. That’s one view you may get to see. Now, we’ve got to take this into context of the little fiddle farts’ body weight. When we are stuck in that amygdala drive, which we’re going to talk about the social ramifications of wearing a mask, the social engagement and the emotional ramifications, we’re going to be stuck in that limbic lock and load mode so we may get some more excessive breathing, more excessive CO2, so forth. So you can simply ask these individuals that you may be conversing with, have you gone a whole day about your normal workload doing your normal workload wearing a mask and how did you feel?

Did you have less energy? Did you maybe get a headache? Were you grouchier? And get them to understand how they felt and take that to a higher degree with the little fiddle farts. And there are some, not a lot, but there are a few good studies out there looking at healthcare workers and the events of hypoxia and that the majority do report shortness of breath, headache, fatigue, inability to concentrate. I am working on a document right now for my Intersect For Life tribe and I’m going to try to make that available once it’s done and available to everybody to use that to maybe present to schools and principals and so forth. So what I would recommend is you follow our Intersect For Life Educational Seminars, Intersect For Life Educational Seminars Facebook page, because that will most likely be where you’ll be able to download this document. And I’m using backup research for all these specific areas.

So that’s the one about hypoxia. So we need to understand that when we look at the basic four rooms of health, digestion is one, blood sugar balance and adrenal regulation is another, sleep is another, and good oxygen. So just in a given standpoint, we are always looking for good oxygen and airway. When we have children that are hypertonic, that maybe there is poor posture and slouch, just by that they can’t get good oxygen because their thoracis can’t expand enough to get good oxygen. So add the mask on top of that, that’s just another double whammy. Now, let’s look at the situation of increased infection, and I don’t want you just to think about increased COVID infection, infection in general. First of all, we have to be very practical. If a family has two, three, four, five little fiddle farts in school, they really should be wearing a new mask every day, unless they are taking those masks every day and washing them and sanitizing them.

So the amount of bacteria and germs and so forth that is going to accumulate on these masks, that family is going to have to have the funds to either buy disposable masks for every one of the family members, one for every day, and get rid of them. Are school’s going to take measures to get UV light devices to help sanitize the masks? They don’t have the funds for that. So we need to educate our academic arena and our parents that they really need to be wearing a clean mask every day. Now, when Fall comes around, we tend to see a spike in various flu bugs and so forth, including strep. One thing I want you to take into consideration is that strep in particularly has been known to come through the nasal passage and land itself in the CNS, and particularly, it can hit the amygdala and the basal ganglia. And this is one of the reasons we see post strep infectious episodes in the forms that we’ll call PANDAS, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Strep.

Note, the neuropsychiatric disorders associated with strep. These infectious loads can come through the nasal passage and land themselves in the CNS. Do we know that specifically of COVID yet? We can’t say that for sure about COVID. But it stands to reason, if we have other pathogens that can do that, this pathogen can as well and we do know there is a big association with neurological disorders and COVID. So when we talk about the increased risk of infection, don’t just land it on COVID but look at other past loads that we know and we have the evidence of. It’s very common that kiddos that have a PANDAS situation, their behavior changes on the dime and we start to see things like OCD, like ticks, like sensory processing dysregulation because of the amygdala and the basal ganglia. So, again, in the Fall when these pathogens are out and about, it’s not just COVID we’re worried about with wearing the mask, we’re worried about these other infectious loads as well.

Social cues and emotional regulation. This is huge. This is so big, this is really, really once you dive in. So we know that facial expression is how we’re able to perceive if a situation is threatening or not threatening and that goes back to our primate days, to the mammalian days, where they were able, if animals and reptiles in particular looked at eyes, they could discern fear. So breaking it down to easy, simple terms, the eyes and the mouth are big facial structures in where humans will gather information about that person in their environment. There is a mapping that goes on. Our brain fills in blanks. So if we can’t see all of a facial structure, our brain will fill in blanks to make a big picture. Is it a happy, good, safe environment or is it not?

But it’s based on the background situation that’s laid down at the time. So if it’s a happy situation, for example, the veil over a woman when she’s getting married, that’s a happy situation. So the background setting in that environment is happy, peaceful, good, safe. The background environment that kiddos are going to go into in the Fall is what? Fear, unknown, uncertainty, a bad situation. That’s why we’re all being social distancing and these masks are going on. So their brain has already set the stage for this is a threatening situation. Now, the eyes reveal fear, anger, sadness. The mouth reveals in what they see in the neuroscience mostly happiness or discussed. Before the age of 14, little fiddle farts fill in maps on their brain about a certain situation via eyes, via face by parts.

After the age of 14, these structures kind of connect together so I can look at a person and I can quickly, in 13 seconds, makes the connection between the eyes and mouth and make a full picture of what that person’s facial expression is telling me. Before that, it’s in parts. So if we’re covering a big part with a mask, these little fiddle farts are only getting information from the eyes. The information we get from the eyes really is processed with the amygdala. Now we’re back to that fearmonger. So amygdala is constantly discerning and it can’t create a full picture. It’s constantly discerning, is this a safe place for me or not? And usually, the medulla is run by fear. When they’re in fear, the way the brain works is it will only concentrate and lend its attention to the fear based mode and we can’t be in a learning growth environment. So this is really critical.

The mouth is going to lead us more into disgust with my internal self, more interoception, and it could throw my whole interoception, my internal sensation, and how hits the brain and processes information. So, long story short, these kiddos are going to be in a constant sensory dysregulation state. They’re going to be driven into limbic load, frontal lobe flips off, and everything we’ve already talked about goes out the window. This is what we’re concerned about leading to an emotional pandemic. So now COVID has taken us from a physical immune system pandemic to an emotional pandemic. These children are not going to be able to sustain a good academic curriculum when they’re living in this state, and that’s important for teachers to understand because the academic curriculum that they were used to having is going to have to really be backed down if these children are going to be in these kind of classroom environments.

And of course, information processing. We have our five far senses that come from the outside, sight, smell, sound, touch, taste that have to come and hook up with our internal senses, vestibular proprioception, the microbiome. If I’m living in this fear and I have anxiety, sensations from a microbiome are coming in dysregulated. Our immune system and our visceral system, those 10 sensory systems all have to engage together for us to get a good picture and a good feel of our environment to emotionally, academically, socially respond motor skill wise, respond appropriately to our environment. And this is going to be dysregulated in the healthy child, but let’s take this into the context that one in six children already have sensory processing disorder, this is further going to dysregulate their ability to process information.

If we look at the masks and the auditory dysregulation, not being that those kids with auditory compromise are going to be further compromised with auditory information coming in, it’s further going to dysregulate their ability to process auditory information. Now, you might get that pushback that says, “Well, we’re going to wear masks that are clear,” so they can see the person’s mouth, but we still have all these other cues and this sensory dysregulation that we have to consider with wearing the masks, along with the hypoxia. So, hopefully, this gives you some things to think about. It’s not just the hypoxia. There’s a whole lot that goes in with this social engagement system, which is going to primarily be your ventral vagus, your higher level vagus, your social engagement vagus that takes so many of its cues to come online, from eye to eye contact and social engagement.

Now, if we take that and move that into movement, we also look at the lack of movement. If they’re not getting out for recess, not getting out for lunch, they’re not getting oxygen by going out playing, so now you’re further depleting oxygen, they’re not getting vitamin D, vitamin D is good for immune regulation, Vitamin D is necessary for a healthy microbiome, vitamin D is necessary for good brain function. Movement, oxygen gives us increased serotonin and dopamine, which increases regulation of our emotional paradigm, of our sensory process paradigm, it gives us information of where our body is in space, we get feedback from movement where our body is, and what we feel like in space, that will increase our ability to self calm and self regulate, and that will be out the window as well.

So I wanted to just kind of brush over masks and movement for this little episode that we have together. Hopefully, this gives you some things to think about to go in with your frontal lobe on board, give some rational and reasonable tips to the other side to get them thinking about it’s much more than meets the eye in regards to learning, attention behavior, emotional regulation, and the way they respond to their environment. So again, thank you ChiroSecure for giving me this platform. Thank you for all of you out there in the trenches, making our profession a better profession, making our world a better world, and now more than ever families and children across the globe are going to need us. So together we rise. Pivot don’t panic. And let’s go out and continue to do our good work. I’ll see you next month with more pearls.

Today’s Pediatrics Show, Look To the Children, was brought to you by ChiroSecure.

Please subscribe to our YouTube Channel (https://www.youtube.com/c/Chirosecure) Follow us on Instagram (https://www.instagram.com/chirosecure/), LinkedIn (https://www.linkedin.com/in/chiropracticmalpracticeins/) Periscope (https://www.pscp.tv/ChiroSecure). Twitter (https://twitter.com/ChiroSecure) If you have any questions about today’s show or want to know why ChiroSecure is still the fastest growing malpractice carrier for over 29 years, then call us at (866) 802-4476. or find out just how much you can save with ChiroSecure by visiting: https://www.chirosecure.com/quick-quotes/malpractice-quick-quote/.

Look to the Children Pivot Your Practice – Drs. Buerger & Lindsey

Now, here’s today’s host, Dr. Monika Buerger.

