Dr. Frederick Schurger and Dr. Beth Bagley had patients this week that didn't need steroid shots for their aches & pains after their atlas was adjusted. They discuss the strengths of the Blair Upper Cervical work. Many Upper Cervical chiropractors do not adjust segments in the middle of the neck, but Dr. Frederick Schurger and Dr. Beth Bagley do. They also have a bit of business talk because they are running a business & need to keep the lights on. Finally, they gave a quick overview of the Upper Cervical safety study that shows how safe this work is, as well as the level of satisfaction of the patients. Dive into today's conversation with Dr. Frederick Schurger and Dr. Beth Bagley!
We're having a good time. The show is getting out there. People are reading, and we appreciate everyone for signing up on the socials. Make sure that you like and subscribe.
It helps us so much.
Give us a five-star review, bits and pieces that get people to know about these things because there are so many problems in the world that can be solved by moving a little 2-ounce bone underneath your head. We're going to start with a couple of patient testimonials. First, I talked about this one where he's been reluctant to come in as a patient for about five years that his wife has been coming in. He’s an engineer. He’s very mechanical and methodical. Except when it comes to his health, he's like, "No. That's fine. I've had fusions. I'm good. I don't need it anymore."
One time, he came in, bent over, ready to get a bunch of steroid shots. He comes in again. They get here a little bit early because they got to get back home for a class. While he's here, he gets a call from the hospital saying, "We need to reschedule you. You had a 2:00 appointment." It was about 2:30 when they walked into my door, and this was for the shots.
His wife is like, "You're not going to get those shots." He's like, "I don't think so." He was holding his adjustment. He's like, "I'm feeling pretty good, doing the exercises that I'm supposed to be doing." I'm not saying that there's no time and place for steroid shots. There is, but quite honestly, I'm very excited that he was doing great and considering not needing them, at least at this time.
I've got a similar story. This lady started coming in. She was a referral from another patient. It’s the typical back pain, neck pain, some neurological things going on in her head and neck, and some pretty intense knee pain. It's always funny because, in my opinion, that's how the body prioritizes things that get well fast. We don't have control over it. As doctors, we would love control over it, but we do not have control over it.
She's doing well. She was holding her C2 adjustment. She needed a lower one, but last time, she told me something all of a sudden after the first adjustment. She thought it was a fluke, so she didn't even say it after the first one. Her knee pain went away, and she was waiting for it to come back. It hasn't come back. She's also canceling steroid shots for her knee, and I thought that was amazing.
It's fantastic to hear that. For the medical doctor out there who does all the shots, and that's your bread and butter, I'm sorry, we won't take them all, believe me.
We won't. There are some patients that might need it to help them to survive. We get it.
I heard the craziest thing from one of my long-term patients. She's been with me for a while. Her knee has been giving her grief. She got some shots to get a little bit longer. Her mother, who was suffering from Alzheimer's, had passed away. She'd been a caregiver for her, so she's able to take care of herself and get this surgery. She knew she'd be laid up if her mom was still around, so she finally did that. The shots helped keep her moving so she could take care of her mom.
I've never heard this phrase used clinically, but she had end-stage osteoarthritis. I've never heard of that, but he says, "We needed to do this surgery and take care of this knee for you because that's how bad it was." I don't know what end-stage arthritis is, but that sounds bad. Anything longer than that sounds like a fusion.
Where does it go after the end stage? It's not death. You hear end-stage cancer. One of my patients jokes because he doesn't have back pain anymore. He used to say he had stage five back cancer when his back hurt. He's a little dramatic.
That's a little bit over the top. I would concur. In getting onto our next topic, I have another patient who was hurting so badly. We got back from a trip down to Little Rock, Arkansas. His wife's like, "David needs to get in badly." I'm like, "Okay." I'd seen him a couple of times. He had something land on his head at a job site. He comes in, and sure enough, his atlas and C3 were out of place. Only a week earlier do I take new pictures of him, and I find that C3 is out of place, so we adjust that. He was back holding his adjustment for the first time in a very long time. He's then out. Atlas and C3 were fixed. They're back and he's holding again. It's working in the right direction.
I'm going to write up a paper. You and I might have to do this jointly because if you've got enough cases, it'll be a case series, is what I'm thinking. One of the things that we do differently in the Blair work than other upper cervical docs do is we focus not only on the atlas. It's two parts. We look at the atlas and the lower cervical as individual pieces. Not only are we addressing these pieces a little bit differently than some of the other orthogonal upper cervical techniques do. They do address them, but it's not in the same fashion. We look at them individually and anatomically differently than those other techniques do. Sometimes that's the missing link for the patient to get better.
I often see C3 and sometimes C5 as randomly one of the ones that could be holding someone back. Three different patients who don't normally have a C2 or C3 misalignment. It could be C2 or C3, but they all were coming in, and it was hard for them to turn their head. When they turned it, they would get the stabbing pain in, I call it the spot, which is right where the trap sits. It's pretty much right between the shoulder and the neck, towards the back but above the shoulder blade. Not that I like when people are hurting ever, but I like to adjust that one because it's so quick. It's not all the time that it's quick. Sometimes it takes 1 day or 2, but at least the range of motion change is pretty quick where they can turn their heads again and they're like, "I think you got it." I was like, "I know."
The first time that I had my C2 go out was right after my sister's wedding. I've told this story before. My brother and I were not horsing around. We were just going down to the pond to go swimming. It was not even a crazy dive. It was very controlled. I swam in high school, so my form is okay. I don't swim a whole lot anymore. I'm doing a very easy breaststroke over to the sandbar. I come on up and I'm locked up as if someone took a screwdriver between my shoulder blades. That was uncomfortable. It took me a month before I had an old-time doc say, "This number two here, let me get that for you." That changed my perspective on all of this.
It's funny because Dr. Drew Hall, who's down in Sarasota, Florida, sent a patient my way who winters down there but she happens to live in Springfield. She's like, "My number twos need to go back into place." She'd been to upper cervical care under a different upper cervical technique, one of the orthospinology folks here in town. It worked, but it didn't take it to the next level or the last step that she needed to get her well and keep her well. It's so curious how these people fall into our laps for better or worse.
I do think in a perfect world that the body is working exactly like it's supposed to be and then there's an atlas subluxation. When we move atlas in a perfect world from top to bottom, everything is restored. I meet a lot of people who don't live in the perfect world.
I live in that perfect world, and I have yet to figure out what that absolute place is. It is a real trick to address these things. In the perfect world and the world that was years ago, we did not have nearly the severity of injuries and accidents that we have available to us. We have a smorgasbord of ways to hurt ourselves. The thought in my head, going back to talking about whiplash and concussions, is that we get this weird buckling of the joints along the way where one will go one direction forward, and the other one will go backward. It goes through this back and forth, forward and backward, which means left to right.
Ideally, in a simple injury situation, everything is going to go either to the right or to the left. You're going to be cocked around like this, as opposed to some weird back and forth that causes things to buckle in odd places. That's more of what we're dealing with, modern injuries and accidents. Gay for modernity.
When we talk about modern injuries and accidents, maybe it's even longer than 40 or 50 years. In high-speed collisions, a couple of things that are going better is that we used to have the seat belts, and then the seat ended here. People's heads would whip all the way back over the seat. We've got a headrest. People sometimes think headrests are there for comfort. No, they're here to stop your head from whipping back. You can still get a whiplash even with them, but it's better. That's the other thing, making sure your headrest is up high enough above your head.
People sometimes think headrests are there for comfort. They're here to stop your head from whipping back.
