Many patients are so used to medical care they have no idea how wellness care works. What does wellness care look like? How does it work? I’ll answer several questions by presenting one patient’s story about her care.
“Paula,” which is not her real name for the sake of anonymity, first came to the office in late July of 2013, complaining of neck pain and headaches. Both conditions were quite chronic. Her headaches had been a problem since the birth of her child 13 years earlier. They landed her in the emergency room several times over the years, and she had taken so much ibuprofen she developed stomach ulcers and needed to stop using it.
At that time, she was using Imitrex regularly to stop the headaches once they had begun, but the drug did nothing to prevent them. They occurred at least once a week, usually more; could last a few days; and were more intense and frequent once a month. The neck pain woke her many nights, forcing her to change sleeping positions. She also had been diagnosed with irritable bowel syndrome.
We decided to treat the neck and headache pain first. A spinal exam showed her joints were out of alignment and were very restricted. Her muscles were chronically tight and tender, with strong “knots” in several of them. These problems were the cause not only of her neck pain but also the headaches. Most headache pain actually originates from the neck. It is called referred pain, similar to how a heart attack can cause pain in the arm.
Her neck was treated with manipulation and electrical therapy, and she noticed some relief after the first treatment. By four weeks, she said her headaches were about 50 percent less frequent and intense. As treatment continued, she got to the point at which she only had headaches with her cycle. She also could tolerate more aggressive deep-muscle treatments and stretching. She also was shown how to self-treat the tight muscles, which helped her progress. She used her Imitrex less and less because the cause of her headaches was being addressed.
The next phase of care was to focus on her chronic digestive problems. Based on her history and exam, she was given supplements to help her stomach and bowels recover from years of ibuprofen use. She already exercised regularly, and her diet was good — though I made the usual recommendation for her to go gluten free. We also started acupuncture. These were helpful for her, and her digestion began to respond. It was interesting to note her neck stiffness, which only partially responded to joint and muscle treatments, finally “let go” once her stomach function was restored.
She is now at the point at which she rarely uses medications to control her headaches or neck pain. Her digestion is much better, and her neck pain no longer wakes her. Her headaches are much less frequent and do not last very long when they do occur. Paula continues chiropractic treatment to control these chronic problems, and she finds relief with care. She is currently doing well, coming in about once every three weeks, and we are looking to reduce that further.
A major difference between wellness and medical care is that with medical care, the patient often needs more and more help as time goes on. Heartburn medications are needed to take care of stomach pain caused by pain medications. In turn, they can cause irritable bowel problems because the stomach cannot do its job of digestion if it is prevented from making acid. After years of this compromised digestion, osteoporosis medications may then be needed because the heartburn meds can interfere with calcium absorption.
With wellness care, the treatment is “front-end loaded,” where there is more care at first, but as the patient improves they need less and less care. This is especially true if the patient makes the lifestyle changes needed to improve their own health.
Dr. Michael Noonan practices chiropractic, chiropractic acupuncture and other wellness therapies in Old Town. He can be reached at firstname.lastname@example.org.