Gaining Ease #23

Dr. Mike Totta:

If someone took a hammer and broke your leg, all right, and then you stood up and walked, well, that would hurt like hell. Okay? So every time you walked, it hurt. And you could go to someone and say, doctor, every time I walk, it hurts. And the doctor would say, well, walking caused your problem, but in fact, you know, it obviously did not. So I think in general, spine problems are not caused by activity. They're aggravated by excessive activity or incorrect activity.

Dr. Bob Lynch:

You gotta be in balance. You gotta have your head. Your head's gotta be solid emotionally. Because we're just. When you really break it down, we're just energy. And if your energy is off, then it can lead to disease and disease.

Chris Bicknell:

One of the reasons why I continue to do this work is because I see young people are struggling the way that I did, and I want to be able to say, you know what? You don't have to do it alone. There are resources. There are people who care. You can make it out in the world.

Dr. Lisa Belisle:

Hello, this is Dr. Lisa Belisle and you are listening to the Dr. Lisa Radio Hour and Podcast on Sunday, February 19, 2012. This is show number 23. Our show is called Gaining Ease. And actually, you may not be listening to it on Sunday, February 19, you may be listening to it via podcast. Today on the Dr. Lisa Radio Hour and Podcast, we are going to be speaking with Dr. Michael Tada of the Spine center at Orthopedic Associates in the Portland area, Dr. Bob lynch of Lynch Chiropractic Arts center in South Portland, and Chris Bicknell coordinator of the Teen center and Lighthouse Shelter at Preble street, also in Portland. It's going to be a good show and I have my co Host Genevieve Morgan sitting across the microphones from me.

Genevieve Morgan:

Nice to see you, Lisa.

Dr. Lisa Belisle:

Good to see you. And we're all ready to go into our. What we've been calling our deep dish.

Genevieve Morgan:

I'm excited about this one because I've been having a lot of back pain lately. So I'm interested in how we're going to gain ease today, what our guests have to say.

Dr. Lisa Belisle:

Well, this is interesting to me because we initially were going to cause we were going to call this something like pain. I can't remember exactly what the show theme was going to be.

Genevieve Morgan:

Oh, it was going to be pain.

Dr. Lisa Belisle:

Yeah. Something about pain. Because there's. Pain is pain. We do, however, like the notion that there is a possibility of gaining ease through the pain. So this is what we are trying to provide people with by bringing on individuals who can talk about gaining ease. We have two people who will speak to gaining ease through pain in the spine, pain in the body, and then we have another individual who talks about gaining ease through finding things like food to eat and a place to sleep.

Genevieve Morgan:

Well, I think when you are in a state of dis ease, it's really important to know that it's not going to last forever, or in most cases, not going to last forever. So I love this show because for people who are out there listening, who are currently in a state of pain, that there are answers out there and that they aren't necessarily always going to feel the way they're feeling right now.

Dr. Lisa Belisle:

Yes, that speaks to something that I believe is very important and that is hope. When I have patients who come into my practice and they have been told you are the way you are going to be for the rest of your life, and whether they're in pain or whether they're in a time of just great sorrow, grief, loneliness, they don't want to hear that. And I think it's really wrong of any. Anyone to assume that any other human being is always going to be the way that they're going to be. Now, if you have lost a limb, then clearly you're not going to regrow your limb. But the fact that we limit ourselves by assuming that we will always continue in the same patterns, on the same path, doing exactly the same thing and have the same types of pain, I just don't believe in that. And that's why I believe in hope. And that's why we're doing this show on gaining ease.

Genevieve Morgan:

Well, and certainly chronic pain is rampant throughout our society. And it's also one of the things that get people on the medical Merry go round where they go from doctor to doctor to doctor to doctor to doctor, trying to figure out what's causing their pain. And they get all these tests done and there's no solid diagnosis. And I think it leaves people in a really hopeless place because most people, when they're in pain, do seek help. It's just often the help doesn't come back at them. Where does your practice step in?

Dr. Lisa Belisle:

My practice is a unique one in that I often will take on what other providers might consider the hopeless cases. And they tend to be the cases that, believe it or not, respond the best. Because there are some cases, yes, of chronic issues, structural problems. People will come in and they'll say, I've had this for my entire life, and I may or may not be able to fix that, but I can often help with sort of the circumstances surrounding that pain, that nidus of infection or that inflammation that's been so chronic throughout their years. The other thing that my practice offers is a listening ear, which often is the biggest problem. You talk about this medical merry go round, and if you're a patient who has a problem that hasn't been solved through surgery or rehabilitation or medication,

Chris Bicknell:

you

Dr. Lisa Belisle:

become the problem patient. And most patients who become the problem patients and who have a legitimate concern, that's a bitter pill to swallow that all of a sudden, because they actually have a problem that needs to be solved, they are the problem.

Genevieve Morgan:

And people hear that, oh, well, your pain's all in your head. Well, okay, so it's in my head, but it still feels really painful.