Hello everybody, and welcome to ChiroSecure’s Look to the Children show. I am your host, Dr. Monika Buerger, and I am beyond excited, excuse me, today, to welcome a very good friend of mine. First of all, I want to tell you a bit about this amazing person. Not only is she beautiful and an amazing chiropractor, she’s absolutely brilliant, one of the business minds that I’ve ever met. I can’t wait to pick her brain. She graduated from Life University in 2001. She is the founder of Dominate Chiropractic Marketing, the dominators, and we are going to dig into that. She’s got a heart like no other. We met in person over, excuse me, between Christmas and New Years while we are both guests for a Spinal Missions trip, an amazing organization by the way, one of the most profound experiences of my chiropractic career. I got to listen to her lecture there, and she brought the house down. There’s no other like the amazing million-dollar practice builder, by the way, in a small town in Asheville, North Carolina, Dr. Nicole D Lindsey. Hey, baby.

Hey. Well, thank you for that awesome intro. I appreciate you. You’re one of a kind yourself.

Yeah, you deserve it. I mean, really, your heart and your soul and your brain is just profound. It was an amazing experience hanging out with you for that time. Speaking of then, we were free birds, right? We were free birds.

Totally, we were. On many levels.

On many levels. But we were talking before we went live about what’s going on in today’s paradigm. I know a lot of docs out there are a bit stressed and a bit concerned and feel a bit trapped or caged. At the same time, you brought up this great parallel about the most profound documentary of its lifetime. Right?

Right, right.

You have to talk to the audience about your thoughts there.

Yeah. I’ll start it with this. Hey, all you cool cats and kittens, right? If you’re watching this right now, you know what we’re about to say is the Tiger King. Everybody that sees it, you can’t stop watching it because it’s just crazy, right? But at the same time, I think it’s very ironic that that is the most popular thing right now, because it kind of symbolizes what we are and what we feel like right now. A tiger trapped in a cage, you know? It’s really interesting how we are drawn to this. The whole world is drawn to this concept of the tigers being trapped in cages, just like we are.

I thought that was such a profound parallel that you put together, because I hadn’t thought of it in that context. You and I went back and forth a little bit on Messenger about what we wanted to bring to the docs right now because this is a very unique time for all of us. We threw out there, a lot of the docs that I mentor, I’ve been saying pivot, don’t panic. Let’s look at this as an opportunity. You’ve done some really awesome things in your office just in this last couple of weeks getting ready for when this thing lifts. I believe, and I think you’re right there too, that we are going to have a huge opportunity explode once this crisis lifts. Can you just tell some of the docs what you’ve done in your office this last week or two to get ready for that?

Yeah. Yeah, absolutely. I mean, I feel that the momentum is building and that this is a great opportunity for chiropractors to shine, to come out shining saying, “Look, this is what we’ve been saying. Take care of your bodies, take care of your immune system so that you are not in that pool of people that is more susceptible to getting sick.” Let’s utilize this time to build upon that, be ready for that so we can pull these patients in and let them know we can help.

What we’ve been doing is we’ve sent out letters to medical doctors in the community, which I do anyway, but we’ve done it with a different purpose and intent. We’ve done it with a feeling of, look, we want to take that burden off of you. You are seeing patients and you’re trying to triage, do they have COVID or just is it bronchitis, that’s really more important to the MDs right now. If you have patients that are musculoskeletal, send them to us, we will be happy to assess them and help them and take that burden from your plate. That’s one thing, is sending and faxing letters and just building that relationship now. You can continue to build on that, and we’ll talk about that over the next few minutes, once this is over.

Then the other thing that we’re doing is we are preparing our office and our business for a huge reactivation campaign. I have been wanting to do this forever. I’ve been wanting to go through all of my entire database and make sure that we have all of their emails in our CRM, which I thought my CAs were doing. If you think that that was being done, I challenge you to check that, because we entered 200 emails in just yesterday that we’re not in. They’re active patients that were not put in my CRM. So we’re tackling that, getting our list ready to do a huge reactivation campaign via text, when it feels right.

Yeah. This is a great time that we should be using our extra time to look at those things and almost like you’re starting from scratch in a way, not from scratch, but like when we start our practices, and now this is a good reboot time to reactivate and get our message, and maybe even a clearer message out, and that we’ll talk about in a minute here. But you even said that you and your associate were in there tearing down your front desk.

Yes, yeah. We kept hitting this wall with the number of patients that we could serve in our office and it came down to we needed another CA, a tech CA. We needed hands on. My office is, we’re maxed as far as space goes and what we’re serving, and I could not hire somebody until I made space for them. I needed a workstation for them and it wasn’t efficient the way that my office was set up. So my associate and I, the other day, it was a lunch break and we actually took apart our front desk, it’s in modules. There was dust everywhere, there were cords, and we tore it up. We rearranged the whole front desk area and we created another workstation. So we’re ready, we’re ready. Letting the universe know we’re ready.

That’s a big thing. I think when we move space, when we create space, the universe will provide. As chiropractors, that is part of our thinking, right? That’s the way we live, right? We look at chemical, physical, emotional, head space, all those things to be as successful as possible. I think the message out there to all of you is create the space in your head right now and if you have to create the physical space in your offices, do it now, because get ready for the implosion, right?

Right, exactly. Yeah, pivot, pivot. Pivot and get it done.

Absolutely. Your expertise is hooking up, I shouldn’t say that, is connecting … Watch my lingo here.

That’s right.

Connecting with MDs around your community. You have a company, Dominate Chiropractic Marketing, and it’s really teaching and helping docs connect with MDs in their community. Question for you, what do you find is the one thing that they want to know about us?

There’s quite a few things, but if I had to pull out one of the most important things that would be they want to know that you are professional, because let’s face it, the medical profession, they have all these different wild ideas from what they’ve heard, what they’ve seen, what they don’t know, what they think they know about chiropractic and chiropractors. When you meet them behind closed doors and you start building a relationship, they will say to you, “It’s so nice to meet you. I had no idea.” They almost have this like they feel guilty saying it, letting you know that they thought the worst about us and about our profession. It’s simple. They just want to know that you are a professional. They want to know what your office looks like. They want to know how you process patients. I’m saying, the simple things.

When I go into their offices and do a presentation for them, I actually include slides, pictures of my office, and I walk them through, I take them through how I process a patient. This is my front desk, the patient will fill out paperwork. The patient will be brought back into an exam room, we will do a full exam. The exam includes this. We will check their range of motion, we will take x-rays on the patient if necessary. They want to know that you are a professional and that you’re going to properly assess and diagnose this patient. That’s probably the most important thing that they want to know about you.

Another thing is they want to know exactly what we do as chiropractors. Number one, they want to know that you’re not woowoo and wacky, that you’re a professional. Number two, they don’t understand chiropractic.

Right.

I’m not talking about … I mean, what you do, Monika, you’re light years ahead of a lot of us in the way that your brain works. I so appreciate that I learned so much from you and being around you and the program you’ve put together for us chiropractors. We think as chiropractors that in order to build a relationship with a medical doctor, that we need to have DAC bars in neurology and have all this extra special stuff in order for an MD to be interested in having a relationship with you, and that is simply not true. The fact that you are a chiropractor, period, is enough.

That medical doctor wants to know what you do, so we break it down to them. We explain to them how we look for subluxations, and that’s going to be unique to your specific technique. If you give your clients in your program [inaudible 00:12:27] to utilize, those are the things they want to know. If for example, say it’s a migraine or headache patient, they want to know what you’re going to look for in that patient. Are you going to look for trigger points? Suboccipital muscles? Are you going to look for decreased neck range of motion? Are you going to look at the cervical curve and see if they have forward head posture? These are the things that they want to know.

Thanks for bringing that, because we take that to a family-based or pediatric paradigm, that right there is huge ammo because what are kids doing all day long?

Looking forward.

Especially now, right? At home.

Mm-hmm (affirmative), yes.

Would you say, if we want to take this approach with a family pediatricians or a family practitioner, even with the pediatric paradigm, using posture as one of the things we look at?

Yes, absolutely. Absolutely. In fact, I did a presentation for neurologists. Two of them were young and they had younger children, and the presentation I did was specifically on the effectiveness of spinal manipulation in the treatment of headaches and migraines, and tension-type headaches. The way that I explained to them, because I always like to give medical doctors an objective tool, something they can utilize in their office to assess a patient to see if they’re a good candidate for chiropractic referral, and one of the things that I taught them was forward head posture. I went through with them how to do this and had them do it on each other. One of the neurologists, young guy, his mouth dropped and he’s like, “All I can think of are my kids playing video games.” I said, “Yes, exactly. This is what we’re seeing, is more and more young children presenting with headaches because of their posture.” So yeah, yeah, this is what they want to know.

Absolutely. Just a spin up on that, we know that … My brain’s a little weird and I get into the neurology stuff, but we even know that we look at things like asthma, dyslexia, ADHD, we have studies on that from the neuroscience realm on those postural changes, those postural imbalances are associated with those kinds of neurological issues. Asthma, for God’s sake.

This is a great dovetail into … Oh, now I’m going to let you, you’re the expert on working with MDs. In the situation like that, would you maybe provide just some journal research on some of those other offshoots, aside from headaches and so forth, but just say, “There’s some interesting articles,” or how would you maybe bring that into the picture too, like asthma or something?

Yeah, that’s a good question. I get that a lot. You have to be careful because your audience does not understand this language and they think chiropractic, musculoskeletal, chiropractic, musculoskeletal. Okay, so that’s the language that we base the relationship on initially. It doesn’t mean it stays there, but you want to meet them where they’re at. You don’t want to try and change their paradigm on the first date, okay?

