I'm often asked about the smoothies I drink, what they are used for and what I put in them ...

Here I've decided to list a few that I've had over the last month or so.  They're not all to everyones taste, but they'll give you an idea about where to start.  Smooth drinking!
 
​BK Smoothie

One banana
Large handful of kale (unwashed)
Large handful of spinach
1/4 avocado
1 tbls chia seeds
1/2 a lime
1 tsp coconut oil
1 tsp matcha green tea powder
One cup of coconut water

BA Smoothie

Half a doz broccoli pieces
3 asparagus spears
1/2 a cucumber
One pear
1/2 a lime
1 heaped tsp of green powder
1 cup of coconut water

Caramel Cauliflower Smoothie

1/2 a banana
Half a doz cauliflower florets
One desert spoon of tahini
One handful of romaine lettuce leaves
A few dates
1 tbls lacuma powder
Cinnamon to taste
Vanilla powder or alcohol free vanilla
Half a cup of coconut milk
Half a cup of coconut water

Papaya Smoothie

1/2 a small papaya with seeds
1/2 a mango or 1 kiwi fruit
1 pomegranate whole (minus the skin!)
1 large passionfruit or two small
1/2 cup of a super fruit juice (pomegranate / aloe vera / noni)
1 coconut water
​1/2 cup coconut milk to taste

Choc-Berry Smoothie

1 banana
1/2 to 1 cup of blueberries (frozen is ok)
1 desert spoon of cocoa powder
1/2 cup of super fruit juice
1/2 cup of coconut water
1/2 cup coconut milk to taste
1 tsp of coconut or flaxseed oil
1 tsp maca powder
1/3 tsp of non-soy lecithin granules
Honey to taste

• Tightness in the jaw muscles of the cheek.  Ropey, sore muscles here may indicate that they are working too hard.  A tight frenulum will cause the jaw to move backwards, disrupting the mechanics at the TMJ.  This can also be a problem at night, as the same backwards movement can constrict the airways and contribute to an obstructive sleep apnoea. 
• Tightness in other associated areas in the hands, arms, neck, back, sacrum, and pelvis.
• Speech and breathing issues.  For example, mumbling and talking quietly or developing a sore throat or gravelly voice towards the end of the day.  Also, it lends itself towards becoming a mouth breather, which leads to hyperventilation and poor diaphragm mechanics.

​Good manual therapy can go a long way towards minimising or eliminating some or most of these issues.  It will usually include a raft of home exercises, as well.

Some patients will opt for a frenectomy, which is a relatively quick procedure to release the membrane under the tongue, done in a dental practice experienced with this surgery.  It is usually performed with a laser and doesn’t require anaesthetic.  To prevent re-scarring, a month long regime of exercises is necessary.  All surgery has potential complications, but should be minimal in this case and in the hands of a dentist who has some experience.  Be careful of damage to the salivary glands under the tongue.

Post surgery, you might expect to feel or see:

• Better tongue movement
• More tongue relaxation
• A wider tongue
• The tongue sitting more on the roof of the mouth
• Better facial symmetry in the cheeks, nose, mouth or eyes
• Less grinding of the teeth
• Better sleep
• More relaxation and openness in the throat area
• Less chest tension
• Better neck and back posture
• Changes to a Dowager’s hump
• Less tension around the base of the skull
• Changes to ease of swallow
• Less back pain

This is a basic overview of some of the issues and possibilities surrounding a tight frenulum and therapy or surgery.  Despite such a small restriction, the repercussions are manifest.

​There is some suggestion that this structure shouldn’t be apparent at all.  Embryologically the right and left sides of the tongue come together, fuse and then the tongue extends outwards during development.  At this stage it is suggested the frenulum should recede completely.  If it doesn’t, and it retains a degree of tension, this small structure has the capacity to effect an enormous number of issues in our lifetime.