Dr. Lisa Belisle:

Yeah, it is still a very legitimate problem. And often, even if I can do nothing else but this, I will listen. And this is something that, you know, if you're a busy medical practice and you're a medical care provider and you do care about your patients, but you have to see a patient every 10, 15 minutes, or you have to schedule out six weeks, or, you know, you have this sort of barricade of front office staff that's really doing their best to help you, but they're kind of holding out people who need to be seen. Then you have the frustration of not being able to help your patients. And what I am able to do in my office, and it's by virtue of the way that I've structured it, is I give people the time to come in and tell their stories and talk about the sort of social and family and emotional ramifications of whatever problem that they have, and then we can start to untangle things a little bit. And it's so multilayered pain is so multilayered, just like psychological.

Genevieve Morgan:

And Chinese medicine takes that global view of everything, but also of pain, and so does Ayurvedic medicine, that pain is not just a mechanical problem, it's a mind, body problem, but that it's individual to every person. Is that right?

Dr. Lisa Belisle:

Yeah. There are certain patterns that have been observed in Chinese medicine over the thousands of years that it's been out there. It's interesting to study Chinese medicine because people think, oh, you just, you know, how easy is it? You stick a few needles in people at various places. There are volumes and volumes of texts out there that discuss pulse diagnosis or tongue diagnosis or skin diagnosis. I mean, in Chinese medicine, similar to Ayurvedic medicine, they've been practicing observational medicine forever. And this is the benefit that we have, so we can individualize it. It's not as simple as, oh, you have hypertension, take this medication. We can get down to very specific reasons for hypertension, very specific reasons for back pain, neck pain.

Genevieve Morgan:

So you could have two patients come in in a morning that each have the same disc herniation, an L5 disc herniation, but their root of their pain is completely individual and different, and the treatment will be completely different.

Dr. Lisa Belisle:

That's right.

Genevieve Morgan:

Well, that's really encouraging because it means that if you're sitting there in pain right now, that you are the instrument of your own healing.

Dr. Lisa Belisle:

Well, and that is very true. I know that Chris Bicknell is going to talk about this and even Bob lynch is going to talk about this. The fact that you make choices, you choose to continue to seek healing, you choose to continue to show up. And this is again a theme that goes over and over and over again. We talk about, show up, show up, show up, keep showing up, don't give up, show up. In Our Daily Tread, the book that we read from on occasion to benefit Safe Passage, the quote from Martin Luther King Jr. Is one that really rings true. The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy. Now, Martin Luther King Jr. Is talking about this from more of a societal standpoint, but it's also where you stand in your life when you are undergoing troubles or when you have pain. And if you have decided that, okay, I'm going to accept the label that everybody has given me, that I'm a hopeless case, that I'm a problem, then you're going to feel very differently than if you've decided that, you know what I'm going to look at this as an opportunity, as Susan Connolly did in a show a few weeks ago that she had this. She had breast cancer. She was living in China with her husband and her two sons. And this was an opportunity for her to live a bigger life.

Genevieve Morgan:

It's true. And when you're in pain, it's hard to see that. But I think small changes and small choices just get you further down the path. And as you've said before, that you show up for the small change and then it makes it easier to make the next change. And I know in my case with my back pain, one of the changes I've made is that I'm not driving as much because when I drive my back really hurts. So for the time being, I'm just not going to drive, which means I'm walking more. So that one small change then starts to help.

Dr. Lisa Belisle:

And these small changes that start to help can also give you a chance to look at something that might be going on that's deeper in your life. What might be causing some of this pain, whether it's psychological pain that's impacting physical or physical pain that's causing psychological pain. You and I have talked about Ayurvedic medicine and the different chakras and that your first few chakras are the sort of foundational chakras. This is sort of the need for food safety, all of the things that keep you just foundationally secure. And in Ayurvedic medicine, which evolved actually from Chinese medicine, there is this notion that if you can't get the foundation solid, then everything above it is going to be shaky.

Genevieve Morgan:

Well, I brought in this great book by Carol Truman called Feelings Buried Alive Never Die. And can I tell you what she writes about back pain? Back problems are feelings of no support, having difficulty coping with emotional difficulty, feeling burdened emotionally, feelings of frustration and wanting to get someone or something off your back. So that's exactly what we're talking about, that you have a mechanical problem, but you may also have unconsciously some of these deeper rooted things. I'm trying to figure out what I have against my car, but clearly there's something related to that.

Dr. Lisa Belisle:

Well, if it's as simple as your car, then you're pretty golden. And when I do acupuncture on people, the meridians that run up and down the back and actually in the core of the body are again, very foundational. In fact, the ones that run up and down the back themselves are the bladder meridians. And we've talked about the Kidney meridian. And that's your very of inborn qi, your inborn energy. And the bladder and the kidney are related.

Genevieve Morgan:

What are the bladder Merinians?

Dr. Lisa Belisle:

Well, this is again, it goes back to there's five elements and the kidney and the bladder are associated with the element of water, and that's the winter. And the emotion associated with it is fear. So it's also wisdom. So if you're feeling secure, then you feel more wise. If you're not feeling secure, you feel fear. And I do see this, that, and actually the knees are another thing that are associated with this particular set of meridians, the bladder and the kidney meridian. If your foundation is insecure, your knees want to buckle underneath you, you just aren't able to kind of keep holding up this life of yours that you've entered into. So I think there's a lot of crossover between all the things that you're describing.

Genevieve Morgan:

Yeah. And when you mention the chakra, the first, second and third chakras that go from the seat of your spine well up to the third is about the center of your belly. They're about survival, creation and power.

