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The following article appeared on the front page of the Coeur d'Alene Press, Easter Sunday, March 31, 2002.

                                                Picture Caption

James Palmer, a local chiropractor, treats the ankle and foot of Dennis Osterdock, who suffers from neuropathy. 

 

                    Neutralizing   Neuropathy

  Diabetes patients: Treatment helps ward off amputation  By JOHN MASON Staff writer  COEUR d'ALENE-- Dennis Osterdock was terrified he might lose his feet.  Just a couple years after learning he was a Type 2 diabetic, Osterdock felt that tell-tale burning sensation at the bottom of his feet -- a precursor of bad things.  "You get two feelings," he recalled, "a real fire on the bottom of your feet, and a feeling like you stuck a needle in your foot every once in a while. " He punctuates that last phrase with a sudden cry of shock. Like 60 percent of all Type 2s, Osterdock was developing neuropathy, a degenerative nerve condition that happens for a variety of reasons, but is particularly nasty for diabetics.  Besides terrible pain, diabetics can lose sensation to their feet.  A minor scrape or cut could go unnoticed, get infected and spread until the only recourse is amputation.  That's what all the medical literature Osterdock could get his hands on told him.  That, and there's no way to reverse the symptoms."It's almost a foregone conclusion today that if something doesn't change, I'll have to get an amputation," he said. "And it scares me to death. "Then he met James Palmer, a local chiropractor with a keen interest in neuropathy. While Palmer attended Cleveland Chiropractic College, the bottom of both his big toes were becoming numb.  He treated them exclusively using physical medicine he learned in school, creating the craft he has since shared with any patients he learns suffer from neuropathy.Like Osterdock.The burning has diminished by 70 percent after a handful of treatments, said the smiling Osterdock, 55, an outside business consultant.  He continues to see Palmer about twice a week for 10-15 minutes at a time. "I know full well at the rate it's been going I won't be able to feel the pain at all," he said. "The fire's gone away.  The numbness isn't getting worse. "There are more like Osterdock.Catherine Ziegler was 44 when she learned she was a Type 2.  Her numb feet were so cold she wore two pairs of socks. "My calves were so tight I thought they were going to burst," she said. "It was like walking through Jell-o."Ziegler would crawl up the stairs of her home with both hands hanging on the rail.  It was, she said, really difficult to just live. "When you're 44 and you can't walk, you think, 'Well, my life's about to be over because I won't be able to do anything.  I'll be an invalid in 10 years.'"Ziegler was prescribed a number of drugs to deaden the pain and slow the neuropathy, but nothing that would reverse the symptoms and lessen the burden of walking.  Her husband, a sports massage therapist, worked in the same office as Palmer, who learned about her condition and offered to treat her.  Last year, after several 15-minute sessions, Ziegler felt so good she joined a softball team. "I hit the ball once and started running," said Ziegler, now 50. "I thought, 'Oh my gosh, I'm running!' I made it to first base and I was in heaven. "She then stole three bases in one game.  Bob Caton is another Type 2.  He's 76, a World War II veteran and has been in neuropathic pain for the last six years.  One toe was so bad it had abscessed to the bone, but he refused to let doctors cut it off.  Visits to his family doctor, Sacred Heart Medical Center in Spokane and the Mayo Clinic in Minnesota were equally fruitless: "They all told me there wasn't much they could do about it, " Caton said.  Then last year he saw Palmer's advertisement in the newspaper and figured he had nothing to lose.  Where he once thought he'd spend the rest of his days in a wheelchair, Caton is driving himself around town since he can now feel the gas and brake pedals again.  The pain in his feet is now a 2, rather than a 10, he said, and he literally cannot convey how happy he is about that. "I don't even know how to express myself,"  he said.Osterdock, Ziegler and Caton are three of 13 patients Palmer has treated within the past year.  Most are Type 2's, others have different reasons for their neuropathy.  All have remarkable testimonies that Palmer's treatments have done what authoritative medical literature says is impossible. "It almost sounds like we've discovered the fountain of youth," said Palmer, an enthusiastic baby boomer. "I'm here to tell you it's absolutely that profound. "Palmer believes he is the only physician in the country who can reverse -- not just control -- neuropathy.  There's a big difference.Medical literature, like Harrison's Principles of Internal Medicine (used at Harvard's medical school), says diabetic neuropathy can only be treated with pain-killing drugs (with no mention of reversal).  Ninety percent of patients at Spokane's Rockwood Clinic of Neurology suffer neuropathy.  Dr. Scott Carlson, its primary physician, is considered locally as the most knowledgeable in this field, and his office is booked three months out.  Their standard treatment includes controlling the symptoms through dietary and pharmaceutical methods, as well as physical therapy.  