A Comprehensive Guide to Biological Medicine and Wellness

By Mike Chan and Dmitry Klokol

With the arise of chronic, age and lifestyle-related illnesses, overwhelming stress, toxins and pollution, the society began to value more aspects of personal health than mere physical symptoms – the balance and harmony of mind, spirit and body. The society came to realization that it is not enough to eliminate the symptoms of the disease or even to treat the core of the illness. In most of the cases, the end of hospital treatment of the disease is only the beginning of the actual struggle for the patient. Whatever considered to be an accomplished mission from the point of view of medical protocol is only the beginning of the battle for the patient, which he, often left alone, not necessarily wins. 
Our experience in research and practice in various parts of Europe and Asia has brought us to conclusion that best definition for the term “biological medicine” is – “common sense medicine”. These therapeutic paradigms are developed, employed and practiced by European Wellness Centers (EWC) – a global network of institutions tied up by the concept of European Biological Wellness. Our philosophy does not support mechanistic approach to the patient but encourages holistic care, promotes therapies stimulating healing and regeneration, and puts wellness as a corner stone of the intended outcomes. Another two integral components of Biological Wellness are maximal safety of the therapeutic modalities and its compatibility with conventional medicine.  
Therapeutic paradigms of European Wellness are built on the platform of classical medicine taught and practiced all over Europe. Years spent on gaining experience and collaborating with most prominent European doctors and precise selection of fine treatment modalities from certain Asian traditional medical systems allowed us to formulate a unique system of Biological Wellness that to our knowledge does not have analogues up to date. The core of European Biological Wellness contains principles of biological medicine, which states that the human body is inherently capable of self-healing, and these abilities depend on anatomical, physiological, mental and spiritual balance. Once any component of this integral system is compromised, the occurring imbalance results in the development of disease. While conventional medicine predominantly identifies and emphasizes on symptoms and certain links of pathogenesis, our way of biological wellness, addresses the underlying causes of disease and acts concurrently with any existing treatment, modulates and balances the entire organism and directs it to effective healing and recovery. 
The main objective of the book is to offer to the medical community effective holistic diagnosis, detoxification, biological repair and rejuvenation based on the individual needs of the persons and taking into consideration the health status and medical conditions. The book also provides specialized Biological wellness, recovery, and performance enhancement programs for athletes,elderly people, individuals with various untreatable illnesses and congenital disorders with the purpose of improving their general condition and facilitating their primary treatment.

• Language: English
• Publisher: Troubador Publishing Ltd
• Release date: Mar 28, 2019
• ISBN: 9781789019117

Book preview

1

PHYSICAL EXAMINATION OF THE GUEST

Physical examination can be started by measuring the guest’s vital signs, which include temperature, pulse rate, respiratory rate, blood pressure and blood oxygen saturation. Next will be the Karada scan of the guest, which will measure their body weight, height, BMI, visceral fat and total body fat, as well as estimate the guest’s body age and daily expected kcal intake and loss.

For obese guests who are undergoing weight loss protocol, it will be necessary to measure standard body circumferences.

1.1 HEAD AND NECK EXAMINATION

Perform a head and neck examination emphasizing the typical sites of lymph nodes, which are a common location for cancer metastasis, as well as looking for any skin changes that can be suggestive of cancers (for example, basal cell carcinoma, melanoma and squamous cell carcinoma are cancers that will have abnormality on the skin). Examine the anterior neck region to appreciate whether there is any possible enlargement of the thyroid or whether there is any presence of thyroidal lesions.

1.2 OTOSCOPY

Otoscopy or examination of the ear is required to perform to examine the external canal, tympanic membrane and inner ear structures. For assessment of auditory acuity, Weber and Rinne tests should be done whereby a tuning fork is used to test the guest’s response to sounds and vibrations.

1.3 RHINOSCOPY

Rhinoscopy, which means the assessment of the nose region as well as examination of the frontal and maxillary sinuses, should be done as a part of the head and neck examination. Assessment of the sinuses will include examination of any colored nasal discharge, and also whether there is any tenderness/pain on palpation. Percuss gently and perform transillumination over the frontal and maxillary sinuses. Inability to perform transillumination to visualize the sinuses indicates the presence of inflammation of the sinuses.

1.4 OROPHARYNGEAL EXAMINATION

Examination of the oral cavity and pharyngeal area is also recommended as part of the examination routine.

