Throughout life the brain is constantly changing as a consequence of experiences, physical activity, and environment. Most people develop one part of the brain more so than another. This is why some people are more artistic (right brain) than analytical (left brain) and vice versa.
When the processing of neurological signals in the brain decreases to a critical level, brain asymmetry (one side weaker than the other) develops, which can create cognitive and behavioral dysfunction. Many times faulty neurological processing can cause “functional” disease within the nervous system and body, creating abnormal function and symptoms where physical pathology or disease can’t be found.
Unexplained and often untreatable conditions of the nervous system are usually due to improper diagnosis, or the true underlying cause of that dysfunction has not been found.
Functional neurologists are specialists in finding the faulty neurological circuits that are creating your condition. The chiropractic or functional neurologist also focuses on improving and/or restoring the areas of the nervous system which have become dysfunctional through birth trauma, physical trauma, a nutrient-deprived diet, stress, environmental toxins, poor posture, etc.
Chiropractic neurologists serve in the same treating-and-consulting manner as a medical neurologist. Since the treatment does not include drugs or surgery, certain conditions are better seen by a chiropractic neurologist as opposed to a medical neurologist, and vice versa.
Most people associate chiropractic with back and neck pain. However, the recent advances in brain research and imaging strongly support the new specialty of functional neurology. This advanced branch of chiropractic offers new hope for those who have not found relief from conventional treatment.
Ongoing education and advanced training allows Dr. Zembroski to assess and provide treatments for complex disorders involving the nervous system.
Common conditions treated with functional neurology:
- Concussion/Traumatic Brain Injury
- Foot drop
- Vertigo and dizziness
- Movement disorders – tics, tremors
- Visual disturbances and eye fatigue
- Memory and concentration difficulty
- Reflex Sympathetic Dystrophy (RSD)
- Post-stroke rehabilitation
- ADD and learning disorders
- Peripheral nerve injuries/neuropathies/radiculopathies (most commonly numbness and tingling of the arm/hand/leg/foot)
- Carpal-Tunnel Syndrome
- Migraine headaches
- Neck and back pain
- Mood disorders
- Other neurological disorders
Additional symptoms of an unbalanced nervous system:
Unbalanced brain function results in asymmetries of these circuits, leading to a number of musculoskeletal and autonomic symptoms. It is imperative to perform a meticulous history and neurological evaluation to determine the function of the nervous system in each individual.
Tests performed at the Darien Center for Functional Medicine include a neuro-physical examination, computerized blindspot analysis, brain mapping, computerized videonystagmography (VNG), and radiography.
It is through this battery of tests that we are able to define the brain asymmetry, processing deficits, and other dysfunctions of the nervous system.
Chiropractic Neurologists, or Functional Neurologists, are specialists in evaluating the function of the brain and nervous system. Once the deficit has been diagnosed, a treatment protocol is implemented to increase the potential of the brain and correct the brain asymmetry.
Dr. Zembroski offers a comprehensive examination to evaluate the brain and nervous system. If you have been through different modalities and medicines with little or no improvement in your condition, please call for a one-on-one consultation to discuss how chiropractic neurology can help you.
Additional benefits associated with chiropractic neurology:
As a society, we are overfed and undernourished. Because of this, we are setting ourselves up for chronic disease, premature aging, and unhealthy lives.
Functional nutrition is used as a therapeutic and prevention-oriented modality in the functional-medicine model. It is important to understand the value of food—not as calories, but as information. The right nutrients turn on health-promoting genes and turn off disease-promoting genes. These findings are part of a new science called epigenetics.
Approaching clinical nutrition from the functional-medicine perspective means identifying imbalances unique to the individual, which are contributing to that individual’s symptoms.
These nutrient imbalances can occur in a number of different systems, including digestive, absorptive, detoxifying, hormonal, structural, and inflammatory. Rather than focusing only on relief care, the goal is corrective care.
Once the malfunction is corrected, the symptoms disappear. A healthful diet is one component of lifestyle modification.
Research has shown that a whole-food, nutrient-dense diet provides the most benefits for weight loss as well as for reducing cholesterol and other disease-causing biomarkers.
