The short answer is:

Yes.
You do have to do the paperwork.

Infrequently people do not want to fill out their intake form, informed consent, and HIPAA forms.
These are all required by my board.
They must be completed prior to your appointment.
Filling out the form protects you, because when you complete the forms, you are told about what is involved in the process of getting care.
Filling out the form protects me, so I don’t initiate a type of care that is inappropriate for you based on your history and spherical presentation.

The form is too long

Sometimes people will complain that my intake form is too long.
I agree it is long.
Why is it long?
Because you are a complex person who has already seen many doctors.
I can guarantee you that I am not the first person you are seeing for your health.
I generally am seen after the patient has seen many other health care providers without adequate resolution.

If you feel like my form asks too many questions about things you don’t think are relevant and you don’t want to talk about, you probably should be going to a different provider.

When you write down your history, and provide me with your previous labs and imaging then I begin to get a good idea of who you are and the questions I need to ask to know what you need.
I spend 30-60 minutes reviewing your intake materials before I meet you.
I come up with many questions to ask you so I have a good idea of where we need to start.
If I did not have such a detailed intake form, we would have to spend much more time talking.
I am taking you and your history and your health seriously.
You are not trivial.

I just want to be cracked

Sometimes people complain about the intake form because they just want to be popped, or just have one symptom they wish to address and they know how they want it addressed.
If you just want to be cracked, I recommend going to The Joint or to someone in your insurance network.
They will provide you with specific and superb care.
If you just have one thing you want to have addressed and you need it to be addressed in one particular way, and don’t want to fill out the form, you probably need to find someone else to help you.

Curiosity Won’t Kill This Cat

The best quality to bring with you to your care is curiosity.
When we think we know all the answers in advance, we are selling ourselves short.

Who You Are

You are a seeker. You don’t give up. You are a problem-solver. You are intelligent and interested in deep
health knowledge, but might not be a healthcare professional. You are curious. You might have had a
baby five months ago, five years ago, or five decades ago. Ever since you had your baby you may have
noticed changes in your body. Pains here or there. Sex doesn’t feel the same. Pooping and peeing is
different and sometimes not under your control. Maybe gestational diabetes or hypertension came
back; you had breathed a sigh of relief when it resolved after pregnancy thinking it gone for good.
Anxiety, irritability, depression, apathy, forgetfulness, or a foggy mind could have been written off as
“Mommy Brain.” You could have been told that the changes you notice are a normal part of being a
mom, or worse, a normal part of aging. But, you aren’t sure. That doesn’t seem true. You have seen
naturopaths and PTs, chiropractors and acupuncturists, urogynecologists, neurologists, and
gastrointestinal specialists. But still, you aren’t right. These treatments help some, but it doesn’t last, or
there is something that has yet to be addressed. You want to feel whole. You want your body back and
your life back. You are willing to make the lifestyle and thought-pattern changes that are required to
experience the change you want. Whether you are 25, 45, or 65 this postpartum rehab is for you. It is
not too early. And it is never too late.

What is the problem

Why are you even having to deal with this? The problem is two-fold. One: You don’t live in Taiwan. And
two: our healthcare system is set up as silos for specialists who have difficulty seeing how the body
functions as a whole. The bias of our healthcare system is toward pathology. So if someone has a
functional problem, biomedicine’s primary impetus is “watchful waiting,” suggesting the cause is stress,
or suggesting you see someone else, maybe even someone in alternative medicine. In the meantime you
don’t feel good and are trying to figure out things for yourself. If you do go to someone in alternative
medicine these folks very often also function in silos and have a tendency to see the same type of
patient and do the same type of workup over and again. A chiropractor tends to see everything as a joint
or nerve problem. A massage therapist tends to see everything as a muscle or fascia problem, a
naturopath may see things as a chemical imbalance problem. Acupuncturists could have the most
comprehensive approach in all of alternative medicine, but there is a lot of variance within the field, so
your experience will largely depend on the training of your acupuncturist.
Ok. So the silo problem we talked about. But, Taiwan? What I’m talking about here is tradition. In
Taiwan Tso-Yueh-Tzu is a 30 day postpartum ritual that is practiced. After a woman has a baby, she lives
in a spa-type setting for a month where she is nourished, rested, and cared for along with her baby.
Many cultures have similar concepts. In Latin America the forty days following birth are called the
cuarentena. During that time the family and friends take care of mom and the household and she is
devoted to caring for her baby and for herself.

The Vedic texts of India describe the six weeks following birth as a sacred window in which the mother

must eat certain foods and abstain from most activities.
They say what is done in the 40 days following birth is so potent, it predicts the next 40 years.
In our culture we lack a tradition of caring for postpartum women. I’ll never forget taking a class on
women’s health and the lecturer was two days postpartum with her newborn in arms! I felt so guilty
being there, thinking “That lady needs to be home with her baby!” If in our culture we do not have
traditions or taboos around the six weeks postpartum, much less do we have any traditions or practices
supporting the mother’s physical body recovery from pregnancy and birth. The assumption is that the
body heals on its own. And when it doesn’t…maybe that’s your new normal or maybe you start the
quest seeking health.

The problem is:

You are a complex creature living in a reductionistic healthcare system that doesn’t
realize the need for universal postpartum renewal.