A tongue tie is a poorly diagnosed and treated affliction.  Mostly, it is never picked up and if so, reluctance to treat it is common.  For the purposes of this article, it may be better to break down the issues in relation to what I find in a paediatric population compared to adults.  Although the anatomy is similar, I commonly treat either group for entirely different symptomology. 

The Anatomy

The tongue is a group of muscles (technically, it’s an organ) that have significant attachments and substantial fascial (also known as ‘connective tissue’, it supports and connects structures throughout the body, often forming networks that traverse large distances) planes.  It attaches to bones in the throat (hyoid), the jaw (mandible) and the skull (temporal bone).  The tongue has as much ability to affect any of these structures, as they have to affect the tongue.
The tongue is innervated by no less than 5 cranial (brain) nerves.
The tongue is involved in functions of speaking, swallowing, posture and alignment.

Children

Here I will outline some of the more common reasons that parents will bring their children to see me.  Not all of these cases are related to tongue tie in that there are other potential causes, but tongue can can produce the following issues.  When the mobility and therefore function of the tongue are affected, it won't be able to extend for long periods of time and may recoil (a possible cause of clicking when feeding) when the baby lowers the jaw during sucking.  This results in breaking the seal and poor suction.

Sometimes there are problems breastfeeding.  Some of the factors to consider include:

• ​Not latching on properly
• The latch cannot be sustained for long
• Sliding off the nipple
• Prolonged feeds
• Restlessness after prolonged feeds
• Falling asleep on the breast
• Gumming and chewing on the breast
• Not gaining weight
• Unable to utilise a dummy

Given the problems above, potential results that may ensue include:

• Nutritional deficits
• Colic
• Reflux
• Spilling from the side of the mouth
• Stimulation of the gag reflex
• Sleep apnoea
• Altered sleep patterns
• Speech problems
• Impairment of facial and jaw development
• Dental decay
• Teeth gapping
• The teeth either growing away from the tongue or inwards towards it

To breastfeed well and without pain requires a good and correct latch.  This means:

• That the chin should rest on the breast, below the nipple
• The lips should roll outwards
• The lower lip (if not both) should be hinged outward
• The jaw is open wide (130-160 degrees)
• The top lip should be just above the nipple (not the areola) 

​

Last week I fielded questions from a researcher at the Australian Catholic University about the Parkinson’s Disease (PD).  At the end of the discourse I was asked, “how can I explain what you do so that PD patients would understand?”

It’s a good question …!

Traditional PD treatment follows a well worn pathway:  GP’s; Neurologists; medications; and exercise, for example.  Things progress:  new surgical procedures, new medications, and new forms of exercise.  The advancements can be necessary and worthwhile for most patients.

Many patients will comment that the nature of the work I do is a little different.  Well, perhaps that is so, but only in the context that not many people are doing it and not in terms of anatomy, neurology, combinations of therapies and connecting some of the dots.  Rather than thinking that some of the PD work I do is outside the box, I choose to nominate that I am widening the container.

Like many outward signs of most health issues, once the  symptoms appear, you can almost bet that several (or even dozens) of other things have preceded it in order to manifest signs.  For example, a tremor in PD.

I have said many, many times in practice that the human body is remarkable in it’s capacity to adapt.  It’s part of our survival mechanism and we wouldn't have gotten this far without that ability.  It is when we run out of adaptions that the dominant signs of a health problem occur.  The body has nowhere to go.

This brings me to the first general concept when treating PD (or any other health issue for that matter).  Often it is a matter of peeling back the layers (of compensation) until the body has a bit more room to  move or breathing space.

This leads on to other concepts.  The next obvious question to ask is “what are the layers that have to be removed?”

How many of you know that one of the first signs of PD is constipation?  No one thinks about this much because we all get constipated every now and again or perhaps you’ve been constipated for your whole life and in some way you consider it normal?

There has been bucket loads of research (see the library on this website) about compensatory or genetic inflammatory gut issues that lead to a heightened immune response, first in digestive tract and then in the body as a whole.  This allows for molecules to pass from the gut into the blood stream, which then cross the blood-brain barrier and affect neurological tissue.  