Dr. Lisa Belisle:

Well, and that is why we have the show every week is so that we can inspire people to not only survive, but create and gain power in their own lives. And this show, we're very excited about gaining ease. As I said, we'll speak with Dr. Michael Tada, Dr. Bob lynch and Chris Bicknell. We know that people will not only gain ease, but also be inspired.

Genevieve Morgan:

Looking forward to it. I'd love to gain some ease.

Dr. Lisa Belisle:

We at the Dr. Lisa Radio Hour and podcast are pleased to have a segment we call Wellness Innovations, which is sponsored by the University of New England. Today's Wellness Innovation comes from Psychology Today and may be found on the Dr. Lisa website. This is called chronic pain versus the brain. How does a person become a chronic pain patient? Researchers used magnetic resonance imaging MRI to demonstrate that individuals with chronic back pain had alterations in the functional connectivity of the cortical regions compared to those individuals not suffering from chronic pain. Interestingly, these areas of the brain are unrelated to pain. And this altered brain function leads to additional and unwelcome diagnoses such as depression, anxiety, sleep disturbances and decision making difficulties. In the healthy brain, all the regions exist in a state of equilibrium. When one region is active, the others become quiet. In contrast, those with chronic pain experience continued activity in the frontal part of the cortex of the brain associated with emotion. These are disturbances of the brain not directly associated with the sensation of pain.

Dr. Lisa Belisle:

This week's show we've called Gaining ease, show number 23. We were going to call it something like pain, but we thought let's think positive. And in a positive vein, we have Dr. Michael Tada, who's going to come in here and talk to us about back pain. Thanks for coming in, Dr. Tada.

Dr. Mike Totta:

Good morning. Thanks for having me.

Dr. Lisa Belisle:

And we have Genevieve Morgan, who's sitting next to me.

Genevieve Morgan:

Hi, Dr. Tada.

Dr. Mike Totta:

Good morning.

Dr. Lisa Belisle:

I should say before we start that it's always interesting when worlds collide that you and I have had children in the Armouth school system. Well, we used to. Now they're all graduated. Our sons played baseball together and your daughter graduated with my son. And we even have a safe passage, our daily tread relationship. So it's very interesting to have you in as an expert and you're truly an expert in this field, but also have this whole backstory, this whole Yarmouth thing. It's a small world. Maine is a small. It's a whole big small town.

Genevieve Morgan:

I like that backstory.

Dr. Mike Totta:

It is a very small world.

Dr. Lisa Belisle:

It's a good backstory and it is a backstory. Oh, gosh. Oh my gosh. Did we just do a huge pun? Thank you for that, Genevieve. All right. Clearly this is the first interview of the morning. You have a very impressive background. What I'm interested in is this physical medicine and rehabilitation residency that you did at Temple. You work as the medical director at the Orthopedic Associates Spine center. And one might think you are a surgeon, but you're not, correct?

Dr. Mike Totta:

No, I'm the medical director and I play a role in directing the medical therapy for spine problems, of which there are a lot of folks who need more medical therapy than surgical therapy. So we're very busy.

Dr. Lisa Belisle:

Well, you are very busy. I know that to actually get into your practice, there's this, there's a process, there's faxing things over and referrals. And you have so many people that have back issues that want to see you that it has to be triaged.

Dr. Mike Totta:

Back problems are very common, extremely common. And non surgical back problems are extremely common. So there's a saying among non Surgical spine physicians that if you have a friend that you want to refer for a back problem, you send them to a doctor with a really long waiting list because that way they get better on their own and they don't need anything done. So we think that we're doing a community service by keeping people on a long waiting. I mean, I'm joking.

Chris Bicknell:

I'm not serious.

Dr. Lisa Belisle:

That's good to know. But it is an interesting truth is that a lot of back things will get better on their own.

Dr. Mike Totta:

A vast majority, yes. It's sort of an interesting concept that I'm based in a surgical practice, despite the fact that spine problems are predominantly a non surgical problem.

Genevieve Morgan:

And aren't people's thresholds for pain different?

Dr. Mike Totta:

Oh, unquestionably pain is. You know, every now and then a patient will stay in my office and say to me, you know, exasperated doctor, it's not all in my head, is it? And of course I look at them with a concerned look in my eye and say, of course not. But in my brain I'm saying, yeah, it is. Sure it is. Pain is a perception. Pain is something you feel in the uppermost thought process of your brain, the most developed area of your brain. So in essence, it is all in your head. All pain is, quote unquote, psychological. It's influenced by psychological things. You know, of course, if I light your foot on fire, that's real pain. That's caused by what we call a nociceptive or a neurological source. But what's interesting is it's now very clear that there's pain that's generated and the perception of pain that's changed by neurological processing. So essentially things that are in your head and not so much in your body.

Dr. Lisa Belisle:

I see this a lot in people who have had pain issues for a while, that when they start to do things, when their lives start to start to sort themselves out and they sort of get busy doing something else. And this is not everybody, because some people have real anatomic problems and real physiologic pain. But there are some people who have some low lying something, and once they start to sort things out, the pain kind of goes away. Do you see that?

