#003 - Torsten Liem meets Joseph Gill-Lussier (English)

00:00:03:

00:00:06: Hi, Joseph.

00:00:07: I'm really happy that you're here

00:00:09: and

00:00:10: Hamburg

00:00:11: at

00:00:11: the OSD.

00:00:15: Let's start with what motivates to study osteopathic?

00:00:20: because you told me before you were a musician for professional jazz music so... to change your profession basically.

00:00:30: Okay, well that's a good question and the reason why I changed my profession was because i hurt myself you know in music And there is Nadia Todorov which is an osteopath.

00:00:44: That helped me recover and found out it was magic You know?

00:00:49: It was so impressed with that.

00:00:50: But thats'the reason why went into Osteopathy.

00:00:52: The reason why continue to be an Osteopath Today its not same reason.

00:00:58: It's because I'm always amazed at the results that we have in clinic, and those abrupt changes sometimes happen with chronic patients who've had issues for years.

00:01:15: They're so stimulating and motivating to me... ...and i am still amazed by the result of getting a clinic with certain patients.

00:01:24: It doesn't happen every day but it's something that really feeds me to learn more and evolve.

00:01:31: And I think teaching is part of the learning process, so thats why i am at this level now in teaching as a student.

00:01:39: Cool!

00:01:40: And your specialty is Cervical Genetic Headaches

00:01:45: or?

00:01:47: Cervicogenic Syndrome.

00:01:48: We are with headaches and dizziness.

00:01:52: How it came where you entered this specific field?

00:01:58: Yeah, well I have many different diplomas.

00:02:02: I was a musician but also physical education teacher... ...I had another grad in that field and one of my teachers was a kinesiologist working on rehabilitation.

00:02:15: And at the very beginning of my study in osteopathy, he wanted me to collaborate with a neuropsychologist and concussion patient.

00:02:25: So I started working with concussed patients already in the inter-disciplinary team.

00:02:33: So those complex patients at the time in two thousand nine, I don't know if you remember Torsten but The post-concussive syndrome and all that wasn't very fashionable And we were already looking at different profiles of the syndromes.

00:02:47: We are working with kinesiologists Neuropsychologists now still passed together.

00:02:55: I had a very specific experience early on in my training as an osteopath.

00:03:01: And it wasn't even graduated from osteopathy that i was already In the field and eventually, The head of the ENT hospital or center Had some patients they treated and he saw the results called me.

00:03:16: so It's been more than a decade That work in a specialized expertise group health practitioners or different physiotherapists and medical doctors, ENTs neurologist for patients that have issues that arise from the neurological subunit of their neck.

00:03:40: So tonight this headache dizziness a lot of different symptoms that mimic dangerous pathologies but in the end it's somatic problem.

00:03:54: Yeah,

00:03:55: I can see.

00:03:55: I mean, surgical genetic syndrome is really a complex let's say disease or patients suffer a lot and how

00:04:06: you would

00:04:07: consider your... okay it's subjective question but how do we consider the treatment success in a way?

00:04:17: Well in ten years we've had at the clinic around fifteen thousand osteopathic care.

00:04:24: and so in my country, Osteopathy is not yet regulated.

00:04:29: You come

00:04:29: from Canada?

00:04:30: I'm in Canada in Montreal the French part of Canada And So The head of the ENT department at the University of Montreal and the Head of the Service of the E&T service In the hospital or center Isam Saliba, the only reason why he would collaborate with us is because of efficiency.

00:04:55: He's not interested in philosophy and theory but a very pragmatic man who didn't have success with those types of patients before working for us at Stilpad.

00:05:07: So we have a team of five osteopaths in the clinic, where he's medical director and we collaborate.

00:05:14: He is co-director on my PhD at the Faculty of Medicine.

00:05:19: We've developed fall prevention programs for elderly also.

00:05:23: so there are wide range interventions that were put into place

00:05:29: to

00:05:30: help patients who haven't found help with standard care.

00:05:34: So as a complementary approach to standard care, astiopathy works very well in the interdisciplinary thing.

00:05:40: Yeah I can see your workshop is extraordinary.

00:05:44: what would expect participants could learn from you

00:05:51: about

00:05:52: Cervical Genetics Syndrome?

00:05:54: Well...I think there are objectives of this course you know, a little bit of know-how.

00:06:04: So to have a different approach in osteopathy because the patients are complex.

00:06:08: they've seen a lot of other osteopaths.

00:06:11: so we have to do something different to get different results.

00:06:15: A new approach.

00:06:16: it's called advanced volumetric approach which encompassed the whole body with also specific aspects to the neck but also encompassing this whole body experience for the patient.

00:06:28: So, Christopher

00:06:29: could you explain your approach a little bit more so that people understand what it means?

00:06:36: technique approach involving the collaboration of patient with breathing and also a lot body awareness to work in structural way.

00:06:51: Also, their attention I think surprise them with something that is very interesting.

00:07:02: I like this very much, because it's a big difference in normal osteopathic approaches and also one of the bases in psychosomatic osteopathy where the patient is an active part because selective focus awareness brings in the changes of physiology and competence, and correlation with patients?

00:07:27: Yes I do agree.

00:07:29: The patient as a collaborator is not passive object upon which we have an intervention.

00:07:37: We collaborate on that.

00:07:41: one aspect was to know how.

00:07:46: One other aspect is also some knowledge to do patient education about the different aspects that are also going to aggravate the condition, whereas belief and behavior and things like catastrophizing hypervigilancy.