The way the gut deals with this inflammatory/immune issue is through the lymphatic system.  Here is one possible layer of compensation that I seek to affect.  By the time PD is manifest, I often find the lymphatic system in the gut has become sluggish, overworked and is struggling.  It’s a balance between not wanting the lymphatic system to overwork in the first place, but once it has to, allowing it to operate optimally. 

Perhaps the gut also has other restrictions or adhesions related to surgery, genetic predisposition or dietary elements?  It is possible to work manually with the mobility of the gut in order to improve its function.

Most people think of PD as a brain or neurological issue.  There are certainly compensations that occur in the brain and involve the most direct link to the tremor that occurs via a lack of dopamine production in a structure called the substantia nigra in the midbrain.  However, there are other structures in the brain, the ventral tegmental area (VTA) and the nucleus accumbens amongst them, that also produce dopamine.  It is possible to work with these structures manually in order to optimise their function in the face of their inability to produce dopamine.  I will often find secondary compensations in areas like the basal ganglia (movement initiation and repetition) and the cerebellum (balance, co-ordination, body awareness and feedback to and from the brain and body).  The question becomes, can I optimise the function of these areas given that they may have compensated their activity, either prior to PD as a result of something else, or from the disease itself?

If you like, the second concept is one of removing any secondary but related compensations that accelerate the progression of PD.

Another tertiary concept is the improvement of the actual structure itself (substantia nigra, VTA etc) beyond its ability to produce dopamine, so that it functions as best it can.

So how is all this treated?  Each structure or tissue (or even cell) has it’s own anatomical, physiological and energetic signature.  These signatures can be identified via manual assessment if you know what you are looking for.  If you know what the signatures normally feel like, you are also able to know what they feel like when they are ‘off’. 

When structure or tissue is under duress, there is a resultant physical tension.  The body has a natural tendency towards healing (you cut yourself, it heals).  If the tension of the dysfunctional tissue can be changed, often the body part / cell / tissue will reorganise itself so that it functions better.  It just needs the chance.  See Brain work and Neuromeningeal Therapy elsewhere on this website for more information.

Is this type of treatment a panacea for PD?  Certainly not.  If you are not looking at your diet, bacterial population in the gut, stress levels, and heavy metal exposure amongst many other things, then it is likely PD will continue to manifest unabated.

However, it can be very effective as part of a larger program …

Nearly 60 years after autism was first identified, the number of cases continues to rise ....
            
There are many types of disorders along the autistic spectrum.  I frequently see these in my practice amongst children and adults alike, from very mild to quite severe.  In our capacity as parents, teachers and practitioners we may have all come across people with some of the classic characteristics: difficulty with social interaction, challenges with verbal and non-verbal communication and repetitive behaviours.

Despite the vast differences in presentation of people with autism, the common factor is that the brain functions a little differently.  During development, something spurs the neurological and physiological processes to reorganise themselves away from the norm.

American figures suggest a 10 fold increase in the number of cases diagnosed in the last four decades.

From my perspective, manual treatment can help the brain to make the connections it might be missing.  

I have also begun to notice, in a significant number of autistic patients, the occurrence of lymphatic disturbances in and around the small and large intestines.  

I have also read a large number of studies recently that are uncovering the gut/bacterial connection to the disorder.  For those that are interested, I have listed several articles in the Paragon Health library.  However, the one I would suggest starting with is:

                                 Gastrointestinal Microflora Studies in Late-Onset Autism 

I will also focus on the gut-brain link in an upcoming blog article.

There are some commonalities in the manual assessment of the brain in patients with autism. However, because we see a spectrum of disorder in autism, each person can also be different.  This might be influenced by the type of presentation someone presents with?  For example, perhaps the main issues are concentration and memory; language difficulties; movement and co-ordination; or perhaps social and emotional interaction.  Each subset manifests in a different part of the brain.  Although technically, I think it is more exact to say that the particular part of the brain affected determines the presentation.  It is also common for the pathways of brain dysfunction to overlap, so that I may be treating several areas concurrently.

