Episode 60 of The Living Life Well Show: Free from Headaches with Dr Al Cobb
[00:00:00] Welcome to the Living Life. Well show the intersection of God's word, today's science and healthy living with common sense application, all based on the truth of the word of God. I'm your host, Dr. John Skelton. Now let's get straight to the truth. today. I am excited for this episode because I have Dr. Al Cobb with me, and we're discussing all things headache. Well, why is a functional me medicine physician and a chiropractor getting together to talk all things headache? Well, first of all. It is for a comprehensive approach.
In addition, we're also having a special, presentation, if you will, about how you can get control of your headaches, about how maybe you [00:01:00] haven't been getting the answers that you need. Because as you'll find out, we discuss how prevalent headaches. Are, , in our particular practices and there are some common things that you can do as well as some common misconceptions to overcome.
So if this pertains to you, if you're interested in finding out more about headaches for you or for a loved one, uh, we would welcome you to to sign up for our free from Headache Seminar on July 24th at 6:00 PM It'll be at, , my facility, the Live Life Well Clinic. Here in Lubbock, Texas.
And so if you want more information about that, you can get that on our socials, , live Life Well Clinic on Instagram or , Facebook, or you can, also send us an email at admin at live life well clinic.com and we'll have some links in the show notes as well. So without further ado, , here you go.
Here's the rest of the show.
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Al Cobb, DC: [00:02:00] So I'm Al Cobb. I'm a chiropractor here in Lubbock at the Blair Chiropractic Clinic. We specialize in head and neck conditions and through a technique called the Blair Upper Cervical Technique that was started here and developed here in Lubbock and has since kind of gone throughout the world. So. I'm passionate about the upper cervical spine because I know the impact that it has.
It's the most freely moving joint in the body. The most neurological input, it's the closest to the brain, and a lot of really intentional and intense and complex veins, arteries, all that stuff. And it makes me think and be on my toes all the time for head and neck conditions. And so when I, whenever I, get so passionate about this, a lot of things pop up for me. We see a lot of conditions that are cervical spine and nature, but also can be a vast array of different things because of the complexities of what's going on with the head and neck. So for me, if I have a patient that has. [00:03:00] Headaches or an just a sudden onset of headaches.
I've got a, a list of things that go through my mind, and I'm sure you do too, Dr. Skelton. But I think, do I need to send this person to the emergency room? Is this the best place for this person? Or have they had a complex series of accidents that's caused this chronic headache, and is it sending pain to the head in different ways or sending pain throughout the rest of the spine or.
Throughout the rest of the face, whatever it is, in different ways. So we have a very gentle and specific way to correct things. We see things with a 3D x-ray, and then we'll take a very gentle and specific approach to adjusting the neck. It's not your twisting or popping or jerking, which is not necessarily dangerous, but can be better for some types of conditions as well.
So we take a a more co a more comprehensive and. Hands off and conscious and. Careful approach to [00:04:00] chiropractic care. And I love what I do and the reason I'm passionate about headaches is my mom had migraines her pretty much her entire life. We eventually found out that
if she had garlic, she would have a migraine that day and be down. Oh wow. Food, food triggers or food allergies can be a weird trigger for those. But I remember days at a time, she just wasn't around and, and I didn't, didn't have the chance to treat her obviously. She lives in Tennessee and so I don't see her much, but I.
She's got her, her health under control a lot better. And she knows her triggers and like she understands why she gets migraines, and now she can live a little bit more free from those. But I get passionate about that because I know the lives are being impacted. People aren't able to show up as moms aren't able to show up as, as workers aren't able to show up in their own world as.
They were called to, so they're, they're not able to live out the callings in their life, kind of like I was after a concussion. So, I'm passionate about that and that's why I think this, this workshop can be really impactful for [00:05:00] people.
Jon Skelton, MD: You bring up a point and, and talking about a an ER physician and a chiropractor and, and kind of, getting together, on this, that, that really is unusual.
And, and I don't know that the general public really understands why that's unusual. But it is, and part of the reason I will tell you is because of. What you just kind of described with what you do with, with your cervical spine approach, because, , for you guys listening out there
the ER when they have a patient that comes in that has a severe headache after being adjusted. One of the things that we always worried about was a vertebral artery injury. That can occur with that quick popping. And again, it's very rare but it can happen and, and does happen in in some individuals.
And so, the, the ER doc tends to tell people never go see a [00:06:00] chiropractor and, you know, those things. And, and I've been guilty of myself at that at times, but I. And speaking with your, your colleague, Dr. Elder, it was great to really find out that you guys really approach that, that differently and, if that type of adjustment's needed that that might be something that you guys employ, but you take a much different approach as opposed to it's a one size fits all adjustment.