You and I have a problem because even in larger trucks and vehicles, it still only gets to maybe right at the back part.
If you're tall, you need it as far up as it goes because it's not for your comfort. It's to stop your head from whipping over it. The tendency is that if you get hit hard enough, you'll lift in your seat and still go somewhat back. Do your best to make sure it's high enough.
The other thing to think about is the way cars are built now compared to many years ago. This goes back to my time in automotive plants and engineering. We used to have bumpers on cars. We don't have bumpers on cars anymore. Everything is that plastic fascia. It is foam-filled. There is a piece of foam back there, or behind that you never see. You won't see that piece of foam if you're in an accident. They'll see it at the auto body shop. That piece of foam if they pull that off and it disintegrates, which is what it's supposed to do, they have to replace that piece of foam before they put your car back together.
With an old-style bumper, there was a cylinder that also needed to be replaced. It was designed to explode. You would hit, and that cylinder would pop out of place to deflect the energy that was coming into the spot, except those things were expensive to replace. That's why they got rid of them because there's got to be a more cost-effective way for a collision.
At what cost? It's not the cost of fixing the car. It's the cost of damage to the tissue in your body, which is why we see these more problematic. There are lots of concerns and things. Consequently, we've seen more reverse curves. Instead of seeing that nice C-shaped curve, we see an S-shaped curve because you've got this back-and-forth motion.
Your neck is supposed to have, I call it, a banana. The circular part of the banana faces forward. That's what it's supposed to do. When it happens, it straightens out, so we need it curved. My goal for anyone isn't to get the curve back. There are some chiropractic techniques whose goal is the curve back. I want structural integrity, and I want your body to be functioning as good as possible. If it’s with a curve, your body will do it. If it's without a curve, I'm okay with that too. I do like seeing curves. It's great, but I'm not going to force a curve to come into somebody's body.
This comes back to those lower cervicals that need to be addressed, sometimes individually. Sometimes the atlas will bring that all together, and the curve comes back overnight. I've seen a negative forward positioning reverse back to a normal curve in young children and some adults. People that have been in car accidents, we're going to be working on that forever, trying to get those joints to work back to where they're supposed to be.
Speaking of injuries that I'm seeing from things, I've noticed some interesting ones. In spring, there are gardening injuries, about twelve of those. People are overdoing it in the garden, coming in and annihilating either back, neck, or both. The other thing is pickleball. Do you guys have pickleball there?
They do. I have yet to play. I have several patients who swear by it.
They love it. It will keep us in business. Guys, keep playing pickleball when you are a little old. You maybe haven't worked out in a long time, you go play pickleball and you give it your all. I'm laughing with them because they know they're doing it to themselves. We are seeing some pickleball injuries. I've only seen it played. I've never played it either, but it looks fun.
It’s with any of these sports and anyone getting back into activity. It’s not that we had a long winter. We had a very short and mild winter and a long pollen season. We're coming right into summer 2023. Thankfully, we're getting a couple of reprieve days with the rain in the cold. It is coming right on in, and it's going to be a hot one.
I want to talk about being a business owner. I have this thought process. There might be some people out there who are maybe thinking about being chiropractors or being in the service industry. I have a couple of things that come to my mind about when you're renting a location because you rent also. I rent in a location that's right next to a sushi restaurant on one side and a dry cleaner on the other side, but they don't do actual dry cleaning either. That's just a place where they take it out, dry clean, and bring it back. I don't want dry cleaners right next to me because there are lots of chemicals. It's a place for people to pick up and drop off.
That's why they've done it in this fashion because the EPA rules are probably so ridiculous that they said, "We have one large warehouse building that we have to worry about, and these are the drop-off places." I am so amazed at how fast they do all of that. I will drop off stuff because I've got a place like that down the road. I know they do the same thing. Yet, I've got my dry cleaning back in the afternoon if I drop it off by the right time. They're very fast.
The last thing is, right next to them is Subway, which is one of the healthiest places you can eat. No, I'm being facetious. Everyone knows what the smell of Subway is. If you're going through an airport, you know there's a Subway coming up. Like a Cinnabon, you know what Subway smells like. You walk into Subway, and you're like, "Definitely Subway."
What happens when Subway's fan breaks? Do you know what else smells like Subway? My office. Every time they're baking bread, it smells like Subway in here. It's not good. I could tell when they were baking the cookies. I even knew when they were cutting the onions. Their fan just got fixed. That's why it's at the top of my mind.
What I wanted to talk about is why all of these tiny things matter when you're starting a business seems so overwhelming. What's cool is that you deal with the stuff when it comes up. If somebody out there is wanting to start a business, know that you don't have to figure all of it out all at once. That's overwhelming when you try to think of it like that, but it's one step at a time. That's the same thing as building chiropractic practices. You meet one patient at a time. We change the lives of these people one at a time. What's so cool is that's how any service-type business, whether you're a CPA, works. We have the coolest job, though, out of all of them.
Equivocal, I'm finally fed up with my EHR system or Electronics Health Records.
That's the computers that the doctor would use to take the records and the servers.
All my nurses, billing stuff, and talking back and forth with patients, I haven't liked it for a while. I finally said, "I'm motivated. I'm going to make this stuff happen." To your point, there's going to be a lot of work. It's going to take a while for me to get everything put together, and it switched. However, it's a pain point of understanding that you don't have to know how to do everything right off the bat. You don't have to do everything immediately.
It's funny because I talked to another colleague of ours. She doesn't do a cervical, but she's a patient. She was making the same comment. She's like, "I'm done with that company." She's got this same billing stuff system I've got. We're both going to the same new system because we're like, “We’re tired of this. We've heard so many good things about the other system. It's time.” Sometimes you say, "I'm going to do a little bit today, a little bit tomorrow, and the next day." Before you know it, it's done.
This applies to not just business but everything in life. The best time to plant a tree was years ago. The next best time is now. If there's a thing to be done, you've got to start chiseling away at it, especially if it's giving you pain points that are preventing you or your staff. In my case, my spouse. My wife helps me out with some of the billing. I see her spreading over this thing every month that she has to do pretty much by hand. She's got a system down.
If I can hit a button, it automatically emails to the patient. I don't have to worry about the printing. We may still print for some but I don't have to do all the extra work for it. The Amish people would be the exception because they don't have insurance. That would be the difference there. It's all the little things, and it's getting under care. I don't want to start because once I start, I'm not going to stop.
I'm afraid to meet a new doctor because you've had bad experiences with doctors in the past.
I had a potential patient come in here. He's like, "Doc, you're doing all the right things." He saw how I was dressed. He says, "I like how you're dressed. I like the way you talk and say things. I don't want to pay for a new exam in X-ray." Anywhere between the $300 to $500 range is a very common price for a new exam in X-ray in an upper cervical office. That's a price tag. You're paying for the expertise, and he wasn't comfortable with that.
That's a lot of work.
It is. We make it look effortless, mind you. We put a lot of work and effort into making sure we figure out exactly how each segment's built, how they are out of place, how we're going to put them back into place, and knowing what not to touch too to understand that about a patient. He's like, "Doc, I've been under care forever. I like what you're doing. You're in that Palmer Method family. That might mean something different."
He wasn't comfortable with what I was recommending to start. I said, "I've got somebody for you. If you don't like him and you don't get better with him, he is going to send you right back over here because he understands what I do and how it's different." These are all the little pieces, but you got to start and figure out, "Is this the right path?"
