ROBERT J KLEIN, DO

1652 42nd St, NE, Suite A   Cedar Rapids IA (319) 395-0223

Practice News

04/01/2010 - Osteopathic Medicine, Past and Present

Osteopathic Medicine, Past and Present  

The concept of osteopathic medicine was formulated by an allopathic physician, an MD, back in the l870s. His name was Andrew Taylor Still, MD, DO. He was aware of the deficiencies in his allopathic medical training because he could not help his family members as they were dying of meningitis. He felt that instead of giving medications, it made more sense to help the body help itself instead. His philosophy of health included good nutrition, avoiding habit-forming narcotics, avoiding dangerous medications, and using manipulation to help the body. When he tried to promote these improved, holistic, ideas to his MD colleagues, he was so far ahead of his time that he was rejected. He started the first osteopathic medical school in Kirksville, Missouri in 1892 so other physicians, besides himself, could practice in this manner. The medical degree conferred was Doctor of Osteopathy. He gave this branch of medicine the name osteopathic to show how the idea supports the body, including the musculoskeletal system. The idea that the musculoskeletal system by itself is also important and shouldn't be ignored was part of his philosophy. He promoted understanding of blood flow in and especially out of an area, adequate lymphatic drainage, proper nerve influence, and respect of the body's ability to heal itself. He understood that nerves transmit substances, not only electrical messages, and that connective tissue has great influence on health because it is the source of blood cells, the immune system, etc., and that it is not just a support system against gravity. Many of his ideas were not proven valid by physiologists until many decades later. The founder of chiropractic, David W. Palmer, attended an informational seminar on osteopathic medicine in Kirksville in 1892, and borrowed many of his ideas to start that profession, which emphasizes spinal and nerve health, but as far as I know, he never gave Dr. Still or osteopathic medicine credit for these ideas. Mr. Palmer, who had been a grocery wholesaler, started talking about chiropractic in 1895 and founded the first college of chiropractic in Davenport, Iowa , in 1898.

Unfortunately, allopathic physicians, MDs, about a century ago decided that they had the only scientifically valid system of health care and tried to get rid of every other philosophy. This included naturopathy, hydrotherapy, chiropractic, homeopathy, and osteopathic medicine. This animosity is why it took 70 years for all 50 states to allow osteopathic physicians the right to practice their complete system of health care, like the MDs. Because MDs wouldn't share their hospitals with osteopathic physicians, our profession had to build its own hospitals and medical schools. The profession's resources were spent fighting for our rights to practice in each state, building our own hospitals, and also building and funding our distinctive medical schools without government or a charitable institution's help. Because this was required for us to survive, we did not spend money on marketing. Medical doctors are so well known simply because they are the majority of physicians in this country, and the chiropractic profession has spent great sums on marketing so they are also more well-known than we are. Fortunately, now allopathic and osteopathic medical students, interns, and residents often do train together in the same medical facilities. The medical schools remain separate because the degrees conferred are different, even though much of what is learned in either type of medical school is the same. The difference is that the DOs have the distinctive osteopathic philosophy and training in osteopathic manipulative medicine as described above. If I had become an MD surgeon as I had originally planned, I would be trained in performing the surgery, caring for people in the hospital afterwards, prescribing medications as needed, etc. However, if I had become a surgeon with the DO degree, I could use my training in osteopathic philosophy and manipulative treatment to help prepare the person for surgery, and help them recover afterwards, shortening hospital stay and overall expense by helping the bowel function sooner, helping promote lymphatic drainage, helping the patient be more comfortable so they could walk around sooner, etc. Also, many times simply providing osteopathic manipulative treatment for carpal tunnel syndrome, etc., can avoid surgery altogether. Allopathic physicians, MDs, are not trained in this aspect of health care. As explained elsewhere in this web site, I did not become a surgeon, but I was a family practitioner for five years and I am now a specialist in providing osteopathic manipulative treatment. Currently, osteopathic physicians are 6% of the doctors in the country, but they see 10% of the patients each year. This is partly because of osteopathic medicine's emphasis on primary care. 50 years ago, there were six osteopathic medical schools. Now there are 26 osteopathic medical schools training physicians on 28 campuses. In a few years, 20% of the medical students in training will be osteopathic medical students. Similar to medical doctors, osteopathic physicians are active in all specialties of medicine, and always have been. Examples are family practice, pediatrics, obstetrics and gynecology, cardiology, infectious disease, cardiothoracic surgery, orthopedics, general surgery, internal medicine, and so on. Because of our complete training, like the MDs, in this country, we are referred to as osteopathic physicians. There are osteopathic colleges in other countries that grant the DO agree, and those physicians are also trained very well, but only in manipulation and cannot be fully licensed like we are in this country with that degree earned elsewhere. These foreign trained physicians are referred to as osteopaths. They are licensed by special boards in their own countries. They do not perform surgery, write prescriptions for medications, etc. like osteopathic physicians do here in the United States.