Palmer's treatments, while effective for some, are not necessarily appropriate for all patients, said Judie Peterson, an LPN at the clinic. "You can't say he can reverse all types of neuropathy," she said. "He claims he can help lots of neuropathy patients, which is probably true and accurate for him. But not all neuropathy is treatable. "But the most prevalent form of neuropathy is diabetic, Peterson said, which the clinic can only treat symptomatically. "We can't claim to reverse it," Peterson said. "Conventional medical wisdom is it's (diabetic neuropathy) a one-way street," Palmer said. "We hope you don't go down it very fast because in the end is amputation... Well, that's just simply not true.  Treated properly, you can reverse the symptoms and get the feeling back. "Palmer said he provides "sheer forces" to the blood flowing through the arteries, which generates chemicals that cause vaso-dilations. "Bottom line, using physical medicine I cause the body to emit enzymes that give rise to increased blood flow," he said.  It's a remarkably simple process if one were to watch him, as if he were performing a chiropractic treatment on a patient's ankle. "You could hear it pop, and it seemed like it was releasing oxygen or toxins, " Ziegler said of one of Palmer's treatments. "I don't completely resolve the problem, but I reverse the symptoms so that it becomes tolerable," Palmer said.  According to the American Diabetes Association, approximately 40,000 non-traumatic patients receive amputations because of neuropathy complications, costing millions of dollars in medical expenses every year.  Nearly $339 million is spent yearly to manage diabetics in Idaho alone, according to a 2001 report by the state's Department of Health and Welfare.  Palmer estimates 60-70 percent of all diabetics suffer neuropathy, which makes them likely to suffer amputations.  Palmer would like to change that, but no one is listening to him.  He's contacted the major insurance players, including Group Health and Regence Blue Shield, offering a demonstration of his procedure. Essentially, he's been snubbed."Some of their letters are comical," he said. "I should write a book on their responses. "Among their reasons, according to written correspondence between Palmer and Dr. Richard Rainey, medical director for Regence Blue Shield of Idaho, Palmer's therapy is unproven.  Others, like Group Health Cooperative, wrote "we do not have a business need to add providers of your service. "Palmer put flyers in the boxes of every physician at Kootenai Medical Center, telling them to refer patients to his new treatment.  None, save pulmonologist Henry Covelli, responded."I admit that I thought it was hocus-pocus," Covelli said. "In reality, the proof is in the pudding.  It works. "Covelli witnessed one neuropathy patient, whose name he would not divulge, suffer so greatly in her left arm that she could not lift a gallon jug of milk.  She had been to a primary care physician and even a hand surgeon, but had no luck before finding Palmer."  After a couple of weeks she was relieved," Covelli said. "I was impressed. "Since then Covelli has referred to Palmer patients who are "at the end of their ropes. " Palmer's treatment has worked with the last eight he's sent, he said.  As to why no one else is listening to Palmer, Covelli has a few theories. "Most of us have never heard of using manipulative therapy," he said. "It's not in the (medical) literature. "In allopathic medicine (traditional Western medicine) we study things, we have a proven efficiency, and therefore we embrace it.  Some of the non-allopathic methods are not well-studied, and therefore not embraced. "As a chiropractor, Palmer is well aware of that stigma. "MD's are in the driver's seat. I'm guessing they think no chiropractor could ever do anything for the well-being of diabetics, let alone solve a problem they've failed at for years. "Covelli also suggested since Palmer's treatment requires no pharmaceuticals, no one is willing to fund a study into his techniques. "If you're not going to make money off a drug, no one will fund it," Covelli said. "Who would shell out money for a non-drug therapy that could alleviate pain?  That's not going to happen.  Unfortunately, that's the case." Like Covelli suggested, most medical professionals can't get around the lack of science behind Palmer's methods.KMC's Diabetic Program coordinator, Carla Gentry, has been a nurse for 18 years.  She's never seen one scientific article or presentation supporting Palmer's claims, and that's a fact she can't afford to overlook. "We would not refer patients to him," she said. "Our reputation is that we prefer to give information to patients that are consistent with national standards of care. "Gentry added that neuropathy is "a very frustrating problem, so people are open to all kinds of suggestions. "KMC spokesman Mike Reagan cautioned neuropathy patients against "putting all their eggs in one basket" with Palmer's treatments. "You've got to be careful when you're talking about single cases that you don't give people false hope," he said. "Anecdotal medicine works in one case and may not work in others. "Reagan returned to Covelli's remarks regarding the allopathic medicine perspective. "The problem here is allopathic doctors are trained based on double-blinded studies," he said. "When they hear of other treatments working, often they're anecdotal... There's some rap against chiropractors that the scientific evidence it works on a consistent basis is not there. "That evidence is just what Palmer is trying to prove, but no insurance provider or medical practitioner is willing to participate in a demonstration study.  Sooner or later someone will listen. "The worst belief in all of medicine is at play here," he said. "And that belief is that current care is the best care you'll ever get." John Mason can be reached at 664-8176, ext. 2021, or jmason@cdapress.com.  P.O. 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