Valuing yourself too. If the transmission in your car goes out and you need your car to get to work, you're going to pay $2,000 and find a way to pay it. It sucks. I wish you didn't have to spend it, but you're going to find a way because you value your car to get to work. How much more important is your body than your car? Infinitely. I do think insurance has ruined a lot of people. People think insurance should pay for everything. I wish it did. That would be amazing, but it doesn't, especially doctors, not just upper cervical doctors.
Medical doctors are getting out of the game.
Tons of doctors are, and because the insurance companies are only out for themselves and not out for you, the consumer. Value yourself as much as you do a car transmission. If you needed a tooth taken out and you're not going to have dental insurance that pays for that fake implant, that's another $3,000 right there. You want to smile and not have people stare at you, so you're going to pay that $3,000 for an implant. Could you survive without it? Absolutely. You could survive without your car.
I'm going to tell you, if your nervous system and body are breaking down, you're going to be so much happier that you spent that money now versus waiting when it's time for surgery. You're never the same after surgery. It's never exactly what you want it to be. It might be better than where you are right this moment, but it doesn't get you well. It cuts out the pieces that are broken.
You don't need a car. You can get around on the bus system or you can bike, but what is your quality of life? What are you capable of doing or not? Somebody came in and said, "Doc, I hate it when I can't think straight. Get my head on straight." That's what we did. It's funny because we're close in price tags as far as our rates. It might be somewhere in that $2,000 to $2,500 for an initial plan of care to make sure you're stable, and then it's less. Maintain that.
The initial phase of care for anything, hopefully, most chiropractic offices, but mine and yours are more expensive. Honestly, once I hear about what people are spending on dental care, I keep going, "I need to raise my prices." I'm not going to do it based on that. I want the care that I'm offering to people to be accessible to lots of people but I also need to keep the lights on in my office.
We have our expenses and bills. We won't talk about inflation because I don't understand that.
It's bad. That's what hurts me because people's paychecks aren't going up, but all the prices are going up. I haven't raised my prices yet, but I probably should.
Let's ask two questions. 1) Is upper cervical care better than regular chiropractic care? I've got a study for this. 2) Are there any risks associated with upper cervical? Let's hit this research paper and then wrap it up.
I'm going to answer because you're looking that up. Do I think upper cervical care is better? It's different. I almost put it on a different level than chiropractic care. Conventional chiropractic care, although amazing, and some of my best friends in the whole world are conventional chiropractors. They know what I do. I don't want to call upper cervical chiropractic, chiropractic. It is chiropractic, I know but it's different.
It is a different step of what chiropractic was developing, and it still is one of the more advanced ways to address the human frame and the anatomy of our body. Let's go through this study real quick. What are the risks of chiropractic? Back in 2011, Dr. Kirk Erickson and a couple of others did this study, where they collected data from over 1,000 patients. We had 88 doctors or so in this study.
It's a pretty large study considering upper cervical as a smaller community. I do get this question from people. "Can chiropractic cause a stroke? Can this hurt me?" I love answering it because there are multiples but this study especially.
This study, in particular, drives this home because the first step here is we've got the symptomatic reactions being either intense or serious. What do these mean? A symptomatic reaction is a new symptom or a worsening of an existing symptom by more than 30% following UCCC as an upper cervical adjustment. They defined intense as anything above eight. Anything that was a serious adverse event is a life-threatening reaction or hospitalization.
An asymptomatic reaction is a new symptom or a worsening of an existing symptom by more than 30% following UCCC as an upper cervical adjustment.
We had 83 doctors in this study and over 1,000 cases. This was only upper cervical. Most of these were atlas or axis combined. We had 338 patients out of the 1,000 that met that symptomatic reaction. That had an increase. Only 5% of 56 patients had an intense change. In earlier studies that were done by Rubenstein, he used adverse events. This was general chiropractic that most people are familiar with. Unfortunately, I'm going to use the term "rack them, crack them." They would've had a 56% compared to 13%.
You can get sometimes really sore, especially after the first upper cervical adjustment. We explained that to a patient. I get excited when you get sore because I know your body is responding. It's awesome.
The difference is 31% had a change for the increase in pain and discomfort, whereas most people think.
It's diversified from what you see on TikTok and YouTube.
That was at 56%. Half of that population had that.
That's a lot. I wouldn't have thought about that.
For the intense, the over 8, they would've had almost 3 times. Fit 13% versus 5%, which is no serious adverse events occurred in all these 1,000 patients. Of the 83 doctors, many who had been practicing for 20, 30, 40, or 50 years have over 5 million career adjustments without ever having a serious adverse event. Not to say that it can't happen or will never happen, but that's a lot of doctors, patients, and adjustments. Here's the upside. We don't tend to adjust every time you come on in. We can spread those visits out further. If there is a risk, however small, it is even smaller when we don't need to do it as much.
One of the risks when people talk about stroke and chiropractic is when the doctors or chiropractors twist the neck. There is an artery called the vertebral artery that has the potential that usually the patient already has an event in progress and has neck pain because of it. The doctor twists their neck and makes it worse, which is not great. A stroke can occur, and it's awful. We never ever want anything like that to happen. What's cool about almost all of the upper cervical techniques that are done is there is no twisting of the neck. Even if somebody did have an event in progress, God forbid, this wouldn't make it worse. Hopefully, we would see the warning signs and send them to the ER.
For the symptoms, the common reactions that people were having, tiredness or fatigue, was the highest. It's the radiating pain or shooting pain. Neck pain was up there at 5%. Dizziness was under 5%. I see that one more commonly because what's happening is we're increasing blood flow to the brain. All that's happening. That could be part of the headache as well associated with dehydration.
I see tiredness or fatigue of more than 10% after the first adjustment. We worry people about it. Maybe they don't complain about it or they just go to sleep. I also hear people having the best night's sleep of their lives for their first adjustment. I love that.
That is very common. Patient satisfaction in this survey was 91%. In the same Rubenstein study, they had a smaller group but still a large and good group of 77%.
That's still fantastic. That's why I'm saying these doctors are doing good work. First of all, if you've read the previous episodes, we've had personal experiences with why we chose this. When people come into the office, if they have a subluxation or a misalignment that is causing nervous distress, I expect them to get well. I am surprised if they're not getting well, and I'm trying to figure out why.
I've got one who's not responding as well as possible. We're coming to that point where she's still having problems. I changed some stuff up and we're going to see where she's at. She's like, "We've been doing this for 3 or 4 months, doc. I'm still not seeing stuff." I'm like, "No. We've got to reevaluate stuff." I might say, "We're going to take the month of June off. You go play a bunch of golf. Come back in July and then we're going to double-check stuff. I want to see how you're doing." She plays golf, maybe newer to golf but maybe she'll notice that her golf game gets worse. There's something else that has crept back in because sometimes the change is so subtle and gradual that you don't even notice it.
Sometimes it's like a switch. More likely, it's a subtle change over time. When we reevaluate and we're like, "You had this," they're like, "I forgot I had that." I love when you forget about it. That's great.
I've got this last table here that we're going to go over very briefly. Most of these people were coming in with some neck pain dysfunction. A good number two, almost coming right in behind it was low back pain. We see good results with that. Number three was headaches. Some mid-back pain and some upper or lower arms and legs. Fibromyalgia was a small component. This was general. As patients walk into the office, they present it.
Most patients are going to have neck pain and back pain.
That's what's drawing people into any chiropractic office though, but we do see a lot of fibromyalgia. This equilibrium would be a balance of your type of things like vertigo. TMJ is common.
We see a lot of those.