So can you talk a little bit more in depth about kind of why you got in specifically into. Blair and, and looking at this approach as opposed to, you know, the traditional teaching of, chiropractic school in general. Because I think it is, it is a bit unique, right?
Al Cobb, DC: Definitely is. So when I was, in my early, probably the first two or three quarters of chiropractic school, we had we had a lot of anatomy classes and biomechanics classes, and I started to realize how complex that whole area is. We eventually moved on to have [00:07:00] just solely devoted anatomy, neurology, and physiology courses for the head and neck only that whole quarter.
And I was like, think there's something to this, like this area is. This is a, this is a crazy area. And so I started to see like, wow, this is, this is really important. I started to talk around and there are, what we practice is upper cervical chiropractic and generally upper cervical chiropractors, and there are probably seven or eight techniques that practice this, this particular way.
There are, we are mainly. Image informed. So some chiropractors won't take an image or like an x-ray or something. And so it's not anything bad against them. We just prefer to see what we're dealing with. And then we adjust really gently and specifically for those areas. But as I was learning, I remember talking with people about some of these different techniques and I just eventually found my home in the Blair technique.
And it's it fit all of my categories, you know, it was a little bit more scientifically rigorous. You had to you had to be [00:08:00] more. On your toes thinking about things and understanding how this would affect. Not only the, the biomechanics of the upper cervical spine, which is the neck, the upper neck, but also how it would affect blood flow to the area or how it would affect the lower, the lower neck or if it would affect anything else that's going on with the jaw or things like that.
So, and also at that time people were getting really into cone beam cts, which is pretty much a 3D model of the neck on your screen. And so. I was like, that's, I don't ever wanna take an x-ray again. I wanna see this in motion for the rest of my life. I don't I don't want to take an x-ray. I, I'd rather do this.
It's lower dose of X-ray images and it's more specific and you can see a lot more. So you don't have to guess. And I think that's why I love it the most. You don't have to guess what's going on with the neck. You can actually see this is where we need to adjust and how we need to adjust and. Up until that point in school, you're kind of taught the, the, the, a little bit more aggressive manipulations of the neck that [00:09:00] take a lot more force and twisting and all that stuff.
And, you know, you hear some of those stories of, of chiropractors who have a bad accident in the office with a patient. And man, that's like, that is truly my biggest fear in practice is to have somebody come in and they don't walk out. Well at all. They, they feel better, they feel worse when they leave as opposed to feeling better.
And so I just took it to myself like, man, I, I wanna be a specialist in this area. I wanna really dive deep into it and understand it well, and, and I think people get better care for the cervical spine when they go to an upper cervical chiropractor. Especially if that person kind of like what we do here in the clinic, we've, we've really, I mean, we sit and talk for hours a week about cases and how this could potentially impact this and if we need to send this person somewhere else for other care.
So kind of like what you said, we, we don't assume because you have a spine, you're, you need our, our help and also because if you need our help, you need a jack, an adjustment to the neck. [00:10:00] So. Like you said, we, we try to only adjust when it's absolutely necessary and then allow the body to just adapt and heal in its own particular and unique ways.
Jon Skelton, MD: Yeah. And I think that's a, that's a great approach. 'cause it, it, it is taking each person uniquely and not prescribing, what you know to do on the assembly line to them. And it's not a one size fits all. And so that's what, that's what I, I think is, is really need and what's lacking in, most of medicine in general is that lack of personalization and really getting to know and understand, , what is going on with the patient , and the world I come from of traditional medicine . If you go see an osteopath, you might get some sort of an adjustment, but typically now they're not focusing on the physical either for the most part just 'cause they're stuck in the insurance world like everybody else.
And so what do they do? They, they take out [00:11:00] their, , script pad and start writing and they say, here, this is your cure. So.
Al Cobb, DC: Yeah, absolutely. And man, I think that there, it's so valuable to have that as an option as well too. Like what you do is extremely necessary work, especially in the emergent care world.
And also at the same time, like I've, I've sent people to the emergency room from, from our clinic before they could. Have anything done in, in here? Just 'cause I'm like, I wanna see, you know, like, what's going on here? Like why is, why is your pupil not dilating? Or why is your pupil not constricting? I'm gonna have you go over there first, then you can come back.
And so, man, I think that what you were saying is, is really impactful because you want people to get the highest level of care. And usually how that works out is time and expertise and understanding. And when it comes to headaches and in general, there are hundreds of types of headaches. I think over a hundred was the last time I looked, and some of the biggest ones are probably [00:12:00] 10 or so of 'em, but there's so many different ones, and.