Dr. Mike Totta:

Oh, Lord, yes. There are two really brilliant thinkers in my field. One is Dr. Waddell, who medical students, and you may know this yourself, he's an orthopedist from Scotland and he developed some physical exam maneuvers as well as some historical information databases that show that there are certain ways that people communicate what he calls psychologic distress. Okay. And I think that's kind of what you're doing. You're dancing around in your comment. And psychologic distress is essentially. It's not that people are crazy. It's defined as an acceptable way of communicating psychological unrest through physical symptoms. Another word that we use is somatization, or mental issues creating physical manifestations. And that is so real.

Genevieve Morgan:

Well, for example, if you really don't like your job all of a sudden, you might, every time you sit down at your chair in front of your desk, feel back pain. Is that sort of what you're. For the people listening out there, that might be what you're.

Dr. Mike Totta:

Absolutely, absolutely. The second guy who's a brilliant thinker is a guy by the name of John Sarno, who's a physical medicine doctor from nyu. I think he's still alive. He must be in his mid-80s. I've never met the man personally, but I've read several of his books. He is way out on the far end extreme of thinking about back pain and disability related to spine as being predominantly psychological. What Sarno believes is that some people, because it's not socially acceptable, you know, to go out on the street and, you know, start ranting and raving, that people communicate their rage through physical problems.

Genevieve Morgan:

Well, Sarno brings up a good point that in the 50s, everybody had ulcers. You know, stress was. Was expressed as ulcers. But now in the 21st century, it seems to be back pain. You know, ulcers have gone.

Dr. Mike Totta:

Taken a dive.

Genevieve Morgan:

Right?

Dr. Mike Totta:

Yeah, yeah, yeah. And it's not because we're drinking less coffee or, you know, whatever else you think is going on with ulcers. But yeah, it's an interesting phenomenon, the disease of the decade. The most prescribed drug in the United States right now is Vicodin Hydrocodone, which is a narcotic pain medicine. The most prescribed drug in the 1970s, when I was in high school was Valium. Okay. You know, mama's. Was it a Beatles song or something? Mama's Little Helper's Little Helper, yeah. Mother's Little Helper. Right, right.

Genevieve Morgan:

Rolling Stone.

Dr. Mike Totta:

Roll. It was. Okay, sorry. Yeah, yeah, sorry. I'm not a rock historian, but, you know, these are sort of reality manifestations of again, the psychology, the genetics of human beings have not appreciably changed since the 1970s. So it's a cultural issue.

Genevieve Morgan:

So what are some of the non surgical, aside from getting a prescription for Vicodin? Because some of the treatment for back pain is sort of counterintuitive. You're in a lot of pain and you don't want to move. But actually, in our conversations, moving seems to be the thing that helps.

Dr. Mike Totta:

Correct. When I went to medical school, it was just starting to change from the old culture of the 50s and 60s where if you had back pain, I mean, literally just back pain, you could be admitted to the hospital and put in traction for a week. You know, those are the days before HMOs and cost concerns. But what they found is that that didn't really help people. And there's an awful lot of what's done in spine that is artistic. Okay. Lisa will tell you there's something that doctors hide behind. Okay, I'm probably going to lose my medical card. I'll be out of the fraternity for saying this, but doctors say, oh, it's part of the art of the practice of medicine. That sounds really good, doesn't it? It's like, that's a beautiful thing. You're an artist. Okay. Well, what that really means is we don't have scientific information to base what we're doing this on, but we think it works, so let's just do it that way. And this is my art. This is my practice. Well, really, medicine is supposed to be science. And there's a big push these days for something called. I'm blanking on the word evidence based medicine.

Dr. Lisa Belisle:

Evidence.

Dr. Mike Totta:

Yes. Evidence based medicine is sort of the new catchphrase. And basically what that implies is that you have a scientific basis for what you're doing. So what they did was they studied the concept of spine pain and activity, and they found very clearly that when patients were more active, they're as a population, as a scientific study, not as individuals. Okay. But as a population, people were better off being active than sedentary when they had spine problems.

Dr. Lisa Belisle:

Why do you think that is?

Dr. Mike Totta:

Well, on the same vein of evidence based medicine, there are things that I know scientifically and there are things that I believe. So when I give lectures, I actually have a slide of Dr. Or not Dr. Guido Sarducci. Remember the priest on Saturday Night Live? Because half the things I say, maybe half the things are science and the other half are religion. It's what we believe. So I think you're asking me what I believe. I don't know this for sure, but my suspicion is that activity does two things. One is it improves blood flow to the spine. The spine is a passive area of the body. Discs and bones and joints can't do anything by themselves. They're victims in a drive by shooting to muscle function and tendon function and neurological coordination. So I believe that activity number one improves blood flow. And we know when there's structural damage anywhere in the body, the body's ability to heal is related to the blood flow. That's why your skin heals really well. But maybe ligaments and tendons don't heal as well. And things that have very poor circulation in them, like discs, heal extremely slowly. So that's the issue. You want to get nutrition. Secondly, I think that exercise does a little bit of what you talked about earlier as far as getting active. All right? There's all this neurological feedback that goes to our brains, you know, this whole area that processes pain. And when you're active, you get a completely different type of sort of sensory bombardment to that area. And I think it actually inhibits pain the same way when you hit your thumb with a hammer and you rub it, it inhibits pain.