These parts of the brain can be affected in the absence of any noticeable physical trauma, as might be seen during the birth process, for example.  Given this, it is pertinent to ask what may have a global affect on the brain other than trauma?  It is extremely interesting to note the frequency with which these patients present with bowel and digestive dysfunction, and, as I mentioned, lymphatic disturbances in and around the intestines.

Back to the brain ...

One of the more common aspects I manually feel is the physical tightness of the cranium, the membranes lining the skull (which also attach to the brain), and the outer part (cortex/grey matter) of the brain itself.

Another aspect again involves the cortex of the brain, but more in relation to it's neurological aspects. Sometimes in an isolated area and sometimes in its entirety, the cortex can have a subtle but definite electrical hum or buzz to it's tissue.  The thought that comes to mind is "a sea of electricity".   This is happening at a cellular level in the grey matter.

When tissue becomes oxygen deprived, it also has a particular feel.  This feel tends to coincide with the sea of electricity in cases of autism.  This doesn't strictly mean that there is a lack of oxygen getting to the brain, but probably that the cells in the grey matter don't know how to use the oxygen available to them?  The cells undergo "oxidative stress" which has been defined as: "an imbalance between the production of free radicals and the ability of the body to counteract or detoxify their harmful effects through neutralization by antioxidants."   The oxidation process is essentially aerobic (utilising oxygen) and involves a cellular organelle called a mitochondrion which uses oxygen and has been said to act like a battery in the cell.  We all know what happens when batteries go flat ...

Does this sound confusing?  If so, forget all the information and imagine something we have all seen before ...

Now, this isn't meant to be dramatic and it doesn't mean the brain will look like this!  The brain is so incredibly fined tuned that even the smallest changes can have consequences.

My process is to provide the brain and cells the opportunity and space to change (and recover) if they want to.  Sometimes they will and sometimes they won't.  In the cases where the tissue is reluctant,  there may be concurrent factors at work that also need to be addressed?  My job is to give the brain opportunity and help it to integrate changes  that may involve treatment in other parts of the body, but nonetheless have an impact on the brain.  This is where the gut may come in ...

To further the discussion on concussion, I wanted to post some video clips produced by the CBS network in the USA.  

These clips relate to the concussion study being undertaken by colleagues in the US and how it relates to two former NFL stars, Ricky Williams and George Visgner.  

The videos can be found here:







A modified transcript of one of the videos is written here:

Ricky Williams partners with local institute for head trauma treatment 
researchBy Matt Lincoln/CBS 12

JUPITER, Fla. - Former Dolphin Ricky Williams is working with the Upledger Institute in Jupiter, to prove that there's a treatment for head trauma that actually works.

The bright lights, high volume, and constant movement of a football field. 

Quite the contrast, inside the Upledger Institute, where the only sounds are some whispering and the whirring of a small fan.. 

This is not your typical huddle, but there is a football player in middle.

"I believe that this work can show change that doctors don't believe is changeable," says Ricky Williams. 

The former Dolphins running back and four other former NFL players, are undergoing Craniosacral therapy in Jupiter.  Developed by Dr. John Upledger, the therapy helps regulate the flow of cerebral spinal fluid throughout the body. 

That's accomplished by multiple therapists listening to the needs of the patient, and working with the tissues throughout the body.

"We're not coming up with an idea of what they need," says Upledger team facilitator Chas Perry.  "We're feeling their tissues and applying that, we are feeling the life of the client."

"It's just been a couple of days, and players say they are astounded how great they feel," says CEO John Upledger. 

The craniosacral therapy can fix ailments throughout the body, but it's unique in what it can do for the brain.  

"Football players have a headache that never really ends," says Williams. "This work allows my head to breathe." 

"Our feeling is the NFL will take note and say 'There is something to this'," says Upledger. "And they will help us get our work out to a broader audience.