Facial pain would be that trigeminal neuralgia we talked about a couple of episodes ago. We'll talk about the blood pressure study at another time. I want to find the second follow-up study. A couple of other things. Only six people came in for wellness care probably because they were a family member of another patient. In any case, that is what that is. It's great to know that not 91% of patients were happy in this study.
They’re highly satisfied with their chiropractic care in an upper cervical office. That's what we feel. We feel the love. We love the love. It's incredible. Whoever's reading out there, I want that for you. Find an upper cervical doctor and get checked. Worst-case scenario, they'll check you and say you're fine. What if there is something going on? You can live a healthier and better life by getting your neck checked. Do it. Invest in yourself. You are more important than a transmission.
You can live a healthier and better life by getting your neck checked. Do it and invest in yourself. You are more important than a transmission.
That will wrap it up for this episode. That's a better place than we did where we went depressing. Dr. Bagley, where can they find you?
You can find me in St. Louis, Missouri. We're on the Westside. We are at precisionchiropracticstl.com/.
I am in Springfield, Illinois at KeystoneChiroSPI.com. You can find us on all the socials. Search for that.
Click around, and you'll find us.
That is it. Make sure you like, subscribe, and share with your friends. Maybe they'll read this and be like, "I need to go find one of these upper cervical doctors." If you're not in our locales, let us know, and we will help you find somebody in your locale.
We’re happy to.
Have a wonderful evening, day, or night. We will see you for another episode of the show.
Take care.
I believe that's correct
Did you know that your parasympathetic nervous system that controls your digestion, heart rate, and immune system? When there is an imbalance in it, it affects everything else. In this episode, Dr. Bagley and Dr. Schurger delve into the cranial nerve you didn't know about, the vagus nerve. The vagus nerve is the main nerve of our parasympathetic nervous system. Join us to go over what the "wandering" nerve does for your health & how some problems with your health start in your neck!
---
We are having a grand time. We won't tell you why, but we are having a grand time already.
We should record when we're just talking about the show because I think it's going to be more interesting than most of our shows, but there are curse words that are said that we're not going to say, all sorts of things.
The people who do production have to do extra work on the show.
Sometimes there are hard people that come into the office. We love them, we give them all of our energy, and it takes a lot to be a doctor.
Some days it takes a lot out of us. We joked a couple of episodes ago about, "It doesn't look like you work a whole lot of hours." No. The hours we work are the hours that are allowed. The hours we don't work are us decompressing and doing other work.
We just don't see patients during those hours.
Oftentimes, it's a lot of, "I need my quiet time. I need my thing." This is a full day for us, but after a full day, I go home and I eat dinner. My dinner is consistently the same every night.
It’s meat with eggs and meat and fats.
It's eggs and bacon, and there is some extra fat. You are correct. I have my little bit of keto brick, and then maybe if I'm craving popcorn, I might pop up some popcorn.
He's so boring.
Yeah, it is. It's great.
I know you love that.
I know I have that, and then I'm going to decompress. I'm going to read my book. I'm going to figure out what's going on in The Wheel of Time series now that I have been exposed to this piece of fiction.
Is that the books you're reading right now? I just watched that on Amazon. They woke it up a little bit.
It's the first book. It's a weird little adaption. There are parts that, after having read the book, and then going back. Books are always better. I'm begging questions as to why they did it the way they did it. I don't care. Whatever. Probably because they had to get people on contract.
One of the things I ran into in the office was a patient having done some research on the vagus nerve. She had some weird reactions in her body to a dental procedure. I love that you're going to be going over some of this stuff because I want to relearn some of the things because you're good at that. What I will try to do for everyone is, what he says, I will bring it into an English translation out of science translation.
The presentation and the slides that we're going to use were from something that I presented to a group talking about, how do we measure this? What is the importance of measuring these? They're really small electrical impulses in the body and how important they are. It's at a high level, it's taught to doctors, and doctors need to understand this, but we got to translate it down to the patients. Sometimes we got to translate it down for ourselves so we can even understand it.
For those of you who are tuning in, there are some stuff here that might be worth watching on YouTube as we do this. One of the phrases that I like to use is something called attenuated autonomic insufficiency. It boils down to say, the automatic operating system, as it were, of your body, if it is out of balance, it is attenuated. It is less than where it's supposed to be.
Is it keeping you alive? Yeah, but there's a difference between being alive, in a coma, and effectively in a vegetative state. You have high-level athletes. Michael Phelps comes to mind, who for twelve years was at the prime of his swimming game. Now, you've got other people in other sports who are doing the same thing, trying to figure out how they can be healthier and stronger.
You were joking about the meat diet, but Dr. Sean Baker, one of the lead folks in the carnivore world, in his '50s, is setting all-natural, never done drugs as far as hormone-replacement type stuff in that regard. He is still the world record holder in one of these rowing competitions. The man is not any small man. He's probably 6'4", I'd guess around 210 to 220, somewhere in that range and deadlifts all the time. He played rugby and football through high school and then into college. He can do these sprint-level activities largely because he's doing things to bring up his ability for his autonomic nervous system to function better.
Real quick, I want to explain autonomic. You said automatic, so that's a great way to say it. In school, if you've taken a psychology class, you may have heard something like flight or fight, which is a part of it, and he's going to go over that. I want you to start thinking about there are two types of nervous systems out there.
We've got the stuff that we can control, like moving our arms and legs and taking a deep breath in on purpose. There are the things that we don't control, which is if you're sleeping, how often are you breathing? If a bear walks in the room, what does your heart rate do? That's the difference. You don't have to think about your heart rate right now to make it go. We're talking about those automatic functions of the body.
When we start thinking about the motor functions of the body and the voluntary stuff that we are doing, as you pointed out, how fast you want to walk down the road is dictated by how fast you can walk. Whereas these autonomic impulses, you've got two sides to this. You've got your voluntary stuff, and then you have your automatic stuff that you can influence, but it's always going to run at some level.
This is the question. How do we improve that autonomic function through various modalities? Chiropractic is certainly one of the very powerful ways that you can do this, but one of the crazy things is, I broke down and bought a 110-gallon feed truck tub, filled it with water, and I had been in it every morning. It is awesome.
Are you putting ice in it?
No, it's outside and it's sitting at about 45 degrees, so it's cold. I'm not going to pretend that I'm in there for ten minutes. This is not, "Go sit and enjoy yourself in the hot tub." This is, "I've got a minute. The timer goes off. I'm done." I tested the water temperature in the afternoon. It was sitting probably about 45 degrees, which is probably where it's been sitting all week. It's been up to the 50s here in the area.
Even though it's February and it's supposed to be way colder than that.
It's supposed to freeze.
You'll have an extra cold bath.
I might have some ice that I got to crack through to get into it. We'll see what happens. The point being is, that kind of cold exposure influences this autonomic response and improves our body's ability to function by doing some things. By immersing yourself in the cold and in order to stay there, you have to control your breathing. As you control your breathing, you start impacting these other systems, which is crazy because it starts getting things better, especially as you get used to it. The irony of the thing is, after being in the cold water, I get out and I'm drying myself off. I'm going back into the house to get my coffee, but it doesn't feel nearly as cold as when I was in the water.
Anyway, let's talk about this autonomic automatic nervous system. There are two sides to this coin. The fight and flight, which is our sympathetic. This is when you have a lion chasing you and you got to get away right now. It doesn't obviously need to be a lion. It could be a lot of different things. There are actually three Fs, but this is a family-friendly show, so it's fight or flight. Most people can figure out what the third one is because it's not family-friendly. The parasympathetic side is rest, digest, and heal. There's a balance. You need both.