But your question to me in text was how do you foster a relationship with an MD? One of the ways you can foster a relationship with an MD is once you date a little bit, right, you have this initial meeting, you’re dating, and then they start sending you patients. They’re happy, you’re happy. It’s going well. “Now I would like to talk to you about this next topic, the effectiveness of spinal manipulation in treatment of asthma for children. Would you be interested?” Now they’re a little bit more interested because they’re seeing results. They like what they’re seeing. They may even have a few patients that were asthmatics that they sent you for something else and they’re hearing that their asthma is improving.

This is how it’s done best. However, when you initially set up a meeting with an MD, whether it’s through a lunch and learn or a 10-minute meet and greet, it’s important to pick a topic. If your topic is asthma improving with chiropractic, then that’s what it is. If they allow you to come in talking about that right off the bat, then do it. Okay? But be careful throwing too many things at them. You and I know that chiropractic care can fix just about anything, right, but that’s not their language, so we have to be careful in that area.

Basically, primo bullet point, meet them where they’re at and try not to go in with the we cure, fix, everything, but give them some meat and potatoes to grab onto first.

Yeah. You may have those slides in your presentation there, and if you’re going through it and you’re getting a really good vibe, there’s a lot of gray in this kind of marketing, it’s not black and white, it’s not say this only, that MD may be tracking and asking you some really good questions. This happened with an OBGYN with me. Then if that happens, you take it there. Take it there, you know? But you may not be able to do that with every single one initially, initially.

How did you first get in their door? What’s-

Yes. There’s a couple of different ways. I have found the best way to do this is by setting up a … Now, of course we can’t do this right now because of our situation, but setting up a lunch and learn and going into the MD’s office, in their office, right, where they’re comfortable and bringing their office lunch. There’s all of their staff, I invite all their staff because I want all ears. You can get just as many referrals from their administrative staff than you can them. Pick a topic, stick to it, and go educate the MD. Because when you do this, you are positioning yourself as the authority. That’s what they want to know too, right? That you are the authority in your subject. I have found that that is the strongest way to build a relationship with a medical doctor. It’s not the only way.

Another way is setting up a 10-minute meeting with the MD. If the sound of or the thought of presenting to neurologists or medical doctors freaks you out, I get it, it still freaks me out every time, but I do it, then a 10-minute meeting might be better suited for you. You’re calling the MD, you are setting this up with the medical doctor, and you go in and you meet them before their shift, after their shift, for 10 minutes and use a smaller version of the lunch and learn, but hitting on some really important points in that 10-minute meeting.

When I got to hear you speak in Jamaica, I was just like, “Wow.” If you haven’t got to hear her speak, A, she needs to be out there speaking on more platforms, this is my opinion, but I mean, it was very enlightening. Some of the stats you said in creating that referral network and the longterm success rate of your practice, it was really eye opening. So kudos to you, because that’s not easy to do.

If I understand you correct from that little last pearl, it really takes us to be confident too in what we do and knowing what we do works, right?

Yes, exactly. That’s why doing programs like yours and really owning it is really important. Again, you don’t need all this extra certification, but if where you are you’re not comfortable with your technique, with who you are as a chiropractor, you need to fix that first, right? Confidence, that will help you with this so much. Absolutely, absolutely.

I do want to say something about what you said about from a financial standpoint, what this kind of marketing does. It’s something that I hadn’t thought about until you just said this now, but back in 2008, when the economy crisis happened, this was pivotal for me because it didn’t cost me a lot of money. Here we are, everybody’s practice is down, some 15%, some 60%, some down 100%, right? I’m hearing this all over the place. This type of marketing is going to really help pull you out of that hole because it doesn’t cost that much money, it’s just a lot of your time.

I think, I don’t know, sometimes when you put your own time and blood, sweat and tears into it, I think sometimes the pay off can be a little bit more profound, you know? I don’t know. I just thought I-

Definitely.

Yeah. When we were in Jamaica, I mean, some of those numbers you showed on the potential referral aspect, and I don’t know if you want to throw just a few of those out there, it is quite profound there. Where was I going with this? We were talking about the pivot, pivoting your practice right now. What would step number one be for people you think right now, during this lull?

Yes. If your office is open right now, even on a limited basis, go ahead and get that letter out. I’ll be happy to give it to you, just message me on here, on Facebook, Nicole D Lindsey, and I’ll give it to you in Word so you can edit it for you. But fax those letters now to every single MD in your area to let them know that you can help them. That’s one of the first things you can do.

Number two, you can start building your MD log of medical doctors, healthcare providers, that you want to build relationships with. Start building that list. Go on yellowpage.com, look on Google. Search all the healthcare providers in your area and get them on that list, their phone numbers, fax numbers, emails, so that you can start making these calls as soon as this stuff is lifted.

Yeah, and do you send out progress reports?

Yes. You were asking what do the MDs want to know about you, that’s the other thing that’s important. They really want to know how their patient is doing. They want to know, first of all, did the patient show up? They know they made the referral, did the patient show up or did they not, and what happened? They want to know what you found, your diagnosis. Then, yes, I send a progress report. I also send a discharge report, discharge from acute care for the initial thing that the MD referred the patient into, it doesn’t mean I’m releasing the patient forever. They learn this, you have to explain this to them in your verbiage in the note. But yes, they want to communicate with you. They want to know. That’s their language.

We’re talking about MDs, but we could really take this premise into the physical therapy world, the OT world, right? It’s crossover [crosstalk 00:25:00].

It’s all interchangeable. Yes, yes.

Before we depart, I mean, we could sit here for days like we did on the beach in Jamaica.

I would love that right about now.

We were talking in Jamaica about … I was on the big Tylenol kick and I think I sent you the little thing. By the way, viewers, next month I am going to do a special presentation on the effects of Tylenol or acetaminophen, because this is an incredibly important, and it’s even more important now with this whole COVID thing going on. But like I told you, I said, “You know what? 65% of pregnant women in this country and 50% in Europe report taking Tylenol for low back pain,” and there’s a lot of risks to the fetus on this, linked with ADD, asthma, allergies and we’ll get to that next month, but that is something we also can start from a pain base, right?

Yes, absolutely.

Low back pain in pregnancy, and build on that, right?

Absolutely, absolutely. I think like we were talking about earlier, before we got live, is now this is such a great opportunity for chiropractors to shine. I think more and more people, more and more medical doctors, healthcare professionals, are going to be looking for ways to help their patients get healthier. When you have an OBGYN that has a pregnant patient and they’re seeing studies come across their desks about acetaminophen and they can’t ignore that. So yes, I think that that is definitely going to be a hot topic for OBGYN marketing. OBGYNs are great MDs to market to and in my program, my online course, we have a presentation that I actually use to build relationships with OBGYNs.

Awesome, awesome. Well, I know you’re super busy. I thank you so much for being on here. I miss you. I wish we could hang out together, not in quarantine-

And happy belated birthday.

Oh, you’re so sweet. But again, the brilliance this woman has to share and her mind, her brain, I just love her brain from a chiropractic and a business standpoint. I mean, I’m telling you guys, if you don’t know her, get to know her. Please get to know her because she will turn your life around. I want to thank ChiroSecure for always being there for us and giving us this platform. I think I failed to say you are actually one of the hosts of ChiroSecure’s Empowering Women show.

I am.

So thank you for putting that on. Again, ChiroSecure, Thank you for having our backs, for giving us this platform, for always sticking up for the chiropractic profession, especially right now when so many people are struggling. You’ve been out there to be an anchor for all of us, so we thank you, both Nicole and I. I’m speaking for you, but I know you feel the same way.

Yes, yes. Absolutely.

Thank you to the ChiroSecure family for being our anchors. Be sure you join Eric Kowalke the first Thursday for Look to the Children show. Then again, I’ll be on the third Thursday of May, and you guys want to hear this presentation that I’m going to do about the effects of acetaminophen. It goes beyond glutathione and it goes beyond pain. It is going to be involved in neural development. With that said, I bid you adieu. You guys all hang in there, and pivot, don’t panic and together we will rise.

Today’s pediatric show, Look to the Children, was brought to you by ChiroSecure.

Please subscribe to our YouTube Channel (https://www.youtube.com/c/Chirosecure) Follow us on Instagram (https://www.instagram.com/chirosecure/), LinkedIn (https://www.linkedin.com/in/chiropracticmalpracticeins/) Periscope (https://www.pscp.tv/ChiroSecure). Twitter (https://twitter.com/ChiroSecure) If you have any questions about today’s show or want to know why ChiroSecure is still the fastest growing malpractice carrier for over 27 years, then call us at (866) 802-4476. or find out just how much you can save with ChiroSecure by visiting: https://www.chirosecure.com/quick-quotes/malpractice-quick-quote/.

Empowering Women in Chiropractic – Concussion in Kids – Dr. Monika Buerger

Hello everybody and welcome to an incredible ChiroSecure Look to the Children show. I’m your host, Dr. Monika Buerger, and I want to thank ChiroSecure for always giving us this incredible opportunity to share so much wisdom with the chiropractic world and offers this platform to help us help more children. I am beyond stoked about our guest today. I have such incredible respect for this gentleman. I got to hear him speak a little over a year ago at an autism convention and we’ve known each other in the past, but Dr. Jon Chung is with us today. Hey, doc.

Hi. Thanks for having me on, Monika.

Oh, hey, I am so honored to have you here. I really, really love and admire your brilliance. Dr. Chung practices in Wellington, Florida, correct?

Yes. That is correct. We’re in Wellington, which is a suburb of West Palm.