1.5 EXAMINATION OF THE EYE

Aside from performing a vision acuity examination on the guest, do perform ophthalmoscopy, also known as fundoscopy, to allow examination inside the fundus of the eye as well as the other structures. Ophthalmoscopy provides important information as not only does it enable you to detect diseases of the eyes but it is also the only area of the body where micro blood vessels can be studied easily. A number of chronic systemic diseases, such as hypertension, diabetes mellitus and atherosclerosis, affect microcirculation in a slow and silent way. It is frequently impossible to directly assess during physical examination to what extent the affected organs (for example, kidneys) are damaged, therefore evaluation of the retina provides an opportunity to directly visualize these processes. Based on the obtained data, a biological doctor can have an idea of the pathological processes occurring in the body. Changes in the appearance of the arteries (copper wiring) as well as alterations in the arterial–venous crossing pattern (a–v nicking) occur with atherosclerosis and hypertension, respectively. These vessels are more obvious in the superior and inferior aspects of the retina, with relative sparing of the temporal and medial regions. In the normal state the edges of the optic disc are sharp and well defined. It should be a bit more yellowish than the rest of the retina. At the center of the disc is the optic cup, a distinct circular area from which the blood vessels actually emerge. The macula is a region located lateral to the optic disc. It looks darker than the rest of the retina and has no distinct borders.

1.6 SHOULDER JOINT EXAMINATION

The shoulder joint of the guest should be assessed to determine whether the guest has a frozen shoulder. Frozen shoulder, known as adhesive capsulitis, is a condition whereby patients suffer stiffness, pain or a limited range of shoulder movements. This may occur owing to past injuries or certain diseases like diabetes or strokes.

1.7 ASSESSMENT OF THE HANDS AND FINGERS

Do assess the appearance of the guest’s hands and fingers. Check for any deformities or any skin discolorations. If there is any presence of discoloration, check whether they appear relatively red and well perfused or white and mottled in color. Conditions such as a short, thin, brown, linear streak in the nails, also known as splinter hemorrhages, may suggest endocarditis or also known as inflammation of the inner heart.

It is important to check for one’s nail shape and color as well as to perform capillary refill. Capillary refill is a mechanism for gauging arterial perfusion. This is done by pressing the nail bed or tip of any finger for several seconds until the underlying skin turns white. Upon releasing pressure, the normal pink color of the skin should return in two to three seconds. Delay in returning to normal color implies that the guest is under perfusion and also reflects conditions of vasospasm (narrowing of the blood vessels) and hypovolemia (decrease in blood volume). Severe vasospasm, also known as Raynaud’s phenomenon, occurs most frequently in females after exposure to cold temperatures, causing both hands to turn white and painful.

Interestingly, atherosclerotic vascular disease is a common cause for arterial insufficiency or reduced blood flow of the lower extremities rather than reducing blood flow in the arms or hands.

Next, measure the temperature of the guest. Cold hands are usually a result of exposure to a cold environment. It can also reflect one to have vascular insufficiency or means the veins are not working effectively causing difficulty for blood to return to the heart from the legs. Cold hands also reflect vasospasm or a narrowing of blood vessels and also hypovolemia or a state of reduced blood volume.

1.8 ASSESSMENT OF THE JOINTS

Check for any obvious joint abnormalities. For example, deformity of the metacarpal pharyngeal joints of all fingers suggests systemic inflammatory conditions like rheumatoid arthritis. In conditions where there is only an isolated abnormality of a single distal joint, it is more likely secondary to local trauma or degenerative arthritis.

1.9 ASSESSMENT OF FINGER CLUBBING

Clubbing means a bulbous appearance of all fingers, specifically at the distal phalanges site. It shows loss of the normal angle between the nail base and adjacent skin. Clubbing of fingers is commonly associated with conditions that cause chronic hypoxemia or low concentration of oxygen in the blood, for example severe emphysema.

1.10 ASSESSMENT OF THE CARDIOVASCULAR AND RESPIRATORY SYSTEMS AND ABDOMINAL REGION

We suggest using four cardinal diagnostic maneuvers, which are inspection, palpation, percussion and auscultation, to examine these systems.

For the respiratory system, check for breathing regularities as well as whether any accessory breathings are used, for example the scalene and sternocleidomastoid muscles. Do not forget to also assess skin color, particularly around the lips and nail beds, to check whether there are any signs of hypoxia.

Always look out for edema or swelling of the lower extremities as they are a common finding rather than in the arms and hands. This is because they are exposed to greater hydrostatic pressure owing to their position. If there is any presence of any swelling of the upper extremities, it is usually localized over an area of local inflammation such as cellulitis.