If you only rested, digested, and healed, you'd never get out of bed. In the morning, your sympathetics come on, they turn up. You have that cortisol reaction that helps wake you up and warm up your body, which is why I hop into to cold to kick that into overdrive a little bit. When you're ready to go to sleep as I'm reading my book, usually, what happens is one aisle goes this way and the other one goes that way. The words start turning on the page and I'm like, "I'm going to put the book down and I'm going to fall asleep." That's the parasympathetic trying to bring my brain down to say, "You're ready for bed."
If your sympathetics and parasympathetics are out of balance, a lot of people will have sleep issues like insomnia. "I can't turn my brain off when I go to sleep." That's because your sympathetics are going high and your parasympathetics are turned off or low. That chiropractic helps a lot with that, but we're going to talk about some other things too. Keep going.
The sympathetics, there's a couple of different spots that it sits. It sits basically in the brain stem area. Certainly, part of it in the cortex. Some in the hypothalamus, but this is all brainstem, and this is high-level brainstem going on down. Most of the sympathetics traditionally have been taught that they come out of your spinal cord along basically your upper back T1 through L4. Yet there is some older research that suggests it has higher levels that it comes off the spinal cord up to C4 or C5. There's some question into that, and then there's a couple of ganglion, something called the stellate ganglion that comes up from those lower ones that come up into the neck. Sometimes words come out of my mouth and I'm mixing stuff up, but I'm pretty sure that's a stellate ganglion.
Maybe you need an adjustment.
I'm probably pretty good, but that's another story. It is a superior cervical ganglion. You have a couple of others that are coming off the cranial nerves for both your ophthalmic C5 or cranial nerve 5, which we were talking about. This is part of that trigeminal nucleus. You've got the cranial nerve 3, which is largely involved with eyesight.
There are some sympathetics on that side. That's a lot of your pupilary light reflex. That's a slow response. As funny as it sounds, it's actually a slower response to the dangers around in your life. Unfortunately, we live in this fight or flight response most of the time. The parasympathetic side is more rest, digest, and heal. It tends to be faster and we have that ganglion. In fact, the parasympathetic is what causes it to contract as opposed to open up. Most sympathetics are going to cause a contraction of vessels. Certainly, it's going to raise your blood pressure. It's going to warm you up. It's going to get your heart rate going.
Get your muscles ready for action.
Whereas the parasympathetics are going to start driving you down and start relaxing you. We've got a couple of different nucleus. I'm not going to get into it. We're going to focus in vagus and that's going to take a long time. You have the pelvic nerves coming off the sacrum or your tailbone. We're not going to cover the pelvic nerves. We might cover them peripherally, but the vagus nerve is what I want to focus on.
Vagus nerve is also known as cranial nerve 10. A cranial nerve is a nerve that doesn't come out of the spine but comes out of the brainstem area. That's all the way at the top of the neck, above where you can feel your skull. Cranial nerves are important and they pretty much are what's keeping us alive. Our brainstem is really important and those cranial nerves are, too. Vagus gets a lot of attention because it is impacted a lot. I see a lot of people with trauma responses. I don't know if we call inactivation or activation. It's almost like inactivation like it needs to be activated.
The vagus nerve is also known as the cranial nerve 10. A cranial nerve is a nerve that doesn't come out of the spine but comes out of the brainstem area.
We're going to touch on that because in the concussion space and a lot of other health problems, this has become one of those, it's not quite a buzzword, but it's definitely a buzz because it's becoming more popular. Certainly in chiropractic and how we apply it, but also, in most healthcare and most medicine are looking at this a whole lot closer than they used to.
The vagus nerve is unique because it is one of the few cranial nerves that not only drops out of your skull but also down and affects so much in your body. We're going to go over the branches of that. This may come out a little bit more academic, but it helps to visualize all these pieces. Most nerves go one direction. The vagus is unique because it has directions in and out of the brain. Your afferent nerves, they come back in, they tell you what's going on. Your efferent nerves are going out. I believe that's correct.
It's two-way communication within one nerve bundle where a lot of the nerves can only just be one-directional and there are other nerves that do other things. This one does both.
It's mostly the ones that are looking out into the system and feeding back into the brain. It has some that go out, but for the vast majority, it's looking at what's out in the body and feeding back, which is why 70% to 80% of them are considered afferent. The hub of the vagus nerve is something called the nucleus tractus solitarius. This will come back a little bit later. We call this the NTS. This is a major hub.
What is that and where is that?
It's in the brainstem just above the atlas, which is the first interesting thing about it. When I call it a hub, let's say you have a dozen USB devices that you're interacting with for your computer. My laptop has 2 USB inputs, but I need all 12 of these feeding in. They make little adapters or little hubs that allow you to put multiple things in, and then one wire comes out and your computer can make sense of all of that stuff coming in.
This is exactly that kind of hub where it might be aggregating all of that information into that one spot. It then disseminates stuff to the rest of the body on that parasympathetic and rest digest side of the nervous system. That's why I like to have people think about it that way because this is your major input to tell your body, "How do I start relaxing? How do I start doing things?" A lot of those afferent nerves are the perception for inflammation of the body.
Are you going to go through where these nerves are going?
Yes. That's next. The first branch comes around the back of the spinal brainstem cord area and innervates the meninges on either side of your brain. Let’s talk about the meninges real quick. There are three levels. We’ve heard of meningitis. Meningitis is an inflammation of the surrounding tissue. It’s not the brain, but it’s the tissue around the brain.
It’s like the covering.
We have three levels of meninges. We have the dura, which is considered the tough mother. This stuff is really rigid. It is trying to protect your brain from everything outside. In fact, that’s the blood-brain barrier that’s going on. The next one is the arachnoid which has a lot of vessels around it. That one’s a little bit tighter to the brain. The last one is the pia. The pia mater is right on top of your spinal cord and your brain.
This is the stuff and the material that interacts with your brain and your body. You have three layers to prevent you from directly getting stuff into the nervous system. You've got a box on your computer. You don't want anything to get into the box, especially if it's sitting underneath your desk and your foot decides to go into the CPU. That's a bad thing. That's why we have these things.
It is a protective layer.
It is, yet it has sensory inputs via the vagus nerve. I'm not going to get into any more detail on that because that's a whole other ballpark.
The interesting thing I want to bring up, which might validate some people is, if someone feels like they have pain in their brain like a migraine, can we relate this possibly to a vagal nerve problem?
Could be. I would not rule it out, but a lot of that brain-burning pain may not come from this.
That could be something else.
I would say that's probably more of a vascular issue overall.
I think it could be a mixture, in my opinion.
I would not call this a pain fiber necessarily, although 70% to 80% of it is looking at inflammation. There may be other inflammatory things going on that are subclinical, yet you can still feel it. We're on the second branch now. This is what they call the auricular or Arnold's branch. It helps control some of your perception. A dermatome is basically your skin sensations, as far as how the nerves perceive what's happening at the skin level, which is different than how your body moves. It's really curious.
The placement's different. If someone has shingles per se somewhere on their body, it's usually on one little section on one side of the body following the dermatone and following that nerve that's going to the skin. Hopefully, you never had shingles, but if you know someone who has had shingles, it's very commonly across the side.
The second branch comes around the auricular, so that's all ear, what they're talking about there. This is on the skin level. In fact, if anyone's ever heard of some of this auricular therapy that exists where they go into the ear or that daith, that is influencing this vagus nerve.
This is what I bring up about they get daith piercings to stop migraines. That's what people are doing.