 

 

 

02/23/2010 - My Story

Because of a number of physically traumatic events as a youngster, including falling on my bottom on the ice more than once, and various additional injuries later, I suffered from chronic back pain since childhood. Because my pelvis, the body's foundation, couldn't hold me up against gravity successfully, my posture was poor. My pelvis tipped forward so my bottom stuck out too much in the back. Additionally, the pelvis's loss of structural integrity made my low back go too far forward, forcing my rib cage to also be curved back too much the other direction. This caused the top of the rib cage to be more forward so my shoulders were down and forward, and my neck and head were ahead of where they should have been. This inefficient way of being erect put stress on my spinal nerves and other structures causing many problems. My symptoms included abdominal pain, low back pain, ribcage pain, and a very stiff neck. In driver's education when 14 years old, I couldn't turn enough to see the "blind spot" behind and to the left before making a lane change. Symptoms also included anxiety, cold and clammy hands and feet, and inability to breathe deeply sometimes. This also caused occasional poor voice control, making me sound overly emotional when I wasn't. I also had occasional sudden salivation as if I was going to be sick and throw up, but in about 30 seconds the feeling would go away. At the time, I did not understand why this was happening. I also had an irregular heartbeat that worsened as the years went by. In medical school, I was careful not to volunteer as the subject when we were studying cardiology and learning how to read EKGs. I was afraid it would show a severe heart rhythm problem and I worried that I might be dismissed from school for health reasons.  

Bladder sensitivity and prostate problems, much more common in our culture in older men, bothered me already even as a teenager. I simply had to get out of bed and go to the restroom because I couldn't wait until it was time to get up in the morning. During the day and in the evening, when seated I would often be sleepy and several times throughout the day, this was so severe that I wanted nothing more than to sleep. These episodes would last 10 to 20 minutes. This problem was especially severe in college and medical school. However, even as I drove the school bus before that when I was a senior in high school, with dozens of lives in my hands, I had to fight the strong urge to sleep. When I felt sleepy, if I could take a nap, only for about five to 10 minutes, then it wouldn't happen again for a few hours. However, it was so severe that it continued to occur while driving, while riding as a passenger on the back of my friend's motorcycle, and even a few times while riding my own bicycle. Consider how abnormal that is. I also had bowel dysfunction, difficulty concentrating, foot and leg cramps, influenza every winter, sinus trouble with every cold, bronchitis after most colds, lack of restorative sleep, poor reading comprehension, and a comfortable standing limit of only a few minutes. After riding my 10 speed bicycle for an hour or two, when I would get off and walk I would almost fall down because my legs would not function correctly. As I assisted in surgery as a medical student, it became quite obvious that my back pain would prevent me from ever becoming a surgeon myself because of the prolonged standing at the operating table that is required. My back and shoulders would hurt so much while standing at the operating table that my hands would shake - not good for surgery. I was interested in this field because I like to use my hands to fix things, and I like to help people feel better. However, the way things were going, at 30 years of age I thought I would be disabled by the time I reached 40.  

For five years, I wore a device that helps support the pelvis against gravity and had some relief of the back pain. However, my sacrum, the "upside down triangle" bone in the pelvis between the low back and the tail bone, was finally successfully treated with osteopathic manipulative treatment (OMT) in the late 1990s. This was done at one of my continuing medical education courses by the osteopathic physician teaching that course in visceral manipulation, and my symptoms slowly started to improve. At another course he was teaching six months later, he treated my sacrum again. My improvement continued. The falls and other traumatic events in my life had compressed this bone and the doctor's treatments helped it decompress. This allowed my body to finally begin recovering so that I had a more erect posture and actually gained a quarter to a half inch of height instead of wasting some of my natural height in excessive forward and backward curves. This allowed my spinal nerves to work correctly again. The nervous system sending and receiving the correct messages again allowed my irregular heartbeat, clammy hands and feet, cramps, abdominal pain, etc. all to decrease over a number of years. My progress was prolonged compared to what most of the patients at this office experience because I was unable to get follow-up treatments regularly. Since the doctor that spent some of his time teaching other physicians like me was maintaining his active practice in California and I was in the Midwest , I simply couldn't see him for continuing care. Now, most of my symptoms have resolved and a few are much better. I haven't had the flu in about 10 years. My colds no longer include sinus trouble or bronchitis afterwards. I can stand for more than 30 minutes without pain. I can sit through a church service, or a continuing medical education lecture, and even a movie without falling asleep like I would have before. I can breathe deeply any time that I want, without any pain or limitations. Now, after age 50, and after improving so much from successful OMT, I finally know what it's like to wake up refreshed and ready to go. At times in the past, my back would be so sore that I'd wake up every time I had to move around in bed while trying to sleep. This severely affected my sleep quality. That no longer happens. I can ride my bike for hours and still walk afterwards. I have ridden across the state of Iowa , the long way, five times now as part of RAGBRAI. I thank the Lord daily that I no longer hurt like I did. My future looks good. I tell people that I am in a "terminal good mood" because I am so thankful for my improved condition. My voice no longer sounds inappropriately emotional. I no longer have the generalized anxiety that I had for decades. I comfortably ride my bike to this office about half the year. I can cross-country ski now without the back pain and fatigue that I had experienced while skiing on Mount Spokane more than 20 years ago. I can stand at the sink doing dishes without the upper back pain that I had when doing that before. I can turn my head and neck completely each direction without difficulty. The bowel dysfunction no longer occurs. My reading comprehension is-somewhat better in general, and some of the improvement is because I can stay awake much longer now while reading. I can do significant physical work, such as removing dead trees, including the stump. This involves bending forward for an extended time, digging the dirt away from the roots, and chopping the roots off with an ax. When the tree finally becomes freer from the ground, many minutes to a number of hours later, it is carefully pulled or pushed down, cleaned up, and cut into firewood. Most people don't enjoy working that hard, but I do, and now I can do so without abnormal pain. Life is good. 

 

 

 

 

 

 

 

 

 

 

 

 

 

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