When there is diffuse swelling of the arm, it suggests that the lymphatic drainage is compromised such as disruption followed by axillary lymph node surgery, where it is done for staging and determining the treatment of breast cancer. Swelling of the upper extremities can occur owing to venous obstruction, however this is less common than the lower extremities.

1.11 ASSESSMENT OF THE RESPIRATORY SYSTEM

Check for normal chest excursion by placing your hands on the guest’s back with your thumbs pointed toward the spine. Always remember to rub your hands together to prevent them from being cold prior to touching the guest. A normal chest excursion will lift your hands symmetrically outwards when the guest takes in a deep breath. If there is any asymmetric lung expansion, whereby one side of the hand moves outward at a lesser degree than the other, this suggests that there is something, either air or fluid, occupying the pleural space. If asymmetry has occurred, the guest is likely to have a history of pleural disease.

A normal lung transmits a palpable vibratory sensation to the chest wall. This is referred to as fremitus and it can be detected by placing the ulnar aspects of both your hands against either side of the chest while having the guest say ninety-nine. This procedure is then repeated until all aspects of the posterior thorax are covered. The reason why the ulnar aspect of hands is used to detect fremitus is because they are sensitive in detecting vibrations.

If there is an increase of tactile fremitus, this means that the lungs are consolidated with either fluids or tissue. This occurs most commonly in pneumonia patients. The reason why the vibration sensation is more pronounced is because, when there is a large segment of lung parenchymal involved, it alters the transmission of air and sound.

Meanwhile a decrease of tactile fremitus suggests that there is air or fluid in the pleural spaces (pleural effusion) or a decrease in lung tissue density. This can be caused by diseases like chronic pulmonary obstructive disease.

1.12 ASSESSMENT OF THE CARDIOVASCULAR SYSTEM

Next will be the evaluation of the cardiovascular system, focusing on the guest’s heart and also an assessment of the arterial system throughout the body.

Assess the internal jugular vein

Check for possible distention of the right internal jugular vein (IJ). This is to determine whether there is any jugular venous distention (JVD). Jugular venous distention may indicate that there has been an increase in body blood volume, which can occur with heart failure, or a condition that may interfere with the filling of the right atrium or movement of blood into the right ventricle.

Palpation of carotid artery

Next will be palpation of the carotid artery as this is the best way to assess for aortic valvular and outflow tract disease. However, this should be done after auscultation so that you know whether these problems exist prior to palpation. Carotid artery palpation is done by sliding the second and third fingers of either hand along the side of the trachea at the level of the thyroid cartilage. The carotid pulse is palpable just lateral to the groove formed by the trachea and its surrounding tissue. How firmly you need to push will be determined by the quantity of subcutaneous fat over it. They are easy to palpate and abnormalities of the carotid pulse may be caused by atherosclerosis, aortic stenosis or severely impaired ventricular performance. One tip to remember is to not push on both sides simultaneously as it may compromise the cerebral blood flow.

Listen for heart sounds

Listen for extra heart sounds, which are also referred to as gallop rhythm. They may be heard normally in younger subjects aged 20 to 30 but it may be a sign of pathology in older guests. Normal heart rhythm has two heart sounds, called S1 and S2, which make the lub-dub rhythm caused by the closing of valves in the heart. A gallop rhythm or abnormal heart rhythms contain sounds called S3 and S4.

An S3 sound is most commonly associated with left ventricular failure and the sound is produced by the blood from the left atrium slamming into an already overfilled ventricle during the early diastolic filling. An S4 sound is created by blood trying to enter a still-noncompliant left ventricle during atrial contraction. It is most commonly associated with left ventricular hypertrophy, which is a result of long-standing hypertension.

Heart sounds are detected by gently laying the bell of the stethoscope over the apex of the left ventricle, which is roughly located at the fourth intercostal space around the mid-clavicle line. After placing it in the correct position, listen for low-pitched extra heart sounds. The presence of sound following S2 is an S3, whereas the presence of an extra sound is an S4 sound. These sounds are quite soft, so it may take a while before you are able to detect them. Positioning the guest on their left side while you are performing may improve the detection of sounds. The presence of both S3 and S4 simultaneously is referred to as a summation gallop. They are usually heard in subjects with tachycardia/faster heart rates but they can also indicate myocardial infarction.