You’re a writer, a lecturer in the chiropractic paradigm, upper cervical specialist. And I think the reason we kind of connected so well is one, our love for the vestibular system. So we’re both vestibular junkies. You’re kind of what I refer to as one of the experts in the concussion world and also tying concussion, vestibular work, and dysautonomia, all kind of into one paradigm. So thank you and congratulations on your new little fiddle fart.

Thank you so much.

You just became dad for the second time, right? Another little girl.

I did, I did. We’re thrilled to have some happy, healthy babies back in the household and yeah, mom’s working hard and I’m just doing the easy stuff now.

And you have a couple of websites for those out there in Facebook land to be aware of is protecttheneck.com, correct?

Correct. That’s for my technical writing, for clinicians, practitioners, doctors, and so forth.

And so, protecttheneck.com. You guys get on it. He really has incredible, incredible information. And then your office website is Chiropractic Keystone?

Yes, that is correct.

Okay. And you have … is it on the protecttheneck.com, is that where you have a handout to offer or tell us a little bit about that.

Yeah, so protecttheneck.com is a resource for doctors and clinicians to read a little bit more about the literature when traumatic head injuries happen to people, what can we do from a doctor standpoint to better understand what’s happening neurologically and what can we do best to help a lot of these patients, whether using some of the research that we know, whether it’s in physical therapy, chiropractic, and other modalities. So I tried to develop something where people can easily absorb some of the information. We translate it for people so they can use it in their office as soon as possible.

Awesome. And is that where the toolkit that you have to offer is on there?

Yes. So the head injury toolkit is a seminar that I put on and you can find out information about that seminar through protecttheneck.com.

Oh, fabulous. Oh, awesome. Exciting, exciting. And I should say that Dr. Jon has a background with extensive postgraduate work with the Carrick Institute and with the ICPA. So he’s definitely been in the trenches in the academic arena, as well as the practice arena, and that’s why we wanted to grab him and have him on today for you all. So let’s chat a little bit. You cool beans with throwing some stuff around?

Absolutely. Especially with someone as bright as you, I’m more than happy to.

I bow to you, man. I really was excited to have you hang out with us today. So we know that the rates of head trauma, concussion, they’re on the upswing and it’s a little bit different in the pediatric paradigm, being able to decipher some of the potential consequences of concussion or head injuries. And I understand that, from the literature, we know that when one sustains a whiplash along with a concussion, that kind of throws some other things into the rehab mixer, to the time sequence, et cetera, of healing. What can you tell us on that?

So there was a study that was published in 2018 out of this Canadian concussion center that looked at the outcomes for patients that had suffered a concussion alone, versus a concussion with some documentable form of neck injury. So what they found was in these patients, when patients had a concussion plus a neck injury, they were at much higher likelihood of having a delayed or worse recovery, which means that if a child with just a concussion by itself, we know that on average that they’re going to get better within about 16 to 18 days without any treatments at all. But these kids that will get neck injuries plus concussion, will actually get close to the 30 days if they make a full recovery.

And there’s a high percentage of these kids that don’t make a full recovery and will end up being diagnosed with post concussion syndrome or some type of persistent post-concussion type disorder. So that just adds to this building body of evidence that if you have a cervical spine injury with a concussion, that your chances of getting better unless you get good care for your neck are going to be a lot worse.

And for us, this is gold you guys out there, because we do need to be aware that whiplash injuries will magnify that concussion injury, but whiplash injuries can also mimic the same signs and symptoms, right, as a concussion or TBI?

That’s absolutely true and a lot of us, even if you don’t think that you see a lot of concussion patients in your office, there’s a lot of people in your office that have been in car accidents and some of these people that have had car accidents probably had some minor forms of concussion or brain injury, but they might not have even known that they suffered that, because these symptoms of concussion and whiplash do overlap quite a bit. There was an interesting study by John Leddy, who is out of the University of Buffalo where he took a bunch of patients from his clinic and he separated the groups into patients that had a whiplash mechanism, versus patients that had more of a concussion mechanism, and he gave those symptoms to doctors and he said, “Can you tell the difference between those that had a concussion versus those that had whiplash?”

And people couldn’t really tell the difference, because most people think, all right, if you have a concussion, you’re probably more likely to have cognitive symptoms. But we know that people who have neck injuries, they’re going to have cognitive symptoms, too. So you can’t tell just from symptoms alone whether someone has had a concussion or had a whiplash, you have to really dig deep and look into their history and look at their exam findings.

Yeah, absolutely. And for chiropractors, I mean that for us is imperative. We need to know this, that when people … even the little fiddle farts, if they sustain a whiplash type injury off the monkey bars on the playground or fall off the changing table or whatever, I think we need to be aware that this can set up the same sequelae as a concussion.

For sure. And plus, we’re chiropractors. We work on necks every single day. We should be seen as the experts of the neck because there’s no one that’s better trained in the biomechanics of the cervical spine. We know the soft tissues and the nervous tissue of the cervical spine in and out. We are well equipped to be able to handle these types of scenarios and what better intervention is it for someone than to get a correction to the neck through really specific chiropractic care?

Absolutely. And like you said, we should be on the forefront of this. Excuse me. And the upper cervical spine, in particular, I mean that is a very important area when it comes to the almighty proprioceptive and vestibular input. And I think in chiropractic, we talk a lot about proprioception, but I’ve always kind of had a love affair with the vestibular system as you do, because it’s such a profound sensory system and really regulates all the incoming sensory input, rate, timing, and so forth. Tell the world a little bit about the importance of proper vestibular function.

Yeah, so the vestibular system, and I know we talked about this the last time we were together, is just this magical thing that integrates with so many different parts of the brain, right? And we’re seeing that the vestibular system in people who have vestibular loss, that they have documented cognitive deficiencies, compared to normal controls. And we know that the vestibular system has really robust autonomic contributions, too. And I would almost venture to say that when we are adjusting people through the upper cervical spine, it’s through those cervical sensory contributions to the vestibular nuclei in the brainstem, that is probably giving us some of the most robust autonomic consequences when we’re adjusting people.

And just having that sensory integration between the proprioceptive sensors of our cervical spine with good, healthy vestibular function, I think time and time again, when I’m measuring something like heart rate variability to measure the autonomics of my patients, we see these changes happen so, so fast and it just lends credence that we can’t just break people down into these isolated pieces because the brain is such an integrated thing in and of itself, that whenever we hit these areas that have such high integration, that we’re going to have wide-ranging effects on the body. And especially when it comes to concussion and whiplash, we know that there’s dysautonomia and concussion, and we know that patients with concussion are at a higher likelihood to have things like postural orthostatic tachycardia syndrome, so you might have POTS and have a higher likelihood to have orthostatic hypotension and syncope. So the evidence is there that the autonomic nervous system is affected. It’s just now we’ve got to put our money where our mouth is, and showing that we’re affecting these things in meaningful ways.

Absolutely, absolutely. And that vestibular system, I mean there’s a lot of evidence it’s involved anxiety, regulating anxiety because it has that connection into that limbic system, the limbic structures are from the upper cervical spine. It has a direct connection into the limbic structures, which is huge, right?

Yeah.

And if we’re stuck in limbic lock and load mode, what does that look like? Anxiety.

Yeah. And when we see some of our patients that have … We think of vestibulized dizziness, even though it’s so much more than dizziness, but our dizzy patients are the most anxious people that we have. And as soon as you start to get their vestibular system calmed down, you could see that they become a different human being, just from having that vestibular contribution becoming more normal again.

Absolutely. And scoliosis, I mean there’s studies even looking at asthma, ADD, all these postural disorders that are associated with poor vestibular function, are associated with a plethora of labels that we see in common, everyday life now. So when you are looking at a little fiddle fart, the pediatric patient, are there certain red flags or pearls you look at that might be different than the adult patient?

When I’m looking at a pediatric patient, your exam findings become even more important because concussion is a clinical diagnosis for the most part. It’s like going back to that previous study that we talked about, you can’t really tell if someone has a concussion just by their symptoms alone, you have to assess their entire sensory system to make sure that there’s no abnormalities there. So one of the things that are going to pop up, especially if a kid has gone through their normal developmental progressions, you’re going to see some primitive reflex issues start to pop up again. One of the things that is kind of the gold standard for when someone has a concussion on the field, is that you’re going to see them get into that fencer response whenever they start to lose consciousness. And that’s one of the things that’ll pop up and you’ll see that becomes an issue when you look at things like the asymmetric tonic neck reflex and the tonic labyrinthine reflex start to show up again.

You’re going to see some Moro issues start to come up when it comes to that. And then some patients with a severe enough concussion, you’re going to see some abnormalities with their vestibular ocular reflex, too. So, those are some of the bigger things that I would be looking for, especially in that pediatric population, because balance is a useful tool and eye movements are useful tool, but they’re not as reliable when you’re dealing with that pediatric patient, because their motor control, in itself, isn’t that great until they get into closer to their teenage years.

Right, right, right. And that’s because we don’t have full function of that frontal lobe yet until [inaudible 00:14:43].

Exactly.

So that’s why the motor control isn’t necessarily there. So on the little fiddle farts, we might also see, excuse me, some behavioral difficulties start to pop up or more defiant behavior. They don’t like to be in a sensory stimulating environment. They might be more clingy. We might even see digestive issues, right?

