I sometimes wonder whether the idea of getting something for nothing actually became collectively seeded early in our childhood, when we were exposed to magic carpet rides, 'arising from out of thin air', 'alakazam' and other sorts of myths in which the normal rules governing cause and effect are suspended. When I think about it, board games and television probably did nothing to discourage the unconscious notion that one can actually 'Get Out Of Jail Free' without having to pay the piper. Maybe that's why we have all been so softly and sweetly lured into thinking that indefinite series of never-ending band aids amount to the same thing as being "cured".

Wherever the source came from, somehow we collectively have been led to suppose that medication use can carry on forever without any real consequences, and that endless access to pharmaceuticals amounts to the same thing as health care. The truth, insofar as chronic pain in particular is concerned, ends up presenting a far different picture than your garden variety "happily ever after" fairy tale ending.

The fact is that one cannot use opiates such as morphine, hydrocodone, oxycontin and methadone over a sustained, indefinite period of time without individuals being subjected to hyperalgesia, or increased sensitivity to pain, which can be brought on by damage to peripheral nerves called nociceptors. Hyperalgesia is linked with the presence of platelet- activating factor (PAF),which is brought about by an inflammatory response. Typically the body uses inflammation as a protective mechanism to remove harmful stimuli, and initiate the healing process.

What this ends up meaning is that the longer common pain medications are taken, the worse the pain they are being taken for can become. Seems a little counterintuitive, don't you think? Kind of like 'The Sorcerer's Apprentice' gone wild.

When opioid-induced hyperalgesia is typically reported to attending pain specialists, it often ends up becoming inadvertently compounded by increasing the dose of the opioid, which ends up worsening the problem by further elevating the individual's  sensitivity to pain. That means that the pain sufferer now needs more medication to achieve pain relief, which they experience less and less frequently. Throw in the phenomenon of addiction, and loss of functioning, and you have the sort of individuals who become obliged to seek out non-toxic approaches for managing their pain, which are the sort of people who make their way to the pain management program I became involved with, based out of St. Helena Hospital.

Here the multi-disciplinary staff is dedicated to restoring functional integrity while providing comprehensive, non narcotic- based pain relief. So, as the results of the graduates of the chronic pain program constantly remind us, happy endings can indeed be achieved, but probably more often by applying a little old- fashioned elbow grease rather than rubbing a magic lamp and expecting three wishes to be granted.

For more information, contact Peter Behel, MA, Certified Biofeedback Specialist at (707) 579-7982

Raynaud's disease is an affliction whereby the blood vessels of the
hands or feet become so severely constricted that fingers or toes can
become discolored, turning white initially and in some cases even blue
or purple. Although this condition most commonly targets fingers and
toes, it has been known to affect the nose, lips, and even the tips of
the ears in some people. Stress is thought to be a major contributor in
the development of what is termed primary Raynaud's, or Raynaud's
unrelated to secondary autoimmune disorders such as lupus, scleroderma
or rheumatoid arthritis.

Astonishingly, considering the level of side effects associated with
the common medications used to treat Raynaud's disease (calcium channel
blockers, vasodilators and alpha blockers), working to control the 
constriction that lies at the heart of the disorder seems to be something
of an afterthought for many primary health care providers. The vasoconstriction                                                                  
that is the defining signature of Raynaud's disease can  
be regulated using targeted biofeedback as a means of bringing the
involuntary contraction under control. In my former capacity as biofeedback
specialist at the St. Helena Hospital- based Chronic Pain Program, I 
observed a great many pain sufferers learn to spontaneously
increase their circulation as a byproduct of using biofeedback to learn
how to manage their pain.

I recently had the opportunity to observe how this same approach might
be received by Raynaud's disease individuals in my private practice,
and was not at all disappointed in the results. The first individual
was something of a classic Raynaud's disease sufferer, a 16 year old
young man with finger discoloration so prevalent that it could be
observed from a distance. He had been worked up by Raynaud's
disease specialists at UC San Francisco, but nothing they prescribed
seemed to give this individual any sort of relief for any length of
time.