Within that, there can be multiple reasons for those headaches. It could be blood sugar related or it could be hormonal related, or it could be related to the cervical spine. Maybe you had a car accident a year ago that you didn't consider might have injured some of the ligaments or joints of the neck.
That's now referring pain up to the head, and so when it comes to that. I don't wanna just assume that what I do is the only thing that you need, or even something that you do need. And when we can take that as a whole approach and then kind of get deeper into the, into the root problems of things, then we're able to help the person actually get results as opposed to just, hoping that this works or just assuming that what I do is the thing.
Because really. There are a lot of non-cost things to help with headaches, it's drinking water, it's not drinking caffeine, it's drinking caffeine. It's, there's a lot of different things [00:13:00] that are necessary to take into account there too. So, and that's what we'll be kind of covering in our workshop.
So, if you're interested in learning a little bit more about that and how you can have some at-home strategies and maybe some more intensive strategies kind of in a hierarchy to understand how you might be helped, it's, I think it's an, it's a super valuable opportunity. I.
Jon Skelton, MD: Yeah, absolutely. And that's what I'm excited for in the workshop because I don't ever like to do a free event without getting some actual actionable steps to people.
Because I, I think that,, a lot of people will go to different events and, and things like this, and they're, quote free and really all they're getting is, is. A sales pitch, right? I, I want, I want people to be able to walk away with actual knowledge that they could impart upon leaving, right at that time and possibly see results for themselves.
So if not for themselves, maybe for their loved ones or if they're not [00:14:00] a chronic headache sufferer maybe they just now have more knowledge and a little bit of a, a. Tool belt, if you will, to be able to implement some things to maybe figure it out and also know when they need to actually seek care as opposed to try and figure it out on their own.
So, so I, I think if we can do that for people, then we're actually providing a, a, a really good service and, and really helping to, to educate and better our, our little area here in Lubbock.
Al Cobb, DC: Absolutely. So on that I'd, I'd be interested to hear what are, what are the most common types of headaches that you see from an emergent care perspective?
And then I'll, I'll kind of comment, what are the ones that I see?
Jon Skelton, MD: Yeah. So, you know, the number one thing that I always see in the er by the patient report is, is migraine. And we'll talk a little bit more about what a migraine is or isn't in the talk. But basically there's [00:15:00] this there's the medical definition of migraine and then there is the general public's definition of migraine.
I've come to learn over my 20 plus years in the er, the general public's definition of migraine. Is a bad headache. Yeah. That, that's all that means. I, I is a bad headache for a large amount of people, but. Headache tends to be about the fifth leading chief complaint that we see in the emergency department.
And so, you know, year over year they, they'll do these studies looking at what are the most common complaints that come into the er. And, and year over year headache is always in the top 10, usually in the top five. You know, if, if it's not in the top five, it's, it's right there. Six or seven. So, you know, headache is very common, something that we spend a lot of time on in medical training specifically emergency medicine training.
But migraine, I would say in general is. The thing that, that I see most [00:16:00] commonly second most common you know, is gonna be tension headache. And then after that, the third most common would be head injury actually. So
Al Cobb, DC: yeah, I would agree with that. You know, it's interesting too, the overlap that of the patients that we see is really interesting.
Probably the, probably one of the top five. I think the third, number three reason that people come to chiropractors is neck pain. And I think number four is headaches. Typically what we see especially in a chiropractor in a upper cervical chiropractic clinic, head and neck place, they're like, it's, it's like.
One a day or one a week that is a new patient that has headaches or something. So, I would agree with you and, and I was, I wanted to ask you too, I've seen a lot of people who, I wouldn't say a lot, a lot of people have a true migraine, but then they'll have like a what we call hemiplegic migraine, or some people will just call it complex migraines.
And what that usually looks like for people is a stroke. People are horrified that it's a stroke and for good reason, and [00:17:00] they'll end up in your place and hopefully you'll be able to say, Hey, you're not having a, a vascular event right now. It's a complex migraine. What does that look like? To to see that in the, in the er.
Jon Skelton, MD: Yeah, so whenever anybody has a new onset, different type of sudden headache, you have to assume the worst and act quickly. And so what that typically means is we're gonna image you. We're gonna image your vasculature, we're gonna image your neck vasculature. We're gonna image your brain vasculature as well.
Well, why are we doing that? Well, we're looking for signs that there's a vascular injury of some, some sort. A vascular injury could mean that you're not having blood flow, which would be a typical. Pattern with the most common stroke-like, issue that will have typically a, a thrombotic occlusion, which is a buildup of plaque over time, or an embolic phenomenon.