Yeah, for sure. And especially if you correspond some of these findings, whether you have kids that have high visual sensitivity issues, so if they’re starting to become very light and sound sensitive, that’s another big cue for you to look into. And then when you’re having this overwhelming sensory stimuli coming in, and of course you’re going to act out and you’re going to do things that aren’t part of your normal behavioral patterns, but we also know that concussions will also affect clarity of vision, too. So if you have a kid that’s normally been a really good student, and all of a sudden they’re starting to slip behind, then it might not be a cognitive issue, in itself. It might be because concussion has effected their vision and they’re sitting towards the back of the classroom and all of a sudden, because of their head injury, they can’t see the board quite as well or they’re not reading quite as well.

So when it comes to concussion, having a team with you, so you have someone that understands vision therapies, they could do vision therapy for that child or teaming up with other members of the concussion team is really helpful and making sure that, hey, this kid that you think is just having cognitive issues, it might not be their cortical regions of the brain that’s responsible. It could be these other sensory areas that people just aren’t looking hard enough at. And that’s why people that are trained in the ICPA and understand this type of stuff, are really well equipped to help with the pediatric concussion.

Right. Yeah, and we do, we need to look at … So one of the things we want to take away with this is, you docs out there listening, these what we call primitive reflexes, is what Dr. Jon was talking about, can re-emerge in a time of a trauma. So we look at that Moro, the startle reflex. And you talked about the fencer pose, the ATNR, so we really want to get you thinking about those are some exams that we can do to see if those reflexes are not active following a whiplash or a concussion injury. So do you do those in most of your patients, doc?

I don’t do them in most of my patients, but when someone is having some of the clear signs from their history and other exam findings are kind of pointing me in that direction, then I will definitely take a look at a lot of those findings. In the pediatric population, then that’s something that I’ll jump to straight away, because I know that’s one of the areas that will point me in the right direction pretty quickly.

Then if you had to pick three pearls to give the docs out there, when you have a patient comes in and let’s kind of stick to that pediatric population, and you are suspecting they might have a concussion injury or whiplash injury, what would be three pearls you would say, “Docs, I want you to look at, boom?”

Perfect. So first and foremost is, “Hey, make sure that that patient is safe, because there’s a difference between mild traumatic brain injury, which is a concussion, versus the more moderate and severe traumatic brain injuries.” So one of the first things you just want to rule out is just look at their pupils and see if there’s any anisocoria, making sure that their pupil sizes aren’t terribly asimilar and just make sure that that kid doesn’t have a bleed on the brain. So that’s the first and foremost part, because there’s a lot of docs that are out there, that you guys become that patient’s primary care doctor, right? So if you’re going to be that person’s primary care doctor, then you have to make sure you do your due diligence and make sure that that patient is safe. And if you see any of these red flag signs like anisocoria, the patient has headache that is continually escalating, then just get that person out, get them to the hospital get them a CT scan, make sure that there’s no brain bleeds going on, and just get that taken care of.

The second aspect is once you know that that patient is in the clear, one of the things that I would go to, is those initial primitive reflex responses, especially the Moro’s, if you know that that patient has a really high sensory sensitivity. We talked about the vestibular system, so taking a look at that vestibulo-ocular reflex, because just sometimes training that kid’s VOR might be good enough for them to really start getting better really quickly. And that asymmetric tonic neck reflex is one of the ones that also jumps up really quickly, as a place where you can intervene really, really fast and get that patient [inaudible 00:19:34] better.

And the last thing is, when it comes to actually adjusting the spine of a patient that has had a concussion or whiplash, there’s patients that do great with more heavy-handed adjustments, but then when some other patients have some of these higher sensitivity issues, it’s probably a good idea to start more low force and then work your way back up. So let’s just say that you are a full spine practitioner, you’re more of a hands-on adjuster, you know, it’s probably not bad to just take some sustained contact type style of adjustments if you don’t have something like an activator and pulse device. So treat it like you would adjust an infant and just hold a static contact right on their upper cervical spine and then watch how their autonomics change when you’re just holding that contact on there, as opposed to actually applying a thrust.

Because from my bias, we do NUCCA, so most of our adjustments feel like just a static contact on the person’s neck, anyway, and you can see magic happen really fast, because you can always add more force if you need to, but it’s very hard to take that away, if that extra force just overstimulated that person’s brain. And it’s not to say that you injured that patient, but that person’s brain just might not have been ready for that adjustment at that moment in time, so you start slow and work your way up towards doing something that that patient can tolerate. And that would be my biggest takeaways for the pediatric population.

That’s great. And that those are really important pearls, you guys out there, because an adjustment is a huge metabolic blast to the brain. And so after these injuries, we’ve got this inflammatory load and there’s a lot more hypersensitivity to input. So low, slow, and safe is kind of a good motto. So, rule out any bleeds, and I know this might be a little controversial in some states. Do you ever check the ears for any blood in the canals?

I don’t. I don’t look inside the years, but I’ll definitely do a surface check. I’ll make sure that there’s no clear fluids coming out of the nose or the ears, just to rule out any cerebrospinal fluid problems that might be leaking out. And if there’s any obvious abrasions and stuff like that, then I’ll get that checked out further. Fortunately, knock on wood, I haven’t run into any of these situations where I’ve had to refer for that scenario, but I’m well-prepared to make that referral when I need to.

Yeah, unfortunately I’ve had to do that out here in Idaho. You know, it’s a big winter ski environment and I’ve had some really traumatic brain injuries, was actually sad. They went to the ER, they got dismissed and they had a number of concerning symptoms. They ended up in my office and they’ve had hemorrhages and skull fractures and it can be quite the scary scenario. So let’s talk a little bit. So we got three great pearls there. Rule out bleeds. Look at pupil size and dilation. You’ll see these kids come in oftentimes, just those pupils are huge and they’re on that sympathetic dominant state. Go low, slow, and safe. You’ve got to check the vestibular system, guys because vestibular and visual are going to be huge, and the primitive reflexes that Dr. Jon talked about. Can you touch on what you’re seeing in regards to association with dysautonomia?

Yeah, so that’s one of the cool things that has come out in the concussion literature probably in the last 10 years or so, is that they’re finding that a lot of patients who have suffered concussion, especially that have had persistent symptoms that are going beyond 30 days. A lot of them have POTS, syncope, or orthostatic hypotension. And one of the things that Dr. Leddy has been talking about at the University of Buffalo is that a lot of people with these metabolic injuries to the brain, is that their brain is not prepared to take on this increased metabolic capacity. So you can actually make a case that an acute concussion in those days right after an acute concussion, that that brain is in a state of dysautonomia, because it can’t handle the load that the body is placing on it. And doing something like sub-symptom threshold exercise, is a way where you can help that patient start to progress out of that dysautonomia in those early phases of concussion.

And the reason that this is a cool thing for us, is because you know we love talking about the brain-gut axis, we love talking about the vagus nerve, and all of that really comes into play with this, too, because someone that has a traumatic brain injury, their gut lining is also going to be dysregulated as well. So one of the places where you can adjust the person from a long-term perspective, is start to fix their gut after they’ve had a concussion, so that that gut-brain axis is intact and the gut issue doesn’t also reinforce a bad blood brain barrier. The other things that we could start to look at, is just really start testing autonomics really closely. I measure HRV in all my concussion patients. I’m looking at pupil sizes and pupil reactivity in all my patients, and not only is this a way for you to show the patient, “Hey, look your kid’s autonomic nervous system is working better.” It also tells you how effective the things that you’re doing for that patient, is working for them.

So if you see that that person’s HRV starts to go up, as you start to take care of them, you know that your adjustments or your therapies are probably in the right line, along with the patient getting better physically. And then if you start to see that it’s tanking, then you might say, “All right, you know what? We probably overdid it too much on this session. Next time you come in, we’re probably a dial it down and take it a little bit slower.” Maybe what we use on those lower force contacts or you just modify whatever you need to do in order to make sure that their autonomic system can tolerate the things that you’re doing to them.

That’s a great point. That’s a great point, because they will go into overload a lot quicker. So as you’re working on them, if you see the heart rate variability go up, you know that they can adapt to that. Their nervous system can make room to adapt to that. But like Dr. Jon said, if you see it tank, you know you’re putting them over that threshold and you don’t want to throw them, because then they’re going to end up in that sympathetic shift again and [inaudible 00:25:58] more pro-inflammatory state, which contradicts what we’re trying to do to get the inflammation off the system.

And even if you want, you can just get a pulse ox and just put them [inaudible 00:26:07] and do some of your rehab with them or do some of your adjustments with them and see if the pulse ox is staying steady. If you see it tank, then you’re like, “All right, you know, we probably did too much.” If you see it’s holding steady, then it’s a sign that you’re doing well. So, use tools that cost nothing.

Yeah. You can get them on Amazon for a couple bucks. It’s not that much, you guys out there. It’s a very easy monitoring tool to use.

Absolutely.

Especially, we’ve got to remember the pediatric population, those little fiddle farts, they don’t know how to express themselves well. Our adults can say, “I’m starting to feel a little dizzy or I’m starting to get a headache or get overwhelmed, where in a pediatric population, they can act out. But I think one thing we also need to be savvy on is looking, especially on vestibular overload, they might turn pale, might start to flush or perspire. They might get hiccups. I find with the pediatric kiddos, sometimes they’ll start getting hiccups-

That’s an interesting one.

Yeah, or start sighing or yawning a lot. That means that you’re pushing that vestibular system, so, you need to get it back down.