People ask me, "Does it work?" I said, "It's only $30. It's painful.” A lot of people like that.
I’ve had some patients say anecdotally that it’s helped. I’ve had some that said they didn’t see a difference.
Same. In fact, one of my patients said she got both of them hoping it might help, but it didn’t do anything. The only thing that was touching her migraines was getting her head on straight, but her comment to me was, “I’m going to keep it so that I look like I'm the cool mom."
They're hard to see. I don't usually see them on patients until they're on their sides about to get adjusted. I was like, "You've got one of those." They're on the outer ear but inside of the outer ear. It's not easy to see.
Once you've got it, you might as well keep it because it was super painful and maybe it's helping a little bit. This is a lot of inner ear stuff that's being influenced by that second branch. There is some influence as they're using electrical vagal stimulators to improve vagal tone overall in the body. There are some really good evidence that we should focus on the left ear over the right ear, which I will come back to.
The third branch is the pharyngeal, the pharynx, and the soft palate. It's your mucus membrane. All that secretory IgA stuff that we've been talking about on and off, that's where this is being influenced by. The pharynx and the soft palate are important because if you've ever had a popsicle stick without the popsicle on it stuck into the back of your throat and had the gag reflex, that is that branch of the vagus nerve. If you're the kind of person who says, "I can brush my teeth and I never gag," your vagus nerve isn't working.
It's not a good thing. You're supposed to be able to gag.
A gag reflex is a good indicator that this is working properly. I'm teasing for something coming up here in a little bit, but if you're not gagging on the right, we have other problems. The fourth branch is the superior laryngeal nerve. This is getting into your thyroid cartilage or cricothyroid area, so the tension of your vocal cords for your higher notes, notes that I cannot hit, but Dr. Bagley can very well.
A gag reflex is a good indicator that this is working properly.
Another aside is I'm a singer. When my head is not straight, I absolutely can tell a difference in my voice and my ability to study my voice. There are a couple of things, but I do think that this is part of it.
It wouldn't surprise me that we have some vagal tone influences. I'll come back and explain why the atlas can influence the vagus. We're on the fifth branch. More recurrent laryngeal nerves, but it addresses the muscles around your larynx, esophagus, and trachea. What you're describing as your ability to sing as well is coming through here. All the mucus membranes are influenced by that vagus nerve.
How about dry mouth?
Definitely could be related. There's an autoimmune condition where all the mucus membranes dry up. It'll come back to me after dinner. The sixth branch is the right and left superior cardiac. The deep and superficial cardiac plexus is formed here. When we say deep and superficial, superficial is right at the top of your skin, on the surface. Deep is when it starts going deeper into either the nerves, into the muscles, or into the body overall. That's what we mean by deep and superficial.
We're getting into and creating the cardiac plexus, so this is the cardiac supply for the heart or it ties into the cardiac supply for the heart along with the sympathetic nerves. If you have run a mile and you're waiting for everyone to catch up and you're trying to catch your breath, this is where the parasympathetics are trying to bring down that heart rate back to a normal level.
It’s Sjogren's.
That's it. Thank you. I don't have to think about it after dinner now.
I thought that's what it was, but I was like, “I'm going to look it up so I don't look dumb.”
This is why the internet is great. This is also why if the internet goes down, I will have reference books handy.
You and my husband both. You guys love your books.
There are a lot of them. Here's the interesting thing. This is the last branch of the vagus nerve before it enters the chest. So far, the vagus nerve is taking care of the ear, it's coming down, getting in the back of your throat, getting into your thyroid area, esophagus, and larynx, and then it starts sitting right up here. Before it goes into the heart itself, it starts mingling with the sympathetics for the heart, and then it drops into the chest.
This is the first branch in the chest. You have your inferior cardiac branches that are deep into the cardiac plexus. The left originates from the recurrent laryngeal nerve which is another nerve that's out there, but it influences the atrial ventricular node. This is the bottom half, the inferior cardiac branch of the heart, but the right branch. The left branch gets the AV node, which most people don't think about. The right branch is the sinoatrial node. This is your lub dub. A big part of your heart rhythm is controlled by the sinoatrial node. This is where pacemakers are being influenced.
This is why stemming the right ear might be a problem because it could have a direct impact on that sinoatrial node. This is one of those, talk to your doctor if you are investigating this pathway because there is some back and forth as to whether or not that's safe. Certainly, it is also a concern for us as upper cervical doctors.
When we have a patient coming into our office who has a pacemaker, when we get them adjusted, that pacemaker is geared to run at a certain rate and help make sure that they're working good. A lot of people, after they get adjusted, can have pacemaker problems. You need to be aware of that and make the patient aware of that after their adjustment. There might be some changes as well as they might need to call their cardiologists and have a tune-up just to make sure everything's working the way it's supposed to. Same thing applies to blood pressure as well when you get an adjustment.
I see that more often.
I think that's going to be more common.
I haven't seen a pacemaker in a long time. Maybe they're not doing it as much.
Wouldn't that be grand?
I think because they're doing ablations more now, maybe they're not going to pacemakers as much because honestly, I remember I saw them more years ago, but I don't see them as much.
The other thing is we've gotten much better about how we address heart disease across the board. Heart disease and cancer run back and forth between number 1 and number 2 as far as what's going to get you. Certainly, we've learned that we can be more aggressive with heart disease and get people the kind of care they need. Maybe what ends up happening is the vagal and sympathetic tone that goes to that sinoatrial node doesn't get shot or doesn't die in the process. There's less of a need. I'm speculating. We should probably pose that question to Dr. Peter McCullough and see if that seems to hold true.
Let's move to the eighth branch. It's the second in the chest. This one innervates the lungs. This is going to help you get that better deep breath. It is supplying the front of the lungs and it joins with the sympathetics because the entire breathing process is a dance between your sympathetics and your parasympathetics.
The entire breathing process is a dance between your sympathetic and your parasympathetic.
If you decide you're going to lift a heavy weight overhead, you're going to need more air and you're going to be breathing heavier, so that's going to come up. As soon as you put those weights down, you can relax and that will help. It's that back and forth. The third in the chest is the ninth branch. This is going to the posterior or the back part of the lungs. Similar functions. The tenth branch is the last in the chest. I have the chest defined as everything in the ribcage before we get into the abdomen.
Above the diaphragm.
The tenth branch is the last in the chest. It's for the esophagus and it's pretty much left and right. It has been pretty straightforward at this point. After this, the left goes one direction and the right goes a different direction. The left vagus at the eleventh goes to the anterior gastric, which doesn't sound like a big difference, but it's going to the front and the top of your stomach. The right goes to the back and bottom portions of the stomach. You've got two different influences there. If you've ever thought about, "I have a heartburn. I wonder what's going on there," how is heartburn in the right vagus where all the acid is largely pulling due to gravity affecting the heart also in the right vagus? Isn't that curious?
It is curious.
Are these direct? I don't know. When the right vagus has problems, the right vagus has problems. It might affect multiple aspects of the body. The twelfth branch is the left vagus, and it's just all left vagus at this point. It's all right abdomen. It's going to get your liver. Basically, everything around the liver, which is the hepatic plexus. Plexus means it's all over the place, and hepatic is liver.
It mixes together. That's the end of the line. That's where the vagus stops working. It doesn't go into your legs and toes.
This is the end of the line for the left branch or for the left vagus.
Where does the right go?