Dr. Lisa Belisle:

And perhaps there's some sort of serotonergic, some sort of neurochemical, something that's sort of bathing the neurons in a way.

Dr. Mike Totta:

Absolutely. Again, we visualize the brain as being some sort of magical thing. There's magic going on. And a friend of ours, actually from Yarmouth, Kent Pierce, who's an author, I love the way that he looks at things he doesn't understand, and he just says it's magic. And yeah, it's probably magic in the brain, but it's based in chemistry, it's based in electricity, you know, the concept of nerve signals. Nothing. Nothing. I'm becoming less of a believer in magic, but more of a believer in realizing I don't understand it.

Dr. Mike Totta:

A vast majority of medical issues like spine pain could be explainable with science if we had the tools to measure what the variable is. I think a mentor of mine once said that evidence based medicine and randomized controlled trials, which is the fancy scientific name for good science studies on medical Things are easy to do if you want them to turn out negative. If you want to find out that nothing works, it's really easy to prove that nothing works. What's hard to prove is when things do work, but you don't completely understand why that becomes much more difficult. Because human beings aren't like a physics lab. You can't control all the variables, and that's the problem. So, yeah, a lot of you can say that I absolutely have to do everything based on science. But then you're facing a patient in your office, and you need to do something for that patient today.

Genevieve Morgan:

When a patient is in your office, though, complaining of pain, regardless of the origin, you have to find ways to ease that pain. So what is the protocol?

Dr. Mike Totta:

Well, the first protocol, because I'm a medical doctor, I'm going to look for a medical or anatomic source of pain. And oftentimes when a patient gives you a history, their problem is fairly evident just from what they're telling you, just from the experience of seeing thousands of people. You know, when someone complains of a certain thing, it's more likely to be one thing or another. So we first get a history first, get the information that helps to lead us, Then we'll do a physical examination. Physical examination for spine problems is frequently overrated. There really aren't a lot of things you can find that really mean very much, but there are certainly some things. Numbness, weakness, movement problems, either because of pain or because of a physical blockage of movement. That's all data that you can put together with their history. And then being in the modern area where we have X rays and fancy stuff like MRIs, you get imaging data, you can see inside people, and you put those three things together to come up with a tentative diagnosis.

Genevieve Morgan:

Okay. And then once you have a anatomical problem or your solutions are far more towards therapy, activity, rest and activity, as opposed to any kind of intervention.

Dr. Mike Totta:

Yeah, surgical intervention. Most of the time, the first thing that you do is you modify activity. And by modify, I don't mean either turn it on or turn it off, but sometimes change it, because, again, we believe. All right, here's the religious thing again, that there are certain types of activity that promote good spine health, and there are certain types of activity that may not. And that can be an individual thing, depending on what the problem is with the spine and what the. The predisposition is that someone has genetically, all right, their posture, you know, their muscularity, et cetera, et cetera.

Dr. Lisa Belisle:

It seems to me that one of the reasons you may have come to this way of practicing medicine is perhaps through your background. I mean, you were training with the US National Rowing Team, and you were selected for the 1983 Pan American Games team. So you have a very personal interest in the physical.

Dr. Mike Totta:

Oh, I do, very much, yeah. And I had back problems. In fact, most rowers have back problems at one point or another. But I actually had to stop rowing right after I moved to Maine. And looking back on it now, it may have had to do with the psychological distress of having two young children and a busy job. I don't know. Maybe. But, yeah, that's what actually piqued my interest in spine problems, because I looked for help for my spine problem, and the help that was out there was essentially surgical. So either you needed surgery or you didn't. And, in fact, I went down to Boston, this was in 1992, and saw the son of one of the most famous orthopedic spine doctors in history, basically the guy who discovered disc herniations, which is an amazing thing. It was cool to meet the guy. But he looked at my X rays. At the time, I was 34 years old, which I consider remarkably young now where I'm sitting. But he looked at my mri, and then he looked at me. And this is, frankly, even before he said hello. So it was also a lesson in etiquette for me. And he said, well, if you were playing for the Boston Red Sox, your career would be just about over by now. And so I'm looking at the guy going, okay, this may not work out so well. He said, well, you know, what you really need to find is a physical therapist. Good luck. And, you know, he could give me no information. There was no communication between my relative ignorance and this need for extreme procedure like surgery. So there's this big void in the middle, and that's the void that I fill in my practice, that people who do what I do.

Dr. Lisa Belisle:

Phil, so you've talked about the need for physical activity when one has a back problem, but it sounds like your back problem might have come from excessive physical activity. Is that true? Is there a too much that goes on with this?

Dr. Mike Totta:

Yeah, and I wouldn't probably use the term that too much activity caused my back problem, but it's sort of like if someone took a hammer and broke your leg, all right, and then you stood up and walked. Well, that would hurt like hell. Okay. So every time you walked, it hurt. And you could go to someone and say, doctor, every time I walk, it hurts. And the doctor would say, well, walking caused your problem. But in fact, you know, it obviously did not. So I think in general, spine problems are not caused by activity. They're aggravated by excessive activity or incorrect activity.

Genevieve Morgan:

How do you take care of your own back now? What are some tools?