Upledger says this treatment not only works for people who've suffered head trauma, but he's seen success in autistic children, and Vietnam veterans as well.

Thursday, July 24 2014, 12:23 AM EDT

Yours in health,

David Macdonald
Director / Paragon Health

A couple of week ends ago, I was emailed by a colleague in Sydney suggesting I have a look at the South Sydney - Roosters Round 2 NRL game.

In particular, he was referring to the period in which South Sydney hooker, Adam Reynolds returned to the field after passing a concussion test.  This is a 10 minute period in which medical personnel get to assess whether a player is safe to return to the game. 

There has been some controversy since this incident regarding whether the player should have been allowed to return to the field.  His play over the next three sets in the game was decidedly subpar, which has brought into question the current methods and analysis to decide upon the correct course of action for a head-injured player.

For a commentary in the popular press, please read the The Australian Newspaper and The Brisbane Times.  For vision of the incident and game, have a look at the video below.

The purpose of this blog is not to overly highlight the pros and cons of on-field concussion testing but to begin a discourse on the possible repercussions and options available to those who've suffered a head injury (sporting or otherwise) in which the brain has been affected.

This same colleague and physiotherapist, Adrian Winkworth, has been involved in significant study in the USA which had brought together some of the best practitioners in their fields to look at the best practice of assessment and treatment in relation to NFL players who have a considerable history of concussion.

There are currently many options that exist for players' recovery, return to sport and long-term health which have yet to utilised.  In my next article, I will highlight some of the possibilities that are available through this clinic and that of my colleague in Sydney.

Yours in health,

David Macdonald
Paragon Health Industries

In this post I would like to share some insights on pain that I alluded to last time, in particular, how aspects of manual brain therapy work might help.


In the previous post I referred to an article published in the Australian Magazine called Training the brain to beat pain (Norman Doidge The Australian January 31, 2015).

I also referenced the following paragraph towards the end of the article:

"He was helped by Marla Golden, an emergency physician who specialises in chronic pain, whom he met in 2008. Golden also trained in osteopathy, a hands-on practice using touch, sound and vibration. They have pioneered a true mind-brain-body approach to chronic pain in which patients receive simultaneous neuroplastic input from the mind and body to influence the brain. Golden’s hands are so sensitive, Moskowitz says, she sometimes seems to “see” with them, finding problem areas and rapid ways to ease chronic pain. I have followed a number of their patients and seen remarkable progress."

The picture above represents advances made in recent times with respect to pain.  This is a fMRI or functional magnetic resonance image showing just how many areas of the brain can represent pain.  Even this picture is by no means comprehensive!

Problems exist because each of these areas can represent different types of pain from the body, from different areas and of varying intensities.  The physiology and biochemistry of each area can be different and each area has it's own special connections with other parts of the brain.  This is one reason why medications can be effective for one type of pain and not another.  Specifics count. 

However, the good news is that these specific characteristics give these varying brain parts unique attributes that make them stand out from surrounding brain tissues.  These attributes can be felt by the human hand and are probably what the magazine article was referring to when it says Marla Golden could "see" with hers.  Each of the brain structures has it's own feel.  You might also refer to it as an identifying energy or vibration unique to the make up of the structure.  It will also allow you to identify when brain tissue is dysfunctional or operating accordingly.

With proper assessment and treatment these structures that represent pain can be helped to attain normal function through manual brain therapy work so that they give a more normal picture of the physiological state of the tissue said to be involved in causing chronic pain.  It is a manual way of down regulating the heightened and learned response of the brain structure that may be disproportionate to the actual condition of the 'injured' tissue in the back or leg, for example.

For those who would like a more comprehensive look at the structures involved, I will publish some articles in the Paragon Library in coming weeks.

Yours in health,

David Macdonald
Director / Paragon Health Industries

I would like to draw your attention to an article published in the 'Australian Magazine' this last weekend called Training the brain to beat pain (Norman Doidge The Australian January 31, 2015).

Some of you may recognise the name of the author, Norman Doidge.  He has previously written a best selling book called The Brain that changes itself.