By his second training visit with me, he was managing his blood flow so
effectively that his circulation increased for several consecutive
minutes, much to both of our amazement. He seemed genuinely in awe that
he possessed any sort of influence over something that had plagued him
for so long; and seemed particularly surprised that it seemed so easy.
By his  4th training visit he was completely dilating his blood vessels
to normative levels, and shortly thereafter he seemed to feel that he
had gained enough of a skill package to continue to practice at home.

The other sufferer was a middle-aged woman who complained of dizziness
in addition to her vasoconstriction, which she stated actually
encompassed her entire forearm, in addition to the two fingers she
identified as the primary culprits. Her collection of symptoms proved
to be more complex and problematic, and  only began to unravel after
many visits. She also had been worked up by physicians at UCSF, but
only began to experience symptom relief when we targeted eliminating
her tendencies toward chronic hyperventilation, which had the effect of
both clearing up her dizziness and dilating her blood vessels.

All of which serves to demonstrate that when it comes to investigating using nervous
system control as a means of correcting Raynaud's disease, one
needn't have cold feet.

If you are interested in learning more about biofeedback and how it might help you with your particular condition, please give me a call at 707-579-7982.

Blood pressure regulation- not as implausible as it may sound.

Somehow the idea of actually influencing something as deep-seated as our own blood pressure has always seemed like an incredibly tall order. I mean after all, this is a health condition that is attached  to to a very large medical industry, right? The estimated 1 in 3 Americans who suffer from elevated BP seem doomed to a lifetime medication regimen, and what's even worse,place themselves at risk for heart disease and stroke, the leading causes of death in the  United States.

We're led to imagine that this condition is for the most part fixed and immovable, based on the build up of plaque along the interior of vessel walls that essentially doesn't respond to anything other than interventions such as angioplasty, surgically implanted stents, or- when it achieves extreme severity-bypass surgery. Though we know that cholesterol, diet and exercise play a significant role in the development of high blood pressure, the central impact that stress can have on this condition is something that is paid very scant attention to.

What I have noticed by way of the work I do is that blood pressure is far more flexible than I had appreciated. The majority of  people I currently see are individuals afflicted with chronic pain who continue to suffer  despite a sometimes lengthy history of surgical interventions, exotic procedures and prescription narcotic use. What I train these people to do is regulate the functioning of their own nervous system  through targeted biofeedback, which is a way of displaying how the nervous system is functioning on a computer screen.

When this procedure is successful individuals learn to control their circulation by increasing it; and their heart rate by decreasing it- all for the purpose of learning how to manage their pain. When these twin goals are achieved dramatic blood pressure reductions have been  regularly observed over the years.

I recently had the opportunity to employ this same approach with a non-chronic pain sufferer I began seeing several months ago in a private setting. This person originally complained of tongue irritation  due to incessant scraping across her teeth, and subsequently reported suffering from asthma as well. I noticed when she executed simple, ordinary movements she tended to warp into hyperspeed in a nanosecond, with no  apparent appreciation as to how excessive her movements became. I believed this style that become  reflected in her blood pressure, which averaged  around 132/ 94; and her reduced skin surface temperature, which indicated some level of vascular spasm.

I began showing her how to reduce her vascular spasm, which had the affect of raising her skin surface temperature. After teaching her how to regulate her respiration, she subsequently brought her blood pressure down to 117/78, and her tongue chaffing and asthma have long since ceased to cause her any noteworthy discomfort. If these results are any indication, there is a large segment of the population who would likely be eager for the opportunity to reduce their blood pressure without having to resort to medication to do so.

Contact Peter Behel, MA at (707) 579-7982 or peterbehel@earthlink.net.

If there ever was a poster child for conditions we thought we knew all about, but now our understanding has changed, migraine would be a leading candidate. Originally regarded as primarily a headache, migraine has evolved from being regarded as a vascular (circulatory) disorder to a complex neurological disorder in the past 20 years. During that span of time the model of migraine has developed into now being thought of as a chronic disease, rather than being regarded as merely an isolated pain-based condition the way it once was. The history of migraine is a shining example of, "the more you know, the more you learn what you don't know".