Yeah, for sure. Yeah, and just look at their eyes, too. If you see that their eyes are starting to kind of glaze over or you’re seeing them starting to go upwards on the patient, then yeah, back off a little bit.

Yeah. I say when they start looking like a drunken sailor, you know, that glazed look. You’re like, “Ah, that’s it.” Sometimes these little five-year-olds walk and they’re starting to go and they look like you’re getting them drunk and you’re like, “I swear I’m not giving them alcohol.” They’re just [inaudible 00:27:45]. But this is such incredible information. I think it’s so huge for us on many realms because A, we are the spine experts, right? And we are the [inaudible 00:27:54] in that cervical spine and thank you for bringing up the gut-brain axis, because the research out there does show that after a head injury, it does start the gut dysbiosis and it changes those tight junctions. So it has an effect on zonulin, right, on the tight junctions.

And so it’s incredibly important that I think if you’re not comfortable doing it in your office, any gut work, work with somebody, another chiro in your community that’s like, hey, I like to do the nutritional component, or an MD or something. But you supporting the gut. What other, just as a wrap up, are there other key nutritional anti-inflammatories that you like to use, to start getting some of the inflammatory load down, because we need to get omegas on, we need to get the fats on board.

For sure.

What else are some of your go-to’s?

So during the acute phase, I actually let the inflammatory phase just kind of run its course because they show that the inflammatory phase and the acute phase is really important for tissue healing and tissue responses in the early phase. But once people get beyond 10 to 14 days, then I’ll start to look at some of the boswellia, I’ll start to look at some of the turmeric and boswellia complexes, the omega threes. The omega threes, there’s some tentative evidence that suggests that omega threes can be a prophylactic for football players. They’ve shown some studies that one of the markers of traumatic brain injury in football players, even before they had a concussion, if you’d take DHA, that those biomarkers actually start to go down a little bit. So it might be something that it can help prevent some of the long-term consequences of hitting your head repeatedly.

So that’s one that I look at. Ketogenic diet is showing a little bit of promise in the handful of anecdotal reports. So ketosis for patients with some long-term consequences of traumatic brain injuries, one of the places I would start to look at as well. And you know, compliance is always the toughest part with that, especially if you’re dealing with the pediatric population, but that’s another tool in your tool belt, where having the patient generally go into ketosis and starting to use some of the things that help drive ketosis, might be one of those things that can help the brain recover and reduce that inflammatory load long-term.

The other thing I just want to throw out there is, I know the sphenoid is very much affected. So if any of you guys do cranial work, the sphenoid, because they see that pituitary stock can jar in that sella turcica, so we can also see some hormonal dysregulation down the road.

Yes, for sure.

Yeah. So this is great, great stuff, you guys out there listening in. I want to pick your brain real quick about in 2018 when the FDA approved the blood test, looking at glial proteins and ubiquinol proteins, do you refer for that very much?

I don’t. So the main thing behind that blood test, is to decide that if they need to do a CT scan or not because, basically, that blood test isn’t really to diagnose concussion, it’s to help separate does this person have a likelihood of a brain bleed versus do they not? And the problem with that test as of now, is that the results can take a little bit of time and if that person is having a brain bleed, then that’s not necessarily something that you want to worry about, anyway. So the testing of it is still a work in progress to try to figure that out. But it’s probably something that’s hopefully down the line and will save people from needing some of these heavy dose CT scans and you could bypass it a little bit by using the blood tests. But, as of now, there’s not really a biomarker to say, hey, this person has a concussion versus they don’t.

Awesome, awesome stuff. Again, thank you so much for taking … I know you’ve got a busy, crazy schedule and you’ve got now that new little beautiful little fiddle fart, and you made time in your schedule to hang out with us and give this incredible information. So if they want to find out about your course, tell them to go where again?

So you could go find out about my course at protecttheneck.com. You can also sign up for an email newsletter where I pump out different emails about different head injury cases and I break down some of the research behind head injuries and the cervical spine and you can take a look at some of the stuff there. And then I’ll announce the date for our next head injury toolkit seminar, sometime in the next month or so, so be on the lookout for that. And then if you ever want to chat with me on social media, I’m pretty active on Instagram and Twitter. You can follow me at Dr. Jonathan Chung and I’m pretty responsive to that or you can find on Facebook, too.

Yeah, and he always posts some great research and we like to play back and forth with that research so he’s the man to go to. So, hey doc, thanks again, I appreciate it. And all of you guys out there listening in, thanks so much for joining us. And again, ChiroSecure, thank you for giving us this platform and giving us this ability to get this incredibly important information out to our colleagues and to the general public, because we need to be out there in full force, changing the tide, spreading our message, and giving hope to more and more families and children for generations to come. And we’ll see you next month for an incredible guest, Dr. [inaudible 00:33:19] Slack is going to join me as my guest and-

Oh, nice.

I know. Yes, the first Thursday of the month is the incredible Erik Kowalke, that gives you tons of pearls and tips to get out there and be the ultimate in your communities. And so till next month, you guys all have an incredible month and keep changing lives.

Thank you.

Today’s pediatric show, Look to the Children, was brought to you by ChiroSecure.

Please subscribe to our YouTube Channel (https://www.youtube.com/c/Chirosecure) Follow us on Instagram (https://www.instagram.com/chirosecure/), LinkedIn (https://www.linkedin.com/in/chiropracticmalpracticeins/) Periscope (https://www.pscp.tv/ChiroSecure). Twitter (https://twitter.com/ChiroSecure) If you have any questions about today’s show or want to know why ChiroSecure is still the fastest growing malpractice carrier for over 27 years, then call us at (866) 802-4476. or find out just how much you can save with ChiroSecure by visiting: https://www.chirosecure.com/quick-quotes/malpractice-quick-quote/.

Look to the Children – “Build and Brand” Your Pediatric Practice! Drs Buerger and Kowalke

Hello everybody and welcome to another amazing show of Chiro Secures Look To The Children and again, I want to thank Chiro Secure for giving us this platform and bringing you amazing information and I am super stoked today because I have my sidekick Dr. Eric Kowalke.

Got it. nailed it.

Yeah, nailed it, right? So, he is my, I don’t know if I should call you, is it co-host or co-partner?

I like co-host. I could co-host.

Yeah, we co-host on different days.

Yes.

So, Eric holds the Look To The Children’s show on the first Thursday of every month. So, if you have not listened to him yet, you better dive in and get his pearls of wisdom and thanks for joining us today, doc.

Yeah, this is going to be super fun. I got skipped this month because of Christmas. So, I still get to be on. So, that’s good.

Oh, you’ll be back February, the first Thursday in February, right?

Yes, for sure, yep.

Awesome. Well, Dr. Eric, he graduated from LikeU in 2011. He went out into the trenches, opened up his practice right from the get go and he has nailed it. He has got one of the biggest booming practices in the Midwest and one of the biggest pediatric practices around. I am super stoked that you’re going to be dropping some pearl bombs here. I’m going to put him in the hot seat you guys.

He sees about a third of his practice is pedes and he’s got, he’s cranking over 1200 visits a week. So, he is seeing some awesome cases and some awesome miracles in his office. He is the owner, founder, creator of an awesome app called SKED. So, if you want to take some blocks out of patient scheduling, patient compliance, you got to check out his… And what’s the website for that doc?

It’s Sked, S-K-E,D dot life, L-I-F-E.

Awesome, but we were talking before the show went live and some very cool things you can do with this app. So, really check that out and we’re going to get a little bit amped over his Amped program or his collaboration and Amped is a really amazing program where it’s bringing like-minded docs together to mastermind and take advantage of the newest and greatest in all realms of chiropractics. So, also checkout Amped at where doc?

That’s Ampednow.com.

Ampednow. Let’s get amped now. What do you say?

Let’s do it.

You’re awesome. So, okay, I’m going to drop. I’m going to get you from the right hook, how’s that?

Okay, let’s do it.

All right, let’s do this. So, you knocked it out of the gate from the get go. You’ve been in practice since 2011 and you have a kick butt practice going out there in Wisconsin? No-

Michigan.

Michigan.

Close to Wisconsin. I’m from Wisconsin originally.

That’s where I got that from. Okay. [crosstalk 00:04:03] Hopefully you’re not as cold as we. You’re cold out there.

It’s cold. Unfortunately.

Cold. Huh? So, all right. Since you’ve got to kick butt killer practice at a young age, and by the way guys he has six, count them, six little fiddle parts of his own and he looks so young. I feel like I could be your mom. Yeah, he’s got an awesome wife, six kids, kick butt practice. So, three pearl bombs. You can do more. I won’t hold you to three, but give these guys three pearl bombs of creating this awesome pediatric practice.

Yeah, that’s so interesting. When we started in 2011, I didn’t know really what I was doing at all. Back then it was you hire a coach individually to coach you and tell you what you should do or you start a franchise of somebody else’s program and we really didn’t want to do those. So when we opened, it was actually Friday before we opened on the following Monday, we opened August 1st, 2011 and I had zero people scheduled in the office. We didn’t even know you were supposed to do that. I mean, we didn’t have any guidance really. So, I did a screening that weekend and I got 15, 13 or 15 patients scheduled for the following week and in three weeks we were at 100 visits a week. So, how do we go from 15 people to 100 visits a week? Well, I took one guy with low back pain and through the education process turned into him and his wife and his four kids started care and then one little girl that I met that used to dance and now she couldn’t dance because she had vertigo, she was one of six kids.