Once pain in the body becomes chronic, the way it is represented in the brain becomes different.  Acute pain garners your attention, which is fine in the beginning.  It's a survival mechanism hard wired into our system.  But as time goes on, and you 'survive', the brain says, 'well, I actually have some other things to think about as well, and seeing as I'm no longer under any immediate threat, I'll hand the pain over to more subconscious, automatic parts of myself so I can still keep a check on it but it'll be more in the background, thus saving myself some energy.'

When this happens, many anatomical and physiological changes go on at a central (brain) level.  The brain becomes 'wired' a little differently.  

There are many different systems that converge in the brain, for example:  The motor system (movement); the autonomic nervous system (which controls automatic actions within the body like breathing or digestion); and the limbic system (emotions) amongst many others.  The systems in the brain that deal with pain, share some of the same anatomical structures as these other systems.  This is one reason why chronic pain can be so complicated and hard to shift, because it lends itself towards changes in other systems and becomes integrated.

The good news is, however, that something is being done about it.  This is the link to the article I mentioned:

Training the brain to beat pain

Of particular interest to me was the next to last paragraph ....

"He was helped by Marla Golden, an emergency physician who specialises in chronic pain, whom he met in 2008. Golden also trained in osteopathy, a hands-on practice using touch, sound and vibration. They have pioneered a true mind-brain-body approach to chronic pain in which patients receive simultaneous neuroplastic input from the mind and body to influence the brain. Golden’s hands are so sensitive, Moskowitz says, she sometimes seems to “see” with them, finding problem areas and rapid ways to ease chronic pain. I have followed a number of their patients and seen remarkable progress."



The work would seem to be very similar to the Brain Therapy work that I do in my practice.  I'll write about this in an upcoming blog article.

Yours in Health,

David Macdonald
Paragon Health Industries

An open letter from David Macdonald, Director of Paragon Health Industries, January 2014 …

 
This is where I’d like to talk with you a bit, philosophically, about what I have in mind for Paragon Health Industries (PHI).

When starting this business, there were many things that went through my mind in relation to what I wanted to do; what I wanted to achieve.

But, rather than dwell on particulars, I would rather speculate on what I would like PHI to be in 2017 – a few years from today – in two sentences.

In healthcare and in life, I would like PHI to be perceived as an organisation that has authenticity at its core: expressing a unique voice, veracity and acting as a capacitor for change.  I want PHI to be known for its unmatched level of excellence.

Excellence is not something flown on a banner.  It is deeper.  Excellence is a loyally held commitment.  It is the commanding aspect of the Paragon Health Industry culture.

To be better than the best necessitates thoughtful assessment of everything done, said and produced.  It requires truthful enquiry:  if it isn’t better than the best, what will it take?  If economics, environment or resources don’t allow for it, then the same vibrant enquiry should be asking if it is worth doing.

Allegiance to quality and personal excellence might be the most steadfast road to success for Paragon Health Industries and belief by you, who use the PHI service.

Excellence shouldn’t be conjecture, just a fact.

Expressing a unique voice means not being fearful of expressing what you do coupled with not just talking a good game but backing it up and being authentic to your nature.  The people working in the business should reflect it’s qualities and the qualities of the organisation should mirror the person.

Truth is about your deeds being greater than your sentiment.  It is about doing what is necessary to become great.

Being a capacitor for change means needing to have knowledge but also the ability to use it properly.  It is the line between gaining information you don’t have but still respecting that you don’t know it all.  The best kind of knowledge you gain is garnered from experience.

It is these qualities that will make Paragon Health Industries the leader in its field.  It is these qualities that will be of the people who work in PHI and also by the people.  It is these qualities that will be reflected in the manual skill, assessment, treatment, service and relationships offered by Paragon Health Industries.

Paragon Health Industries is here to help, free, teach, cheerlead or liberate issues and assist in improving the lives of those who seek help.

Yours in health,

David Macdonald
Director PHI