Dr. Mike Totta:

Stretching, strengthening exercises, postural awareness and activity. There's absolutely no question that when I spend time inactive, long car trips, a few days of traveling somewhere where I'm kind of off my obsessive exercise routine, my back hurts more. Now is that psychological distress from being out of my routine? Maybe, I don't know. But it's a combination of things. It's rare that someone can put their finger on a single thing that makes their back problem better. But ultimately you have to address, I believe most patients have to address their genetic predisposition to back problems. Obviously you can't change your genes, but what you can do is you can work very hard at modifying the things that put you at risk. And that tends to be activity, exercise.

Dr. Lisa Belisle:

How can people find out more about your practice and the Orthopedic Associates Spine Center?

Dr. Mike Totta:

Well, we're on the Internet orthoassociates.com we have a fairly good referral relationship with most of the of the primary care physicians around town. So if you go through some of the basic measures that any good primary care physician will use to help your spine problem and things aren't going well, you may end up referred to us. But we're happy to answer people's questions if they contact us directly.

Dr. Lisa Belisle:

Well, it's been very interesting to speak with you today. We've been talking with Dr. Michael Tada who is the medical director of the OA Spine center here in the Portland area. We appreciate your coming in.

Dr. Mike Totta:

Thank you very much.

Dr. Lisa Belisle:

One of the ways in which I find ease in my life is to write on a fairly regular basis. It's become part of my, part of my hopefulness, part of my ability to be a physician and a parent and live in this world. And I share my writing on the Bountiful blog which is available on bountifulpath.com this week's post is a uniquely personal one and one that does speak to the core message of gaining ease. It is called Friends I Never Knew I Had and it is from January 28, 2012. It is uniquely concerning to receive a text from one's child describing potentially life threatening illness symptoms. Headache, stiff neck, fever, lethargy, vomiting. These are not a good constellation of descriptors, especially when one is a physician who has both treated and seen the aftermath of meningitis. The illness often associated with the constellation of aforementioned descriptors. Now add in the fact that one's child is roughly 2,334 miles away in a third world Central American country, and that one's child is barely 18 years old. As you might have guessed, I received just such a text. The past 48 hours have been interesting to say the least. My child is currently in a Guatemalan hospital awaiting the final results of his spinal tap. Fortunately, preliminary results were negative for meningitis and he's scheduled to be released today. The presumed diagnosis, sinusitis, is much less severe and more easily treatable than the one I had feared. To know that my baby was far away and I was completely unable to help him certainly gave me pause. What also gave me pause was that both his roommate's mother, Jan, and his roommate Nico, contacted me via Facebook to give me updates on my son's condition. Both offered up Nico's contact phone number. Nico told me he was taking time off from work to make sure that my son was okay. Keep in mind that I've never met Jan and spent only brief moments of time with Nico during my visit to Guatemala last Thanksgiving, but these kind souls became, in my moments of parental concern, the friends I needed. They were friends I didn't realize I had. We should all be so fortunate as to be loved by those who owe us nothing. Our lives, even when seemingly threatened, often reveal themselves to be surprisingly powerfully blessed. Read this post and others like it@bountifulpath.com

Dr. Lisa Belisle:

Well, we're going from one means of gaining ease to another. We spoke with Dr. Michael Tada of the Orthopedic Associates Spine center and and now we're heading into our Maine Magazine minutes with Genevieve Morgan and she will be speaking to a very different sort of healer. Genevieve.

Genevieve Morgan:

Thanks Lisa. In the studio today we have Bob lynch, who is a second generation chiropractor who has been in practice in South Portland, Maine since 1976 when he joined his father in practice. His practice has been A full service chiropractic office. And he tries to live the philosophy of his profession, which is the body has the innate wisdom to heal itself if given the opportunity, which is very much what Dr. Tada was talking about. Welcome, Dr. Lynch.

Dr. Bob Lynch:

Thank you.

Genevieve Morgan:

Who needs to seek out chiropractic care?

Dr. Bob Lynch:

I would think anybody with a spine,

Genevieve Morgan:

all vertebrae.

Dr. Bob Lynch:

the philosophy of chiropractic is that your structure affects your function and that if your structure isn't in proper balance, then you're going to have some functional disorders that can manifest themselves.

Genevieve Morgan:

Dr. Lynch, give me a little background on chiropractic medicine.

Dr. Bob Lynch:

Well, the practice of chiropractic is a little over 100 years old, but what we do, manipulation's been done for generations with other in Europe and Egypt. But the whole concept and philosophy of chiropractic, where you treat the body without drugs and surgery if possible, is really we're the first green medicine. You know, if you use green as being environmental, you know, it's a very clean way of treating the body.

Genevieve Morgan:

Now you've been doing this for 34 years.

Dr. Bob Lynch:

Yes.

Genevieve Morgan:

So you've seen a lot of spines.

Dr. Bob Lynch:

A lot of spines. I think we were trying to figure it out. We're somewhere close to 20,000 different patients.

Genevieve Morgan:

And have you been able to mark significant pain relief in your patients?

Dr. Bob Lynch:

Well, a long time ago, I had a patient come in and he goes to me, this is the first time I've ever left the doctor's office feeling better. Usually you've got to go home, you got to run to the pharmacy, go home, take the pill, wait for it to work. And being a son of a chiropractor, I virtually haven't had any medication. I think I've had one or two prescriptions in my life. It's usually for a toothache.