So, then you have six kids and two adults. You take one little girl and now you have eight people and so, it just snowballed like that and I think a lot of chiropractors just get in their own head and it’s not so much they can’t do it, it’s just that they overthink it, they over complicate things and I remember when I was in school, I listened to a Reggie Gold tape where he sat down and he did a patient history with somebody and then once they got through the patient history, he tore it up, threw it in the garbage and said, “This is the last time we’re talking about symptoms,” and he would like say, “Okay, you bring your whole family or you don’t come at all,” and that really stuck with me and so, when I educate, it’s really if they really get chiropractic care and they really get why they should be adjusted in the health of the spine and the health of the nervous system and the fact that nobody else is even looking at that system of their body, why would you not bring your kids?

Why would you not want to get them checked or at least their nervous systems assessed for nerve interference? It’s not even logical to think like that and so, if you present it that way as it’s obvious to do that and you just remove the barriers of entry for them to get their nervous system assessed and their kids nervous systems assessed, it really just grows rapidly and you get tons of referrals because if you’re excited about it, they’re excited about it and they’re like, “How come nobody’s ever told me this before?”

And they just go tell everybody. So, they start referring people even if they haven’t even had a miracle or they’re not even better yet. They just had a tour of the office and their first initial consult they’re already telling other people because their experience was just really extraordinary and information that you shared with them was life changing, that they just want to tell everybody else too and then those people start coming in. So, it’s really just the passion of chiropractic and just loving what we do and knowing for certain that if I could just check them and remove nerve interference, they’re going to experience a better life and just communicating that effectively really helped us grow so fast.

Telling the story. So, okay, so let’s talk, we’re chatting with Alan a little bit and stuff beforehand, no matter how many people you see in your office, but with a high volume office and my California, my past life, I say my California office, I had a very high volume practice too. What is your feel on being able to have a neurologically based chiropractic practice at a high volume level?

Yep. So, I was a mechanical engineer. I don’t think I put that on there, but I used to be an engineer before I was a chiropractor. So, I went into chiropractic school very objectively like, “Okay, I’m just going to learn where every nerve goes of the entire spine and then I’ll just know what their symptom is and I’ll just fix the bone that’s putting pressure on the nerve going to that part of the body.” That’s what I thought when I went into chiropractic school and when I learned that, when I started going to the neurology stuff in chiropractic school and what I learned is like, “Oh my gosh, it’s just so much more complex than we can even imagine.” Even to think that our own bodies can learn how our own bodies work seems illogical. We don’t know. We know, but at some point the innate intelligence of the body is just so much smarter and capable of so much more than we’re really willing to give it credit for and can even understand that yeah, I just came to that realization when I was in it.

Anyways, we do torque release technique and what I like about that is the leg checks that we do are using the nervous system for information. So, we’re accessing the nervous system and it doesn’t, I mean, all of your techniques, everybody on this call probably knows 70 different techniques and as long as you’re being intentional about finding nerve interference and you have reliable indicators that can show you places and signs of nerve interference and your technique gives you an ability to remove the nerve interference and improve this function of the nervous system, however you choose to do that, you’re going to help people get better and there’s really no right or wrong way to do it. A lot of it’s intense too. What frustrated me so much when I was a student is as thinking objective, I wanted to know, “Okay, give me a technique that’s A, B, C, D, and if you see this, you do this. If you see that, you do this,” and it’s black and white. Once you learn and practice IS there’s no cookbook.

There’s no cookbook chiropractic, no.

There’s the art of it and sometimes I don’t know if you call it your intuition or sixth sense or whatever, but when you’re present with the child and you’re assessing them, things just show up and you see things and you analyze things through experience and everything else and you just are led to adjust certain things and areas of the spine as part of your technique and it just all comes together. So, I don’t think there’s a right or wrong way to adjust, but I think the key is to be really present and intentional whenever you are assessing somebody for nerve interference and that is even more important than like, “Oh, do you do this technique or that technique?”

Absolutely and I find because I work with a lot of special needs children, right? And kids and animals, they have that sixth sense. They’re there. They can figure out, figure you out really fast and they can figure out your intent and if you’re in there for the right reason and if you’re off, if you’re thinking about a text message or this or that, that they know and they will act up, they’ll respond to that manner. So, I think intent is very much key. You’re right on, spot on, on that and when we do the adjustment, it’s really resetting that information that the brain is processing and we know that now from so much of the research and so, I think whatever volume practice you can choose, if you’re doing it for the right intent, if you’re being specific, if you can reset that volume.

You know what else Monika? I think people are afraid that they don’t see a lot of kids. They’re afraid of pediatrics. I’m going to break, I’m not sure, what do I do with the kid? And I would say if anything, less is more. You can just way over adjust a kid and you’re not going to necessarily hurt them. You just won’t see them heal as fast.

Well, the adjustment’s so powerful and you have this big metabolic blast to the brain and they’re so overwhelmed sensory wise anyway and have these sensory gaps that you put that input into the brain, you put that adjustment and it’s extremely powerful and they can short circuit on you very fast.

Yeah and I think what’s really important is to understand because some chiropractors think that the mom or the parent is paying for what they’re physically doing on the table. So, the more I do is bringing value to what they’re paying for that visit.

And that takes us right back. You made it. That’s an excellent point because that brings us right back to how much we value what we do, right?

It is and you think you know what? My adjustment, I should get paid $90 a visit or $150 a visit. There really isn’t… I would pay $1,000 a visit if my kid needed it. I pay $1,000 to get him adjusted, I pay $10,000 if I knew what I know. There’s really no limit. It’s worth more than what you’ll ever get paid for it. It really comes down to finding something that you can serve people and that is reasonable. You’re getting paid, you’re getting reimbursed for what you should be to grow your business and market and expand, but ultimately we’re just, we’re in a service industry to serve people and they’re not paying for what you’re doing or paying for the results of what’s going to happen through your expertise in what you’re doing and it doesn’t even… That’s why there’s not a time thing.

Once somebody told me, I don’t know if this was an analogy or a story or what, but they walked up to Picasso sitting on a park bench and he was drawing something, a mural and they said, “Well, can you draw a mural of me?” And he just like in 20 seconds drew a mural of them and showed it to them and they’re like, “Wow, it’s amazing,” and he’s like, “Okay, $10,000,” and they’re like, “$10,000? It took you 20 seconds to draw that.” He goes, “But it took me a lifetime to learn how to draw that in 20 seconds.”

The more you learn, you think we’re just talking about the program that you have and I was super interested in it because I would like to know more about it. It’s basically a culmination of 30 years of your knowledge and information into that, which is exactly what it is. When you deliver an adjustment, it’s 30 years of your information and your knowledge and your experience into a few minutes or 15 minutes or however long it takes for you to assess and adjust that child. That’s the value. It’s not the physical of what’s happening and what you’re doing on that visit.

Yeah, exactly and the repercussions so profound of what we do. So, I think for young chiropractors, understanding your own value, it is very critical. So, if I were in an elevator with you and we’re doing the elevator speech thing. So, you have especially a new grad out there, somebody that’s wanting to or wanting to develop a pediatric practice or wherever they are in their career. Give me a ten second elevator speech of why we need to bring our kiddos in to get adjusted.

So, I have six kids. Four months old, three years old, five years old, seven years old, nine years old and 11 years old. So, it’s really easy for me to start conversations with parents that have kids. Once I find out they have kids, I just simply ask have you ever had their nervous system checked or their spines checked? And usually they’re like, “No I haven’t,” right? I’m like, “Well, you know what’s really interesting in the field of work that I do? That’s what I do, but it’s commonplace and common knowledge that we take our kids in and we get their heart looked at and we get the different systems of their body checked and maybe their blood drawn and we look for things and we do that proactively. We measure their height and their weight and we try to make sure that they’re staying healthy. When in their life do we look at the function of their spine or their nervous system?” And you can just let them respond and they’re like, “Oh, I don’t know. Probably never.”

Well, usually when they’re 35 and they have chronic low back pain and they come in and they have to generate a little lumbar spine and it happened when they were six when they fell off the park bench and they just never knew it because it took 30 years to happen or 25 years to happen. They’re like, “Wow.” So, what we do in our office, we have state of the art technology that allows us to assess the spine and nervous system, which is why we see hundreds of kids every single week because we can see is there an underlying dysfunction, something going on that we can be proactive with now help them stay healthy now so they don’t end up like that as an adult? And it really just allows us to see kids and optimize their health so they can live a long healthy life like we all hope to live too.

Awesome and we know now, we know from neuroscience, neurophysiology that chronic diseases, whatever label you want to give it, diabetes, heart disease, neurodegenerative diseases, they start 20 years before the symptoms show up and it’s all regulated by the nervous system and we know that the nervous system is the immune system. So, giving them that little tidbit as well as you give the analogy, they fell off the park bench and 30 years later they have degeneration, but also what other neurological compromise might they end up with 20 years down the road? And I get a lot that question like, “Oh my gosh, we can’t figure out why autism is on the rise,” and I’m like, “Really? I’m not a rocket scientist, but I study a lot and looking at all the stress factors that are on the nervous system now and we know that once that nervous system is dysregulated, the whole neurophysiological cascade from that.”

So, for you docs out there, I think tying that analogy as well as, yeah, 30 years from now we might see the neuro degeneration, degeneration, lumbar spine, but also what about other health consequences?

Yeah, you even talk about, I mean, most people, if they don’t have pain and symptoms, they don’t think there’s anything wrong.

Right.