00:08:04: Could you

00:08:05: stay a little bit longer on what it means for your specific OMT?

00:08:10: Okay, approach.

00:08:11: Yeah where we get a more precise

00:08:14: idea what it means okay.

00:08:16: so basically What?

00:08:19: We're doing?

00:08:20: is we're trying to To have A global body Approach and we try to have an impact on the relationship of a patient with his own body, is an inter-receptive field.

00:08:36: So we work with breathing and the different sensory modalities so that he has more precision.

00:08:44: We know these patients have chronic pain And their body map or somatosensory cortexes are altered in way.

00:08:55: there's an imprecision measured by different tools.

00:09:00: we can do that also, and find out they need to have more stimulation in the whole body.

00:09:08: And not only on their neck because these patients...they've seen a lot of people!

00:09:12: Everybody is jumping on their necks right?

00:09:15: The idea make them feel like they're not only a walking neck pain with dizziness and headache, but there are whole body... And so certain places in their bodies working very well.

00:09:29: So the approach is always taking the whole body of the patient into account when we build up a system or corrective system

00:09:40: When you treat where your focusing on is there are certain steps which increase the competence of practitioners,

00:09:51: and what

00:09:52: is specific?

00:09:53: Well I think that traditional approaches which have had great results.

00:10:02: We're here today because of that, and we are building upon this in terms maybe the lifestyle patients have now.

00:10:15: But

00:10:15: I mean your specific OMT approach.

00:10:17: can you explain a little bit more detail how to approach it?

00:10:22: How do you examine or build on your typical practical interventions

00:10:30: in terms of OMT.

00:10:31: In very simple terms we're looking at the body, in terms its capacity to be compressed and decompressed.

00:10:41: so as a first step These often time monoblock patients, these rather tense and rigid patients that have a lot of problems dissociating the different volumes in their body.

00:10:58: We simply would touch at a different intensity on testing.

00:11:05: we're going to test the capacity of it, to retract and expand.

00:11:09: And simply pressing different volumes towards the center of their body in a way... ...and we want to recuperate that as first step.

00:11:18: instead doing a very segmentary or structural in terms of different structures We are trying get the volume in general of our bodies to be able to compress and distract And we use different approaches, but mainly approaches that used as a drive for the power.

00:11:44: The patient's own breath and its own inner strength A little bit like MET would use muscle strength to push against the therapist.

00:11:58: We are taking the patient in certain way the breath that we're going to resist, and then get a better quality of the tissue.

00:12:11: Because the philosophy behind it is that you want your patient's tissue be able to express an oozing movement which facilitates drainage in regions.

00:12:26: but We're doing so many things that maybe this is part of the active ingredients, but there's much more in terms of education and relationship with a patient giving them sense of self-efficacy.

00:12:41: In the collaborative approach because they need to be moving their body into certain ways to build up tension on the system.

00:12:49: They are also part of therapy And I saw

00:12:54: it really Impressive.

00:12:56: Yeah, yeah you felt it first person perspective.

00:13:02: and another question is So your really engaged in different fields also on your PhD?

00:13:09: You told me so

00:13:10: what

00:13:11: made you put so much energy Also in doing a PhD beside all the clinical work and your teachings?

00:13:21: Right.

00:13:22: So the research is part, I think of advancing knowledge and trying to acquire knowledge in a new way in osteopathy Our clinical expertise as source information for our clinical decisions And research.

00:13:42: it's very interesting that so my PhD i'm interested In quantitative measurements.

00:13:50: we're doing force plate and you know, technological quantitative assessments.

00:13:56: And while also working on proprioceptive outcomes with different exercises the laser pointer in things like that relocalization of the neck amplitude of movements and things like but also questionnaires to be assessed in a quantitative way There is also a qualitative component.

00:14:22: So I think in rehabilitation science, because the PhD is at the Faculty of Medicine and Rehabilitation Science there isn't necessity to talk with patients.

00:14:33: And osteopaths have been doing that for long time trying meet their patient's needs.

00:14:41: What better way than asking them?

00:14:44: you know, and in my field there is no qualitative assessment.

00:14:50: So there's no analysis of the lexical content.

00:14:54: so we don't ask questions to patients whether they're priority.

00:14:58: what have been their experience with those complex trajectory of care.

00:15:02: I know about this because i've been in the clinician for a decade with those patients, you know?

00:15:07: And so and So I think that my PhD is also way to have The voice In their own words of the patient's heard through publications With mixed study quantitative and qualitative.

00:15:25: And that's the goal, to make their voice heard and we understand better because there long trajectory of care comes from... you know, a lack of education on the different people that are implicated in their health system.

00:15:43: So more people will be aware this type problem and less trajectory care is going to belong.

00:15:52: so we want to shorten it and educate the different person invested in rehabilitation.

00:16:01: Very good!

00:16:02: Do I have last message?

00:16:05: for the audience would like to give?

00:16:07: Well, I think a very simple one.

00:16:11: When you see patients that have done lots of different approaches, osteopathic, chiropractic physiotherapy and psychology They're not yielding the results that they want.

00:16:29: It's very simple, you have to do something different... ...to have a chance to yield different result and if you know it is different then there are chances of having a different result.

00:16:42: so this approach isn't necessarily better but surprisingly different for patients who will give hope in acquiring a better quality.

00:16:54: Thank

00:16:55: you so much.

00:16:56: Thanks Dustin!