Even 20 years ago though, migraine was always regarded as complex, involving a cascading affect of hormonal changes, and accompanying features such as nausea and light-inducing triggers that made it much
more complicated than the average head pain. The nutritional triggers such as red wine and chocolate further added to the complex tapestry of interconnected features, and combination headaches involving  migraine
features interacting with chronic tension sites became more commonly diagnosed. In fact, the old joke used to be, "I understand there's some confusion over your diagnosis." And the sufferer replies, "Migraine or yours?"

When I first began seeing migraine sufferers  20 plus years ago, the rationale for applying neuromuscular regulation was that it was primarily vascular or blood flow based, based on the model credited to Harold Wolff. Over the years I've witnessed many individuals learn how to bring their headaches under control by learning how to control their own circulation, with great success. The caveat always was, however, that once the headache had arrived it was too late to attempt to do anything to improve it. The idea behind learning to increase blood flow was to keep the headache from arriving at all.

Recently however, my appreciation for the level an individual could influence their own condition- like the diagnosis of migraine itself- became expanded. During the course of teaching an individual neuromuscular regulation skills as part of an in- patient chronic pain treatment program, I observed a pain patient arrive one day in the midst of a significant migraine headache. By the time we had completed our visit for the purpose of learning how to regulate her pain, she reported her headache had decreased by about 70%, which I had always been taught to believe wasn't realistically possible.

So I guess it just goes to show, what is possible to learn how to influence and improve, like the diagnosis of migraine itself, continues to be in the process of expanding. And when it comes to nervous system based conditions and how far they can be corrected through applied self-regulation, we don't yet have all the answers, but I hope you will take the time to consider alternatives to the standard approach.

To learn more about treating migraines with biofeedback, contact Peter Behel at (707) 579-7982 or peterbehel@earthlink.net

I am joining the online health care conversation with my first AltMD Blog article on my area of expertise - Nervous System Functioning.  I look forward to hearing from you with your comments and questions or ideas.  Enjoy!

• Our presence in the world begins and ends with our ability to move. Yet as fundamental as movement is to our ability to function, scant attention is paid to the overall well-being of the circuitry that enables this process: the nervous system. The operation of the nervous system  can be greatly impacted by stress, yet working to improve nervous system functioning is rarely addressed within the health care delivery system. I believe this oversight is one of the principle reasons why the cost of health care delivery continues to rise at astronomical rates, far exceeding the general rate of inflation. If health care delivery prioritized treating nervous system wellness, the $312 billion dollar annual cost of treating, for example, high blood pressure could be greatly reduced.
• Nervous system functioning can be monitored and the integrity of it's various components adjusted using a process commonly known as biofeedback. Skillfully applied biofeedback training can be used as a means to correct various nervous system operations through conscious regulation of their functioning. The cost of this procedure is a fraction of the cost of long-term pharmaceutical use, with none of the potentially hazardous side effects.

• I am currently involved in a hospital-based pain management program that features the use of biofeedback as a principle means to help wean chronic pain sufferers away from the long term use of prescription pain killers. These individuals are referred to as "failed cases" because the long term use of narcotics has reduced their ability to function, and has often led to problems in their personal and professional lives. When these individuals learn to successfully apply nervous system regulation using biofeedback, their need for potent pain narcotics goes way down, and they regain their ability to function. This is frequently greeted as a godsend to their friends and family members, who have had to cope with the descent of their loved one into a permanently medicated state.

• As an unintended side benefit of the biofeedback these individuals receive, their blood pressures can often become significantly decreased, reducing the need for blood pressure medications. Many symptoms associated with anxiousness and chronic tension are also drastically reduced and sometimes disappear altogether, including elevated heart rate and chronic headaches for example. It's difficult not to notice in today's health care marketplace that if this procedure was prioritized  earlier in the health care delivery pipeline that immense amounts of money could be saved, and people would improve their ability to function.

For more information on biofeedback or to schedule an appointment, please call or email me.  I look forward to hearing from you!

(707) 579-7982
peterbehel@earthlink.net
Sonoma County, Napa, & Marin