So people [00:18:00] that have history of, heart disease specifically atrial fibrillation. A lot of times they'll just flick off blood clots. We saw this happen a lot more with stroke-like symptoms during the pandemic and with COVI and it's rise with, with causing more clot situations, if you will.
And causing these issues. And so anytime somebody comes in with a weakness on one side, a loss of vision, loss of speech, anything like that, we are going to. Act just like it's a stroke and we're gonna do everything that we need to do to rule that out. And so that's the approach that we take first.
So what ultimately ends up happening for most people with their first hemiplegic migraine? I. They get admitted to the hospital, they get admitted to the hospital. They have multiple different scans and see multiple different specialists [00:19:00] because the stroke, if it is missed, can be so devastating and life altering versus a hemiplegic migraine.
You've lost a couple of days maybe in the hospital and some money. But you know, hey, now we know what this is and now we can really help. And so. The number one thing. When somebody comes in and they say, man, this seems like a migraine to me, is my number one question to them is, is this new or different from what you normally experience?
And that is a, a big question that you want to know when you go into assess somebody for a potential hemiplegic migraine.
Al Cobb, DC: Gosh, yeah. That's so helpful. That question alone is, is so helpful because I think. You mentioned earlier, chiropractors having bad events like a stroke happened in their office.
A lot of times it's established patients who have already neck pain or headaches. And the chiropractor just kind of misses a [00:20:00] stroke ongoing or about to happen. They'll come in with a headache and, and they're like, oh, this person has headaches already, or they have neck pain already and we've been dealing with this for three to four years.
You know, so, and they'll just add that tipping point and that question alone, I ask that all the time. Is this like a headache that you've had before? Is it new? Does it feel like it has before? Is there anything else going on? Any numbness or tingling anywhere? I'm sure that my patients get tired of me asking the same question about the same condition, but I'm not gonna let that one slide.
And, and the other one that we see as well is a lot of concussions. So anytime you have a force enough to create a concussion, you have that's about 25 per 25 times the amount that causes a problem in the neck. So we'll see a lot of whiplash injuries from sports, concussions, or car accidents that that end up eventually.
Creating this referral pain to the head, and it's just a headache, it's just a chronic low grain headache or potentially referral pattern from some muscles. So being able [00:21:00] to take care of that and understand why this person is having that is is critical. Another question too they'll have, they'll have a migraine like a week before their their menstrual cycle.
So you can ask. Hey. And with it being headaches, mainly being in, in women, majority to ask 'em, Hey, is, is this something that you know, happens during certain times of your cycle? Are you on birth control or anything? It's things like that that have really helped me understand, and it will help our listeners too, and people who attend the workshop to understand, is this something that is hormonal based or a portion hor hormonally blood sugar related?
Is it worse when you eat something that's. Spikes your blood sugar, and there's plenty of ways to talk through that as well.
Jon Skelton, MD: Yeah, absolutely. You kind of touched on this earlier, and I think this is what, what is important, and this is why we can come together and have a great discussion about, about headaches, is because when you look at medicine, I don't care [00:22:00] whether you're from the, the chiropractic field, if you're from e even you know, say Chinese medicine field.
The differential, meaning the underlying cause or, or diagnosis that you're, postulating when a patient comes in with a headache, it's the same, I, I, I don't care what field you're in, it, the, the, the, possibilities are the same. The, the question is how you arrange that differential meaning, mm-hmm.
From an ER standpoint, when we arrange a differential, we always say, what's gonna kill you? What's gonna, , maim you what's gonna leave you in a wheelchair? We're gonna put those things first. Whereas you go to a primary care physician's office that differential is gonna be flipped a little bit.
That's gonna be more, oh, this is a tension headache. Then it might go to migraine it. Could go to cluster. But, going up to [00:23:00] subarachnoid hemorrhage aneurysm meningitis usually lower down on the list, which those are, those are my top. And so in your case, you know what you're saying, most often is , you're thinking, okay, cervical spine injury, those types of of issues. However, because you're a good physician, you're really looking at that full potential there, and not just focusing on, what's common is common.
Al Cobb, DC: Mm, absolutely. And I've had to really flip that on its head.
And they taught us that in school. Like they, they taught you, Hey, you need to be thinking about these scary things first. And then you can decide like, is this a good person to be in your office? And I think a lot of people, they get into practice and they just forget about that. But just because it's, it's a lot of the stuff that we see, like we hardly see that much low back pain.
Patients. We see some like that, but the majority is head and neck stuff, so I'm having to ask that question all the time. So I appreciate your kind words. I [00:24:00] try to be as diligent and as conscious as a provider as I possibly can, just to help people get a little bit more of a, of a, of a step up on things.