Why This Work Matters

After having a baby all women deserve to have postpartum renewal. Pregnancy and birth (whether
vaginal or cesarean) have profound impacts on the body that the body has tremendous difficulty
recovering from on its own. Sometimes women don’t notice these changes, sometimes they become the
new normal. Sometimes noticeable symptoms take years or decades to emerge. But it is my firmly held
belief that just as women cannot birth alone and require the assistance of an obstetrician or midwife
(and hopefully a partner or a doula, too!), women cannot recover from pregnancy and birth alone and
require the assistance of an individual trained in postpartum rehabilitation. But why can’t we birth
alone? Why can’t we heal alone? The answer is the same for both questions: Because we are bipedal
creatures with a relatively small pelvis, living in a field of gravity, giving birth to relatively big-headed
babies. Other creatures that are not bipedal and who do not give birth to big-headed babies can and do
birth alone and heal from birth alone. But not us. We are designed to need each other. But we live in a
culture that has not recognized that necessity for postpartum recovery.

The postpartum renewal that you need and deserve

can take place as early as three to six months
postpartum, or as late as decades later. It is never too late to experience postpartum renewal. In my
practice I often see women who have had pelvic floor physical therapy. It helped at first, but then the
benefits began to fade. I notice in these women often there are “upstream” problems that make it
difficult for the pelvic floor work to make a permanent difference. If the four transverse planes in the
body are not in right relationship, if the postural muscles are not firing properly, if the drainage system
of the body is not pulling up the blood and lymphatics adequately, if the chestwall is not expanding with
each breath it is easy for the bladder to slip and the uterus to slide back.
This approach is different because it does not stick to one region of the body, like the pelvis. It does not
stick to one system of the body, like the myofascial system. And it does not confine itself to the physical
body.

I’m so excited to work with you!

Before you come to your first appointment I spend time reviewing your intake form, your prior lab, and your prior imaging.

When you arrive, we will spend time talking about the issues that concern you, what has been helpful intervention, and what has not been as helpful.

I will have a series of questions for you that are based on the information you provided me prior to your visit.

We will decide if more lab and imaging are needed now, or if we can wait on those things.

Physical Exam

For the physical exam, I will start with checking your vitals like blood pressure, pulse, and listening to your heart and lungs.

After that, the exam will be reflective of what your needs and concerns are.

Most people that I see have already been to a lot of practitioners and are looking specifically for the combination approach I have of assessing and addressing the fluid body, the viscera/vascular systems, the emotional body, and the energy body.

Sometimes the energy system will shout out to be addressed first.

In that case, we need to start with the energy system to get it organized so all of the other systems can be made sense of.

If the energy system is well-enough organized, I start listening with my hand on the sternum (breastbone) by the collar bones.

This will tell me what needs to be addressed first and in what way.

I let the body guide as we move through the assessment and treatment.

Of course, you stay in your body and you are always the boss.

I always ask for permission before I do anything.

I try to explain what I am doing and why, so you can feel more deeply embedded in your own body and life.

Treatment

Most treatments are done with you fully clothed.

Many treatments are done face up on the table.

When I am working on your tummy, it is easier to work directly on the skin.

In that case, I have you raise your shirt to the bottom of the ribcage, and lower your pants to the bone in front of the pelvis.

If we are doing pelvic bowl care, I put sheets on the table.

I leave the room and you get under the top sheet with your pants and underware off and your shirt on.

When I come back in the room I glove up and use a gel like KY.

To insert a finger in the vagina for the treatment, I lift the side of the sheet so I can see to separate the labia.

Then I put the sheet down for the rest of the treatment so you are fully covered.

After we are done with the treatment I leave the room so you can get dressed.

I am calling the combination of the bones, muscles, fascia and nerves the hard body. Not because all of us actually have well exercised muscles, but because we are supposed to. The beetles have a hard exoskeleton. We are supposed to have a hard endoskeleton. And the joint complex is the bone, muscle, connective tissue, and nerve. I think everyone knows what bone and muscles are. Connective tissue is like ligaments (hooking bones or organs together), tendons (hooking muscles to bones), and fascia (a web-like saran wrap-type connective tissue pervading our body).

In our culture we have a conceptual bias toward the musculoskeletal system when considering pain. We are used to thinking about muscles and bones and attribute pains to them. However, for me, these tissues are generally not the cause of pain unless there is an injury (acute, chronic, or repetitive stress) or pathology. Also, unless there is pathology (like a fracture or cancer) a part of a bone that is not a joint is not likely the actual cause of pain, although pain can be felt there.

In my experience, the musculoskeletal system is very responsive to mechanical input. If the joint or muscle is the actual problem you should not need dozens of therapeutic sessions to resolve it. This is in part because every chiropractic adjustment or massage bombards the brain with neurosensory information that the brain then should integrate and then begin sending corrective signals to the body for function.

Musculoskeletal pain should be responsive to heat or cold, rest or activity. Nerve pain often is experienced as burning, hot, or raw. As it progresses there may be alterations in sensation and a loss of sensation. Nerve pain is often related to positioning. When tension is put on a nerve it feels worse, and when it is taken off, it feels better. That is why sciatica or pudendal neuralgia is worse with sitting. However, knowing that a pain involves a nerve does not tell you what is encroaching on the nerve and causing the irritation.

Because of the types of patients I see, I most often use the hard body as a way of mobilizing the fluid body. Because of the proximity of the fluid body to the hard body, every time a joint is mobilized or fascia is released the fluid body will be stimulated to move. I find this to be particularly true in the thoracic spine referent to the thoracic duct, and to the transverse planes.

I always try to set up the body for an adjustment that is as precise as possible, as fast as possible.