The right stays in the right abdomen. It's influencing the liver as well, and it's also the end of the line, but they're a little different. End of the left vagus is in the right abdomen. The right vagus, that side looked very familiar. Still, twelfth branch, we're on the right vagus. This is the celiac branch that then goes to the adrenals, kidneys, pancreas, intestines, especially the upper two-thirds of the colon influenced by this, and the spleen.
The right vagus is a workhorse all through and through. That's a huge influence through there and this is the end of the line for the right vagus. When you think of the nerves coming from the brain, the intestines, only the upper two-thirds of the colon are influenced by the vagus nerve, whereas the lower third is coming up from the pelvis.
This is why there's not a whole lot of information on this generally because it's not been studied as much because everything that happens in the vagus influences your body. Whereas the pelvic nerves, that happens too. It's less sexy. No surprise that control of your colon, rectum, prostate, reproductive organs, bladder wall, and various sphincters, people are like, "Those are supposed to work, but we're not going to pay attention to that."
They're kind of important.
It really is. That's coming up from the sacral and your sacrum affecting your lower part, but there is a lot of coordination from the spinal cord between these sacral nerves and your vagal tone. There's a connection there.
That's why doctors, I'm one of them, that does the Logan basic technique are very into this information.
It makes sense because sometimes the thing that's bugging you up top is in your hips. Sometimes the thing that's bugging you in your hips is up top. It's good to look. I do a little bit of Sacro-Occipital Technique in the same way as you do with the Logan Basic.
Our number one is always the Sawyer Technique because we can cover so much on that.
The great thing is I've seen many cases of bedwetting, which should be pelvic nerves get better just by adjusting the atlas. The thing about the sympathetics is they tend to be much slower than the parasympathetic supply through the right vagus. The sympathetic supply to the sinoatrial node.
We're back in the heart.
It has the capacity to get your heart rate up above 200 beats per minute.
That's pretty fast.
Yeah, it's very fast. That effect can be seen after two seconds. It peaks at 4 seconds and it'll end after 10 seconds. When you got to get going, it's going to ramp everything up, but it's only going to be around for a little bit because hopefully, you got away from the lion. Maybe your friend didn't, but hopefully, you did.
Just push him in the way and run.
Just remember, when you're putting your shoes on, take your time to tie your shoelaces because you only have to outrun your friend. You don't have to outrun the lion. Isn't that horrible? That is miserable.
At the Saint Louis Zoo, there's a bear that has escaped twice. He's the smartest little bear there is.
What's his nickname going to be?
It should be Houdini.
I don't know why I kept on seeing the Cocaine Bear show up on various podcasts. I'm like, “That's weird but it's curious.” In any case, back to the heart running in the way it's supposed to. The parasympathetic supply to the heart through that right vagus, the same sinoatrial node, affects it in less than 1 second, peaks within that second, and lasts for only 2 seconds. It is 80% to 90% faster than the sympathetic supply. It's using a different chemical.
The speed differential is the neurotransmitter that they're using. It's a low frequency versus high frequency, which we'll come back to here in a moment as to why low and high frequency is important. Norepinephrine activates an enzyme complex that takes 8 to 10 seconds to complete, which is that sympathetic because you can see it ends after ten seconds.
Whereas acetylcholine, which is funny because the best place to get choline is fresh eggs, is an ion channel activation and it only takes a second to cause an effect. This is why it runs faster. We're looking at the brainstem from the back. We see a number of different places that influence the nucleus tractus solitarius. One of them is this intermediate nucleus that goes right into there, so it's one step removed.
Anytime you have a nerve going into a nucleus, one nerve going into a nucleus will have a profound effect on that nucleus. When that nucleus then will have multiple places that it's coming off of to other places, the next nucleus still has a pretty profound effect from step one. What is interesting when we start looking at the upper cervical is that there is a possible role in autonomic or respiratory control. It's because the muscle spindles in the cranial cervical junction around the atlas and axis directly influence, go right into that intermediate nucleus, and then one step away from the nucleus tractus solitarius.
What you said is important, but I want to get it to the point where someone who has not gone to school for this would understand it. The muscle spindles, which means the information that the muscles give to our body, so muscles give information constantly to us.
This is the information coming into the body from the muscle sensation, knowing where it is in space.
The muscle knowing where it is in space and sending that information, that's what a spindle does. It's going to directly affect when it's up here in the top of the neck, up to the upper cervical of the cranial cervical junction, it directly is influencing what's happening in the nucleus, which is like the hub of cranial nerve 10, which is also known as vagus.
Almost. First, this is the hub before that. This is the nucleus intermedius that has a ton of influence to various things, but one of them ends up being the nucleus tractus solitarius. If I was Seven Degrees of Kevin Bacon, it's exactly that. Let's use Joe Rogan as an example. If I wanted to tell Joe something, I'd have to go through several intermediaries to get my message to him. Odds are my message will not be the same message.
Let's use Tim Pool as my intermediary. I probably can get connected because I subscribe to his thing. I could probably get one of them to entertain an idea that I presented. They present that to the next level, so the intermediary one then presents it to Tim. Tim says, "This isn't a bad idea." He sends it to Joe, but it's got to go through Jamie first, and then it finally gets to Joe.
It's not my idea at that point in time. It's pretty much Tim's idea at this point in time because Tim says, "That's a really good idea. I'm going to present that." These guys are good because they won't take credit along the way, but somebody's going to take credit along the way if it's going to somebody else. This is where you get muddy water in between the signals between the hub to the hub. However, for whatever reason, let's say that Tim Pool and I become great friends.
That would be your dream, by the way. "My friend, Tim."
I like wearing beanies. Tim introduced me to Joe, and then Joe says, "I like that idea," that's that two-step difference. That is where the nucleus intermedius talks directly to that nucleus tractus solitarius and then can have that profound impact on the parasympathetic or the rest, digest, and heal side of the nervous system.
Let's back it up to patients who are tuning in. When you were looking at the thermography graph that we do every visit, when we take that graph, we are getting a snapshot of what your nervous system is doing. How stressed out is it? If it is stressed out and it's stressed out in a way that has caused you to go out of adjustment, we see the same thing over and over again. It is not a healing pattern because you only have two states of the body. Rest, digest, and heal, and fight or flight. Effectively, fight or flight is breaking down and dying. It gets you away from the lion.
It should turn off.
If you're always stuck in that fight or flight, then you are slowly breaking yourself down. You get sick, exhausted, and pass out because you're like, "I don't have time. I don't have the energy to do this thing." When we see that pattern present, which is controlled by the sympathetics, we know that there is a problem that something has raised your stress level.
Does that mean you're out of adjustment every time? Not necessarily. I had a patient who was like, "I feel great, doc. Mom was in to visit." His mom's like 89 to 90. His mom is a go-getter. She's all over the place. He comes in and he's like, "Yeah, I feel pretty good. I think I'm going to be holding today." I check him and something's off on the graph. I check his legs and he's off. He's pulling a half-inch-short, which all is telling me he's probably out of adjustment.
I'm not finding the indicators to tell me that he's out of adjustment, so I have him go rest. The graph changes a little bit. The legs are still doing something weird. I basically tell him, "You have some underlying stress going on. Take it easy. This is not the day to go run a marathon. However, be aware of your body because you may need to get in next week to get checked beforehand."
This is where we can start to see the bigger picture of how your body is in or out of adjustment or just under stress. I see that fairly regularly with people. There was a day where every time I took a graph, I looked at it and I'm like, "We're getting you adjusted." When I went to do the leg checks, that was confirming what was happening. This is where all of this nervous system comes into play. I think this graph and picture is a lot, but once you start to piece pieces together, you'll know.
