Clinical Pearls from the 2015 Brainstorm Seminar

Last weekend I attended the Brainstorm seminar hosted by the Parker University Neurology club.  The seminar featured some of the top clinicians in the field of chiropractic neurology and covered wide ranging topics.  Though I've had many opportunities to "cross train" with chiropractors in multiple settings, this was the first official chiropractic event that I attended.  Here are some practical clinical pearls I gathered from the speakers throughout the weekend.  

Source of most problems: Traumas-Thoughts-Toxins (my note: in sports setting we can add Technique and Tools)

Unmanaged stress is a problem in almost every disease

What can I give my patients so they don’t have to come back?

Managing thoughts is the simplest yet most complex skill to learn (“People can’t handle themselves”)

When people lack mindfulness/presence, preprogramming from age 1-6 takes over

Every single thought creates connection or disconnection (music, colors, pictures, words, etc).  These all affect patient

What are you like walking into the room?  Your presentation is critical for the encounter

Be careful adjusting patients when they feel really bad (no matter how much they and you desire the sound of cavitation…).  Can make people more efficient at feeling bad

Cells love learning about themselves

Really bad event can happen yet individuals have completely different response (i.e. loss of job might be devastating to one person but liberating to another)

Lack of breathing is one common component of all negative emotions

Negative thought = dumping $20,000 worth of chemicals into your brain.  We possess the most powerful pharmacy on earth in our brains

Helplessness is one of the worst things for the brain

We aren’t seeing reality.  We are seeing our own perception of reality

You get what you rehearse, not what you intend

Exercise is a stressful way to de-stress

No one in the room is the same as when they walked in

If you get a new thought, the nervous system must adapt to it (=stress)

Brain sometimes must reboot…like a computer…but how do you do it (something healthy vs. heavy drinking?)

Creativity is intelligence having fun

One of the first things to get lost during stress is inventiveness

All unhappiness stems from unfavorable comparisons

Never let an old person inhabit your body

Pain gating deals with perception of current level (involves limbic, past experience, comparisons)

Must understand WHY posture is what it is.  Not just bones, muscles, and joints.  Posture tells a story.

Don’t forget about the auditory system in managing posture (bats = extreme example)

Must address vestibular system for any adjustments to have lasting effect

Learn to see the energy capacity of the patient…how much can they tolerate?

Can the patient withstand whatever you are going to do with them?

ANS is under near constant demand.  Being able to assess this is vital to understanding metabolic capacity

What your patient can tolerate can make or break whether they will succeed

Food tolerance decreases when microbiotic diversity is absent

Gut-brain connection is two way system

If you only fix optikinetics, you’ve just done a party trick.  Must address entire system!

If you are a student and you say you are too busy, it means you don’t want to take it to the next level

When neurons don’t fire, glial cells see them as debris

Gut on fire = brain on fire

No two TBIs are the same.  Can’t work by protocol

Sometimes the best goal with TBI is just to have more good days than bad days

Don’t forget orthopedic basics of neck when evaluating head injury

Head trauma patients have false sense of security when leaving ER.  Discharge standard is basically whether the docs are certain you won’t die when you walk out

Most people have underlying conditions before they get concussed.  Some hits can make you better!

People’s perception of themselves changes post-concussion

If you don’t like intake forms it means you don’t know how to use them

Best way to get referrals is to get patients talking to referring docs about success

Adding mental practice to vestibular training helps suppress PTSD memories

Exit strategy – goal is to make the patient become a former patient

Intricacies matter (ie, should not need scalenes to talk)

Squirming kids give you a lot of information

Watch how head behaves when someone turns around during gait.  Don’t just look whether they kept balance

Sometimes you need water pistol, not shotgun

Are you good at a single instrument or are you the orchestra conductor?  Both are needed but understand where you fit in

Meet the patient where they are, not where you are

Patient’s condition is often a magnifying glass for conditions that existed long before they came to office for present chief complaint

Consider how much resources the family has when assigning homework…particularly key for pediatrics.  Does mom have energy to apply treatment plan at home?

When does the patient go limbic during your exam?

Everyone walks a balance between Bruce Banner and the Hulk

Change in voice volume reflects change in central integration

Don’t automatically accept diagnosis the patient brings to you from other providers

Visual stability precedes spinal stability

Are you dealing with a traffic jam (physiology) or a bridge that is out (structure)?  These are very different problems that manifest similarly

Understand how what happens in one house can affect the rest of the neighborhood (what happens if you turn up the music really loud in one house….?).  You are affecting a whole neighborhood, not just one house

Sometimes you don’t treat the biggest offenders

Pace the patient at their own pace like you are their neurological personal trainer.  We are not Crossfit doctors!

You are part of the patient’s journey but you are not the be-all-end-all

Limbic attachment is one of the best ways to attach memory

Titrate your interventions (example: adjust a finger to see how patient responds before treating more centrally)

If you can make a change happen fast, your chances of success increase exponentially

Patients will give you all the information in some form.  You just need to figure out what they are telling you

The more complicated you make it, the more likely you are going off course

Moving a joint only provides the ability to move.   Need active movement to create lasting effect

Pedigree is not what you started out with but what you end up doing with your opportunities

No one is entirely self-made.  They are given opportunity.  If you waste opportunity, you have misused what you have been given

Put yourself in uncomfortable settings to meet people who will make you better

Run your business as an operation that is a profit making machine.  Develop a business that works for you, not the other way around

Operational and marketing component must exist symbiotically

Goal is to grow to point where someone else is managing your money

Must be sufficiently unique for cash based practice to work