Genevieve Morgan:

That's interesting. Explain that, that chiropractors don't use medication to treat their patients.

Dr. Bob Lynch:

Well, we're not licensed to. So if somebody needs medication, then we refer them to the appropriate provider. There's enough people that can prescribe the appropriate drugs, but we'll prescribe nutritional supplements, diet, exercise, things that they can do naturally to enhance their health care condition.

Dr. Lisa Belisle:

Is there a psychological link, do you think, between pain and its ultimate manifestation?

Dr. Bob Lynch:

Absolutely. You can't separate the mind from the body.

Dr. Lisa Belisle:

So tell me what that has looked like in your practice.

Dr. Bob Lynch:

A couple of weeks ago, a woman comes in, very, very upset. She's got all this kind of pain in her right upper back. But just seeing her, she wasn't breathing. I mean, very Very shallow breathe. And so I evaluated her. I gave her a chiropractic adjustment, manually treated her. She felt better. And then I asked the question, all right, what's really going on? Okay. Because something else was going on that manifested it. And you may seem to sound funny, but I actually tried to teach her how to breathe, how to do diaphragmatic breathing so that she's doing deep breathing. Because you got to be in balance. You got to have your head. Your head's got to be solid emotionally, because we're just. When you really break it down, we're just energy. And if your energy is off, then it can lead to disease and disease.

Dr. Lisa Belisle:

That doesn't seem funny to me at all. In my practice, I teach all of my patients how to breathe. So I stick needles in them and then I almost force them to learn how to breathe. So you and I are definitely on the same page on this one and the energy piece.

Dr. Bob Lynch:

it's interesting. So many people could use the services that we provide, but they don't know it.

Genevieve Morgan:

And you don't have to be in pain to come. I mean, there's a preventative aspect to what you do as well.

Dr. Bob Lynch:

I think that's the biggest benefit to chiropractic because if we can take, well, example, my friend down in Miami, he works for the University of Miami Hurricane football team and the team finally has gotten it after all these years that we want the kids to be treated first so they can avoid the injuries and not just wait till they get hurt and get care. So it's pretty. The profession and what we do has a huge potential for people.

Genevieve Morgan:

And how do people get in touch with you?

Dr. Bob Lynch:

Phone number. They can call us by phone. We have a website.

Genevieve Morgan:

What's the phone number?

Dr. Bob Lynch:

7992263. Website is Dr. Lynch. Dr. Lynch.com and email is really simple. It's Dr. Lynch at Dr. Lynch.com.

Genevieve Morgan:

well, that sounds great. And I think that all of us listening to. You can see by your example that chiropraction can help live a less painful life can gain ease.

Dr. Lisa Belisle:

Yes. Thanks so much for coming in.

Dr. Bob Lynch:

My pleasure.

Genevieve Morgan:

Dr. Lynch is one of many practitioners in our state that deals with energy and healing energy. In the October 2011 issue of Maine Magazine, I wrote a column called Good Vibrations that talks about the philosophy behind energy medicine. To subscribe to Maine magazine, go to themainmag.com or pick up an issue at a local newsstand near you.

Dr. Lisa Belisle:

As part of our Gaining Ease show, we thought we would bring in an individual who has something to do with Gaining Ease in a slightly unique way. Earlier on in the Dr. Lisa Radio Hour podcast, we interviewed Mark Swan from Preble street. And today we're bringing in Chris Bicknell, who is from the Lighthouse and Teen center at Preble Street. So nice to see you, Chris. Hi. And this is of course, a part of Preble street itself.

Chris Bicknell:

Absolutely. Yeah. It's teen services combined together.

Dr. Lisa Belisle:

One of the reasons we were interested in bringing you back in is because we talked about Gaining Ease with our other guests as being you have a pain in your body. You, you need to deal with the pain so that you can live your life. But even if you don't have a pain in your body, you might have a pain in your life.

Chris Bicknell:

Absolutely.

Dr. Lisa Belisle:

So what types of things do you see with these teens that are coming in? What types of pains in their lives are they experiencing?

Chris Bicknell:

Well, we see a whole range of different things that youth are coming to us with, but mostly we see young people who have been struggling with a bunch of different things throughout their lives. It's never usually just one thing. There's we see a lot of hunger, a lot of poverty. We see kids who are struggling, they've been in foster care, placements, in residential placements, hospitalizations, those kind of things. So there's some either mental health issues for themselves or mental health issues in their family. There's possibly some criminal involvement. Lots of different things that can happen with young people who are living in unstable situations. Unfortunately, there's trauma throughout the population that we work with. Whether that's physical trauma emotional trauma or sexual trauma. And so we see a lot of that. And our goal is to create safety for young people who have not felt safe in their lives, either in their homes or in the community, and try and give them the opportunity to make some different choices and changes in their lives so that they can move forward as opposed to kind of being where they're at and struggling continuously.

Genevieve Morgan:

What are the services that the Lighthouse Shelter provides?