But also it's for myself, I need to sleep at night, so I need to be able to lay my head down and think that, man, I really, I really did ride by that person and got them the care that they needed, regardless of if it was. Hitting our bottom line as a clinic or a business. And honestly, I just trust the, the Lord to do the rest of the work in that, that circumstance.
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Al Cobb, DC: is there anything that you just necessarily like, need to get out to people and think, Hey, I'm I'm really wanting these type of people to come and understand and learn at our workshop to be able to understand what they're dealing with or how they're struggling?
Jon Skelton, MD: Well, here, here's what I would tell you is men are reluctant. Men are reluctant to to, to go to anything like this. Men are reluctant to take care of their health in, in general. So what I would tell you is that if you are a, a lady who has a man [00:25:00] that, that suffers with the headaches or is a, is a, around somebody that's suffering with a headache. Invite him to come you both come. If you, if you can, that would be great because a lot of times it's, it's the partner who has to. Institute the, the trip to, to be seen by somebody for this condition. So I think educating both spouses is gonna be very important.
And same thing if you're the parent of a child. You know, we see a lot of, teenage girls especially as they kind of, go through their, their menstrual cycles really getting, starting, started up a little bit later in the teenage years and maybe early college years. We see a lot of migraines associated there as well, so.
If that's you, if you're the mother or father of a, of a teenager that that's had this. And listen, we're about to get on onto football season here, right? Football season, we see lots of concussions. . Do what you can [00:26:00] do now to help prevent those issues for those kids.
So, so really it's for all comers. But, , I have a special heart for for men trying to really take back their health. And so, I would love to see, , some more men there and the women who love them.
Al Cobb, DC: Amen. That's good news. That's a good word. I'll also say too and this is what, what kind of, just the nature of what we do.
A lot of people trickle down and it's been years in the making. People are I. I've been dealing with a chronic migraine or migraines for 30, 40 years. Sometimes, sometimes it's one or two years or five years, but if you've had this headache or this migraine, you're like, there's nothing else that can help me.
You know, we're not promising that we can help you, but we're promising that you're gonna have some information. That can help, hopefully help you along that process to be able to get some understanding and hopefully make a couple of tweaks in your life that can get you just 1% better or 3% better, [00:27:00] and. Biggest thing with that is to not give up hope.
You know what you've experienced. Your entire life does not have to be what you experienced for the rest of your entire life as well. So, always grow and always evolve. Dr. Skelton, thank you so much for being open to do this. This is prob I, I do workshops every once in a while with people and I'm really excited about this one, particularly just because of the uniqueness of it.
Two different professions coming together and I think it's gonna be the most well-rounded look at headaches. In general because we're looking at it from all kinds of different perspectives. A natural health, a a physical side and also like an emergency medicine side. So if there's any question about a, a headache, I think we'll be able to kind of, point you in the right direction or be able to answer it directly.
So I'm excited about it.
Jon Skelton, MD: Yeah, absolutely. And, and thanks again for, for setting this up, Al. I think it's gonna be absolutely fabulous.
Al Cobb, DC: Yeah, absolutely. So, just a reminder on July 24th at 6:00 PM we're gonna have this headache workshop [00:28:00] free from headaches. We're going to do it at Dr. Skelton's office.
Live Life Well Clinic in in Lubbock, Texas. On Milwaukee. You can find the details down below. You also need to RSPP because we're gonna be doing some giveaways. We've got some refreshments coming from some local vendors.
Jon Skelton, MD: Yeah.
Al Cobb, DC: And we're also gonna have limited seating, so 20 people max in Dr.
Skelton's clinic. If we need to open it up, we definitely can, but please, RSVP and RSVP for people that you're gonna bring with you, AKA, your husband's, and we'll, we'll talk we'll look forward to seeing you there. Dr. Skelton. Thanks so much for having me, and thanks so much for, for putting this together and agreeing to it.
Jon Skelton, MD: Yeah, and thank you. And I can't wait , for the 24th.
That's it for this episode of The Living Life. Well show if you like what you've heard and want to learn more or want to know how to put this into practice for yourself, go to live life well clinic.com. Until next time, this is Dr. [00:29:00] Jon Skelton saying go out and live the truth so you can live life well.
The preceding is for entertainment and educational purposes only. It is not meant to be used to prevent, diagnose, treat, or cure any condition. The information contained in this show does not substitute the need for a qualified medical professional, nor is it meant to provide medical advice or services.
If you feel information presented in this show may apply to you, we recommend you seek out the help of a qualified medical professional who can evaluate and treat your specific concerns.