Check for heart murmurs

Heart murmurs are heart sounds that are produced during the systolic and diastolic phases when the blood flows across the heart valves. Abnormal heart murmurs can occur when there is leaking of blood backward across a valve that is supposed to be closed. This condition is referred to as regurgitant or insufficiency murmurs. Mitral regurgitation is a condition where regurgitant murmurs occur.

Murmurs may also occur as a result of disturbance of blood flow across a valve that is not fully open. These valves could be suffering from varying degrees of stenosis, which means narrowing. This condition is referred to as aortic stenosis.

Occasionally, flow murmurs may occur as a result of high output across structurally normal valves. Some valves with insignificant degrees of pathology, for example in the condition of aortic sclerosis whereby the valve leaflets are slightly calcified but they are still able to function normally, may generate murmurs when blood flows across them. Hence, it may take some thought and practice to distinguish the types of murmurs.

1.13 ASSESSMENT OF THE VASCULAR OR CIRCULATORY SYSTEM

Start by palpating the inguinal area, then proceed by feeling for femoral pulses and also check whether there is any inguinal/femoral adenopathy. Inguinal adenopathy means swollen lymph nodes that surround the femoral artery and vein in the thigh region. Note for the consistency of the lymph nodes as well as their mobility. Fixed, firm lymph nodes are concerning as they could be a sign of a pathological condition.

Then place your hands around the knee and push the tips of your fingers into the popliteal fossa, which is also known as the knee pit (the depression located at the back of the knee joint), to feel for the popliteal pulse. Note whether it is pulsatile, which is normal, or enlarged and aneurysmal, which is an uncommon phenomenon. This artery is covered by a lot of tissue and hence it can be difficult to identify and may require you to push pretty hard for identification. Even then, it may not be palpable but you may still be able to identify more distal pulses to assist your examination procedure.

1.14 ASSESSMENT OF THE LOWER LIMB

Color of the lower limb

Different colors may indicate different conditions. Dark bluish or purple discoloration indicates venous insufficiency. Placing the guest’s leg in a dependent position or leaving it dangling may cause the bluish discoloration to darken dramatically. This is because of the action of gravity against an already-ineffective blood return system.

Dark, speckled appearance of the lower limbs is a result of deposition of hemosiderin owing to blood stagnation in the lower body region.

Pale skin color of the leg indicates that the guest may have severe arterial insufficiency as a result of underperfusion or simply means there is not enough blood flow in the lower body region. Placing the legs in a dependent position may cause the skin to become more red as gravity enhances arterial inflow and the result of the maximally dilated arterioles trying to bring blood to supply the otherwise starved tissues.

Lastly, dead tissue turns the skin to a black color and cellulitis, which is a skin infection, can cause the skin to appear bright red in color. However, the changes mentioned above can be difficult to detect in people who are having darker color skin tones.

Note for any leg swelling

Check whether there is any obvious swelling of the guest’s leg. If there is, note whether the swelling is symmetrical and check for the location and extension of the swelling.

Perform knee examination

Start the knee examination by observing it and try to identify its surface anatomy. Then palpate the knee and check for its available range of motion, followed by performing examination maneuvers as mentioned below to test the knee.

(1) McMurray test (menisci)

Hold the knee with one hand, which is placed along the joint line, then flexed to complete flexion while the foot is held by the sole of the foot with your other hand. Place your hand on the inner side of the knee to pull the knee laterally while rotating the leg internally with your other hand. Pain or clicking indicates a positive test result.

(2) Apley Grind test

The Apley Grind test is performed to assess for problems in the meniscus of the knee. The guest is asked to lie prone or face down on the examination table and have their knee flexed to 90 degrees. Then, try to rotate the foot while providing downward pressure. If this maneuver produces pain, it indicates a positive result and presence of damage in the knee meniscus.

(3) Lachman test

The Lachman test is a test to check for any injuries that are associated with the anterior cruciate ligament. The anterior cruciate ligament is an important ligament that prevents the tibia from sliding out in front of the femur.

The guest is asked to lie flat on the examination table. Perform the test by stabilizing the patient’s femur with one hand and pull the tibia anteriorly with another hand. Repeat by pulling the tibia posteriorly. Anterior translation of more than 2 mm of tibia indicates a ruptured anterior cruciate ligament.

(4) Drop Lachman test

The Drop Lachman test is a more appropriate test if the examiner has a smaller pair of hands or if the guest’s legs are bigger in size. The guest’s leg is positioned over the side of the table, flexed 25 degrees. Then stabilize their ankle between your legs. Hold the guest’s femur down with one hand and pull upward on the tibia with the other