Chris Bicknell:

The Lighthouse Shelter and the Teen center together provide a whole group of services that are aimed at creating safety for youth and getting them off the street and finding permanency in their lives. So the Lighthouse Shelter is open from 8pm to 8am and it is a safe place for youth ages 12 through 20 to sleep at night. And if somebody shows up in the middle of the night and they're hungry, there's food there for them. It's a warm, welcoming environment that's designed to help young people who really have nothing else in their lives and no place else to go to be safe. So then during the day, the Teen center is open from noon to 8pm and that provides two hot meals a day, lunch and dinner. We really think that food is a way to connect to people in my life and in everybody's life that I know. When you sit down at a meal, you talk, you share, you get connected. And so when youth come into our programs, we eat with them and we talk about what's going on in their lives, and they share with us. And we don't ask them, you know, do you need this? Do you need that? What do you want? We let them tell us, because most of the time we're working with youth who've been told what to do by people, by adults, by programs and by systems. And as soon as you know me as an authority figure comes in and says, you need to do this, their initial reaction is, no, I don't need to do anything. I can walk out of here. And we say, yep, you can. So, so tell us what you need, and then we'll provide that. So all the other services are relationally based, and kids refer themselves to that. So after food, we have all the basic needs are met. Shelter, clothing. Kids can take showers, do their laundry, use our phones. They can use us as a mailing address. And they can also from there, access other services. Mental health counseling, substance abuse counseling. We do a lot of work around housing and finding places other than the shelter for kids to live. We have educational services available through adult education, so kids can either work on their ged, get referred Back to school. If that's an option for them, or if they only have one or two credits to finish to get a diploma, they can do that right? On our site, we have an employment training program where kids can do a four week classroom component to kind of learn what are employability skills, what are the expectations of employers, how do you talk to people at work, those kind of things. And then we'll place a youth in a job site and we'll pay a stipend to them so that the employer really knows it's a training opportunity. And we can provide some staffing to support that kid through kind of the struggles of their first job. We also have nursing on site five days a week so kids can get their medical needs met and get a referral to a primary care facility physician, if that's possible. We have psychiatry services that are offered once a week. So if youth who are on the street need medication or medication management, we can do that. So there's a lot available right on site that we do.

Dr. Lisa Belisle:

You alluded to the fact that you had a difficult growing up in your own life. Do you believe this has made you more resilient as an adult?

Chris Bicknell:

I do, yeah. Absolutely. I mean, I was faced with challenges that I either had to find my way past or suffer with. And I chose to find my way past them. And I didn't have a place like the teen center to do that. So I had to utilize my own internal kind of workings to make that happen as opposed to having someone offer it to me. One of the reasons why I continue to do this work is because I see young people are struggling the way that I did. And I want to be able to say, you know what, you don't have to do it alone. There are resources, there are people who care. You can make it out in the world.

Dr. Lisa Belisle:

You have a capital campaign. What is your goal with that?

Chris Bicknell:

Well, our capital campaign currently the Lighthouse shelter is a 16 bed program. It's in an old rundown building that was not designed to be a shelter. And so we are purchasing and renovating a building to be specifically designed, designed as a youth shelter with youth in mind and to increase the capacity. Right now, two out of three nights a week, we're turning away young people from our shelter that should be sleeping in our shelter. They either have to go to the adult shelter, sleep out on the street somewhere, or, you know, sell their body for a bed that night. And that's just untenable to us. So we're going to expand the capacity from 16 to 24 we're going to to design a program that really meets youth needs as opposed to kind of fitting it into an old structure because environment says a lot about how you're cared for. And so the capital campaign is to raise the money to renovate that building.

Genevieve Morgan:

And where can people go to donate?

Chris Bicknell:

They can go to preblestreet.org there's a button right on the webpage, or they can call 775-0026 and do you also

Dr. Lisa Belisle:

have need for Volunteers?

Chris Bicknell:

Yes, we always have need for Volunteers that's also on the website, can fill out an online application for volunteers and the range of volunteer things that we need are really broad. So there's a lot that's available to do.

Dr. Lisa Belisle:

Thank you for helping the youth of the Portland area gain ease. We appreciate your coming in and talking to us today. Chris Bignell Thanks.

Chris Bicknell:

You're welcome. I'm happy to do it.

Dr. Lisa Belisle:

Thank you for joining us on our Gaining Ease show where we discussed this topic with Dr. Michael Tada of the Spine center at Orthopedic Associates, Dr. Bob lynch of Lynch Chiropractic Arts center, and Chris Bicknell of the Teen center and Lighthouse Shelter at Prevost Street. It was interesting to have conversations with two individuals who spend quite a bit of time working on the spine and gaining ease as far as back pain is concerned, and then to sort of marry it with a conversation about gaining Ease in a different way, bringing food and shelter and security to a group of individuals who are often forgotten, the teens of the city. As we said in the beginning of the show, our hope is always to provide hope, to enable people to be inspired to live their lives in a way that not only helps them gain ease, but to continue to live in a way that is more than just full of ease, it's also full of joy. We hope you've enjoyed this show. We encourage you to join us for next week's show called Creature Comfort, which will be airing on February 26, 2012. For this show and all other past shows, you may go to drlisa d o c t o r lisa.org and listen to the MP3. Subscribe to the podcast through itunes, get regular Updates through our Dr. Lisa Facebook page, or contact our office through our website and receive our regular newsletter. This is Dr. Lisa Belisle. Thank you for being a part of our world. May you have a bountiful life.

Dr. Mike Totta:

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Dr. Lisa Belisle:

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