So, you’re really educating them on pain and symptoms is just such a small indicator of nerve interference and a nervous system problem that if we can use objective findings and subjective findings to find and locate and remove, your function of your body’s just going to be better-

And the nervous system being able to adapt, when that adaptation, when we get narrow and narrow, now we can no longer take that extra stressor that’s coming in and the nervous system can’t adapt anymore and that’s when they see symptoms then. That’s when you start having the headaches or chronically getting sick or whatever.

And you know what else? Bringing that up, I think as chiropractors we’re used to seeing people come in with a condition or some sort of symptom and then we provide a solution to that symptom and it’s easy to sell them a solution to the symptom and the problem because they’re fighting it and it’s affecting their life. When the reality, if they really understood what we understood, they start care and they pursue care not to fix the symptom, but for the lifelong benefits of what you’re going to do and the side effect of what you’re going to do is probably going to help the symptom, it’s going to help so many other things for such a long time that just makes sense to do that, instead of just going to treat the symptom.

Exactly.

It’s just a mind shift, but if you can, you can get them to think before they even start care, then you don’t have to always be selling them on… You’re not selling them on we’re going to fix your problem and then, “Oh by the way, you should keep coming forever.” It’s selling them on what are we even doing and why are we even doing it? The side effect of that is yeah, your problem is going to improve probably and go away, but it’s even more important that we do this and this is really why you should be doing chiropractic.

Exactly and what I always tell him, I say what I want to do is you’re coming in for X, Y or Z, but most illnesses start 20 years before they show up as a symptom. So, what we want to do is take care of the hare now, but keep the train on the tracks before it derails because once it derails and it’s harder to get that train back on the tracks, that’s when you end up with something, the big, bad, ugly stuff that we don’t want to see and then when they think of that like that, especially when they’re starting their little fiddle farts out right at birth, how we want to keep that train smooth and on the tracks and not derailed and end up with some label that we all know, the labels that we hit now, the autism and ADD and ADHD and et cetera and they get that. Do you find that? They get, they understand that.

Totally. So, let me ask you this and I took your classes through the ICPA 11, 12 years ago.

A long time.

When you take them as a student, it’s like way over your head and so much information. You’re like, I don’t even, I caught 10% of that and out of all the things that you’ve learned over the years and your experience, how do you tie, what would your elevator pitch be without just going way over their head so they don’t even know what you’re talking about?

Oh, good question. I like to talk to them about how there’s a connection between the brain, the body and the body and the brain. The brain needs to be able to perceive the information that’s coming from their outside world and within their body and the body sends that information up to the brain so the brain can know how to respond appropriately. So, let’s say your little fiddle fart is sitting in class and needs to concentrate on math or getting information from the Blackboard and copying it down. The brain is expecting a certain amount of information from its environment, including its own, including the body to come up and then the brain interprets that information and sends a response back down in motor response. So, I know how to hold my pen in space, how to focus my eyes up and down to grasp that information.

When we have a subluxation, when there’s not that, the information coming into the brain is skewed from the world or the body, there’s a gap in that information and the brain wants to help the body be able to adapt to that gap so we can do what it’s supposed to do. So, what that might look like is your little fiddle fart has to move around a lot in class. So, we get enough of that information coming in or they like to pinch or push or pull, that’s getting that gap filled so that they can try to sit and do the tasks that they need to do and what chiropractic does, it helps build that gap and that really makes sense for a lot of people that I work with because so many of their kids are struggling with learning and behavior.

And that’s awesome and that makes so much sense. I think the parents explaining it like that. As an engineer, I love explaining it to people in whatever their profession is too. So, what’s fun is to find out what the parent does, but the parents in automotive or something because when they teach you in control systems and engineering, they have A-Farrant and E-Farrant communication back and forth to the control center. It’s the same. I took chiropractic school, it’s like, “Oh my gosh, they’re talking about A-fare and E-fare control. It’s a control system, but it’s just the brain and it can heal itself.” How amazing is that? But you could talk about, you can relate that to anything like as a car. Oh, there’s all these sensors on a car now that tells you whether you’re going to hit somebody or run in. If the sensor is not working properly and the car doesn’t know that you’re about to hit something and it doesn’t tell you and you’re relying on it, you’re going to run into something.

Absolutely. The latest one that I started using was that there was two planes that I forgot what airport and one was a Delta plane and it came and landed and wasn’t supposed to land because another plane was taking off. This was just a couple of weeks ago. Well, when it landed, it ended up blocking the runway of the plane that was going to take off and you heard the radio control back and forth from the air traffic control to the pilot of the plane that was blocking the thing, he says, “Oh, I thought you said I was cleared to land,” because there was almost going to be collision there. That’s what’s happening with the brain.

Totally!

And if you don’t get that good communication, you’re going to end up with a big crash at some point. So, I’ve been able to use that. People are like, “Oh, I get it.” So, there’s a lot of fun things and I think you do that in some of your programs. I do that in my programs and that’s what we’re really all about is how to bring it down and simplify it so docs can be as successful out there. So, if you’re listening docs pick up on some of this lingo, whatever resonates with you and start simplifying it, but also don’t lose value of the big picture of what you are providing. I think that would be… So, where do you see the future of pediatric chiropractic? What do you think?

Interesting. If you Google search pediatric chiropractic, you get just a ton of videos of people adjusting babies, which can be misconceived, perceived and totally taken out of context and used almost against our profession like it did in New Zealand. So, I think if you haven’t, have you seen the new Vacs 2 movie yet?

Yeah.

So, there’s enough research out there just like there’s enough research that proves that subluxation exists and what it does, but they’re always going to say there’s never enough research. Not saying we don’t keep doing research, but they’re always going to refute that or they can look at the research and say, “Well, it’s not the gold standard because of this,” but if you have, if you remember seeing all of those parents sign the bus for all their damaged vaccine injured kids, if you have enough parents and testimonials of people saying, they say, “Oh, that’s anecdotal,” but you get enough of it, if all of us, there’s 25,000 chiropractor’s email on this show. If all of them just did 10 testimonials a year, pediatric testimonials, that’s 250,000 pediatric video testimonials. If we did 10 a year and put them online, not what you’re doing and how you’re adjusting them and all of that stuff, but the parent with their child saying, “Here’s Johnny. This is what happened. This is what he was like. He got adjusted. He had subluxations removed. Now, this is what Johnny is.”

You times that by 10 years, you have two and a half million videos of people with testimonials in chiropractic. It doesn’t matter what they say that it doesn’t work. That’s just such an overwhelmingly amount of evidence to prove that enough that parents are going to like, “Man, maybe this is legit, maybe I should check it out.” So, I honestly think big mission vision wise, we need to just fix the perception of what chiropractic here is and that subluxation isn’t real and isn’t a thing. It doesn’t make sense. It doesn’t work and that we should just be focusing on low back pain and I think we do it through testimonials and video testimonials and social media and an online presence of truth and parents actually telling the story and showing what happened to their kids. I think that’s how we’re going to fix it.

Good job. In fact, I’m doing a workshop called Misperceptions. It’s open to the public and I’ll shoot you that link too doc and maybe I’ll put the link on this page too about brain-based chiropractic and again, a couple of weeks. So, how we can shift that perception and how we can talk about it differently and in that how we can do campaigns like this to really get the word out. That’d be awesome.

Yeah and what’s so interesting is it’s just learning. As a chiropractor it’s just learning how do I educate more effectively? How do I communicate the effectiveness and the power or what it is that I’m already doing? And as we were talking earlier, your program, developing minds, you were mentioning how you guys do clinical rounds where for a couple hours you all get together and talk about cases and stuff. Let’s just, the more you are so certain in your heart of certain things, you can communicate just with certainty. Like, “Hey, this is what I know. I can help you,” and give them hope. It improves your sign on rate, it improves your conversion and it improves your attention and it improves your-

It improves your outcomes overall.

Yeah, totally!

Where it’s at and that’s what you’re doing and I know Allen’s probably like, “We got to wrap this up a little bit soon,” but we could go on forever and ever, but thanks for taking time out of your Thursday, your third Thursday schedule and I’m sure we can revisit this again down the road, but thanks for the pearl bombs. Thanks for your first Thursday. Now I don’t have to reiterate that as I usually do at the end of the show, that makes sure you watch Eric’s show the first Thursday of every month and he drops pearl bomb after pearl bomb and we’ll definitely have to make this another round too one time.

Totally. I would love to and don’t forget that. I mean, a lot of you guys watch Monika, but what she’s doing and what she’s totally progressing with the profession is huge and so, she doesn’t really promote herself that much. It’s called Devminsu.com. D-E-V Mind. M-I-N, S-U.com. It’s their whole university she just launched in October and it’s awesome and I would encourage you to check it out and just continue to learn more to just serve more people. So, I’m giving you a plug because you don’t plug yourself enough-

It really is about certainty. You hit the nail on the head. The more we own it, the more certain we are, the more we can serve. So, certainty is serve, right?

That’s right.

Hey doc, you have an awesome new year, but we will come back and circle back at one point in time and get together again and again, don’t forget to watch Eric the first Thursday of February. He’s going to blow your socks off with some more information and again to Chiro Secure, thank you so much for allowing us this platform and really digging in to try and make a difference because bottom line is Chiro Secure, all the docs on this show, everybody is really out there with a huge heart and a huge commitment to chiropractic and to make a change. So, I’ll see you the third Thursday of February and until then you guys go out there and keep changing lives.

See you.

Bye.