Someone who's a patient or someone who's interested in upper cervical care and is not wanting to be a doctor. In general, just know that there is a relationship between the top of the neck and the cranial nerves. We're trying to explain how that then affects the hot button issue, which is vagus or vagal tone.
This also goes to the impact that the upper neck has on the nervous system on a much larger scale, so it's not just fixing your neck for your neck pain. It is affecting everything throughout the body. Whereas I love traditional chiropractors, but if I've got a problem in the middle of my back, I know guys who pop that left, right, and center all day long. That is not going to have the same profound effect of the entire body and getting it back into balance.
A lot of people are like, "Why don't you pop my back?" It's not that I couldn't. I did know how to at one point, but I absolutely study and am very proficient at adjusting the top of the neck. Just because I've taken all that time to do that, a lot of times I don't need to adjust the lower stuff because it gets better. If it does, there are 50 chiropractors right around me that can do that for you. I do the thing that they don't do.
I want to wrap up with a couple of things because we're going long here. Both of us have had full days. The first picture is a heart rate variability picture. These two red pictures of the red stuff, they're actually the same data except for the data at the top has not been corrected. There is a technology called heart rate variability. Oura Rings and WHOOP Straps are becoming more popular. Apple watches sort of have it. The Oura Ring sort of has it. What it's looking at is the beat-to-beat intervals that are going on.
We do a couple of other things. Certainly, we do the thermography and we do the pupillary light reflex in my office. We're still seeing what that all pans out to be, so we'll get a better sense of how well your nervous system and autonomic balance are working. One of the things that we know about this heart rate variability and why these two pictures look so different, and yet it's the same data. It's because the one on the bottom looks like the lub dub.
This is the traditional PQRSTU wave. This is the wave that the heart makes every beat that it makes. If you look at the one on the bottom, you can see that PQRST wave presenting properly. The one on the top needed to be corrected by hand. This is a five-minute sampling. It doesn't come out looking right until you do each and every beat. This ends up being the problem with most of our devices is, they're using some algorithm to get it close.
This is why good HRV measurements, 1) the equipment costs a lot of money. 2) It takes a lot of time. 3) The reason I like the Ouras and the WHOOPs, the stuff that is looking at you overnight is it gets a bigger sample size so that algorithm cleans up the data better than what a five-minute sample would do. A good five-minute sample with the right equipment will still give you a much better indication of where you are. There are 3 or 4 different measurements that they use for this. One is called SDNN, which is an overall measurement of your variability.
Before we go way into this, I want to say what you haven't explained yet is heart rate variability.
That's what I was going to talk about. Let's start right here. For those of you who remember the old keyboards that had a drum track on them from the '80s. The problem with those, the early ones, is you would have such an exacting beat that it would drive people crazy and it didn't sound good.
Was it a Casio? Is that what those were?
There were Casios. We had a Yamaha. There were a bunch of different brands that were playing with this. The problem was, when you had a beat that was constant like that, it didn't feel good as the music goes, which is why when a drummer who's playing a really good beat, they're grooving. They're having some fun with it. They're setting that beat. The beat's pretty much there, but there's a little bit of back-and-forth tension that goes on.
The same tension happens in our bodies. The more variability that we have, the healthier we are. The less variability or if you're more like a robot, odds are you might be a robot and that's bad for your health. You want that variability in your system so that your body works better. There are a number of different frequency measurements, which goes back to the acetylcholine and norepinephrine mentioned, where it was like high frequency and low frequency. The acetylcholine happens quickly. When you do the frequencies, it's one over time.
If it only takes one second, you do some math, 1 over 1 second is a very high-frequency number, whereas one over a big number is a very low-frequency number. Sympathetics tend to be more low-frequency. Parasympathetics end up being high-frequency. In fact, it was largely the Russians who figured all this stuff out.
They've done good research in this field. They did really good science. If you can read a little bit of Russian and get into their old databases of all their health stuff, there's a lot of good health information in there. There are a number of different ways that we can figure out and piece out these frequencies by looking at the heart rate and then running it through algorithms to figure out what's going on. The vagus nerve largely influences that. This is a large portion we're looking at.
If you have a healthy vagus nerve, vagal tone, or whatever you want to call it, you will have a good amount of heart rate variability. If you have a poor vagal tone or your vagus nerve is not working right, it doesn't vary much. It becomes robot-like, like the Casios or the Yamahas of the '80s.
If you have a healthy vagus nerve, vagal tone, or whatever you want to call it, you will have a good amount of heart rate variability.
Correct, even though some people still collect those things.
They should. They're awesome.
Some of those were really good. This is why daily readings in the morning are probably the most ideal. As I said, I like the Oura Ring and the WHOOP because they give you an overnight sampling. The more data you have, the better picture you get because you can fudge the data a little bit to say, "I did really good tonight." Whereas other nights, maybe less so or if you got a smaller window.
There are a number of apps on the phone that work with a Polar heart rate strap that you could do every morning when you wake up. Put a slap on the strap, take a five-minute reading, and see where you're at. There are different ways if people are interested in doing this on their own. In fact, I would recommend if you are interested in doing this. Instead of trying to find a doctor's office that has heart rate variability, I would invest in one of these technologies to measure and see where you are. That's going to give you a better picture all the way around. Dr. Bagley, let's wrap it up. Any other questions?
I know you could talk forever on this, and you have before. In general, I think it was a really good quick overview. I know it didn't feel quick, but there are lots more. A quick overview on sympathetics, parasympathetics, the powerful vagus nerve, and one of the ways that we can test it which is heart rate variability. In general, we see incredible results with Blair Upper Cervical Care and how the interactions with the vagus nerve can happen. We see changes in how people's digestive tract works, how their heart's working, and how their breathing is. This could be an explanation of why we're seeing this so much.
There are incredible results with Blair upper cervical care and how interactions with the vagus nerve can happen.
I've got a second thing I want to quickly hit on. When the vagus nerve comes out of the skull, it actually comes out along the parallel to both the carotid artery which is on the inside and the jugular vein on either side. It's sitting in between two large vascular pieces. The carotid arteries tend to maintain good muscle tone.
Arteries, in general, have muscle tones. It's sitting right on the front part of your atlas with the carotid and the jugulars on either side. We commonly see on MRI when there's a subluxation present that one of the carotids sometimes, but oftentimes one of the jugulars is occluded, basically shut down and not working the way it's supposed to, which the vagus is right here. It's affecting the vagus on that side, too.
What you're saying is it's not just the interaction at the brainstem, but it's maybe a physical interaction between the atlas bone, that top bone in the neck, and the vagus nerve itself that's coming out.
That absolutely may be possible. Multiple components and multiple pieces. Many times I have somebody come in with, "Doc, I got neck pains and migraines. I had this lung problem that has cleared up recently." I'm like, "Did we talk about a lung problem?" "No, I never mentioned it. It had been around so long. I don't even think about it." It's one of those things. What are all the pieces to the parts? Can we point to one thing? The only thing I keep on pointing to is the atlas.
I do that a lot, too. It was so good to talk to you again. I hope the people tuning in have heard some things that they enjoyed and also understand better about how your nervous system works. If you could leave us a like, a subscribe, or do a little comment, that always helps. If you have questions, throw some up there. We will be looking at those and answering your questions in future shows. I'm Dr. Beth Bagley and I'm in St. Louis, Missouri. You can find me at precisionchiropracticstl.com/.
I'm Dr. Frederick Schurger, KeystoneChiroSPI.com in Springfield, Illinois.