Supplementing a healthful diet with nutraceuticals—vitamins and minerals, enzymes, and plant-based products—is necessary to achieve optimal health.
As the environment becomes more toxic and the food supply decreases in variety and nutrient density, maintaining optimal levels of nutrients is not possible with diet alone.
The government’s Recommended Daily Allowance (RDA) of nutrients is inadequate because it fails to account for bio-chemical individuality, lifestyle habits such as smoking and drinking, use of pharmaceuticals, sickness, or disease states. In addition, its guidelines only marginally account for a healthy pregnancy.
Common sense and scientific research both lead us to the conclusion that if we want to be healthy and disease-free, we must put the right raw materials into our bodies: real, whole, local, fresh, unadulterated and unprocessed foods—free of synthetic chemicals, hormones, and antibiotics.
The Darien Center for Functional Medicine offers nutritional counseling to assess your health needs in regard to your active lifestyle. Through nutritional counseling, basic health needs are met and specialized information is given to fit each person’s everyday lifestyle.
What is Attention Deficit/Hyperactivity Disorder?
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurobehavioral condition characterized by hyperactivity, inattention, distraction, and impulsivity.
It is usually first identified when children are school-aged, although it can be diagnosed in people of any age group. Most children have high energy levels and short attention spans; this does not mean they have ADHD.
True, ADHD is characterized by excessive hyperactivity, poor attention, and impulsivity, as well as problems that interfere with daily activity. Some children with ADHD have problems with attention; others have issues with hyperactivity and impulsivity, and yet others have both.
The real issue with ADHD is that it can interfere with a child’s ability to perform in school and to develop healthy relationships with others. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR), three to seven percent of school-aged children are said to have ADHD.
What are the Symptoms of ADHD? Inattention, hyperactivity, and impulsivity are the key behaviors associated with ADHD. However, children with ADHD may also have the following symptoms:
- Easily distracted
- Difficulty focusing on one thing
- Bored with a task after only a few minutes
- Not seem to listen when spoken to
- Careless mistakes
- Difficulty processing information as quickly and accurately as others
- Struggle to follow instructions
- Fidget and squirm in their seats
- Talk nonstop
- Dash around, touching or playing with anything and everything in sight
- Trouble sitting still during dinner, school, and story tim
- Constantly in motion
- Difficulty doing quiet tasks or activities
- Very impatient
- Blurt out inappropriate comments
- Shows emotion without restraint and acts without regard for consequences
- Often interrupt conversations or activities of others
What Causes ADHD?
Multiple sources and research studies have found that ADHD is most likely caused by an interaction of neurological, genetic, environmental, and nutritional factors.
According to the Radiological Society of North America, the American Psychiatric Association, and research that is published in the November 22, 2003, issue of Lancet, ADHD is a physical dysfunction in certain regions of the brain.
New high-resolution, three-dimensional maps of the brains of children with ADHD indicate significant and specific anatomical differences within areas of the brain thought to control attentional and inhibitory (impulse) control systems, compared with brain scans of children without ADHD.
These studies have found that individuals with ADHD have abnormal brain anatomy, as well as low levels of certain brain chemicals (neurotransmitters). The study found abnormalities in the “fiber (nerve) pathways in the frontal cortex, basal ganglia, brain stem and cerebellum,” which are the areas that control things like attention span, impulsive behavior, and motor activity.
According to the Official Journal of the Society of Biological Psychology, ADHD is also caused by faulty genetics. A gene responsible for converting dopamine to norepinephrine has been isolated and found to be faulty in cases of ADHD.
Those two neurotransmitters (brain chemicals) are responsible for focus, attention, movement, impulse control, etc. When dopamine is not converted to norepinephrine, certain regions of the brain malfunction, leading to symptoms of ADHD.
Recent advances in brain research and imaging strongly support the specialty of Chiropractic Neurology, which focuses on evaluating the function of the brain and nervous system.
Once an individual has been properly evaluated and diagnosed, a non-invasive, drug-free protocol should be implemented, restoring balance to the system and thereby relieving the symptoms.
Call the DCFM today to schedule a consultation. 203-655-4494
A balance disorder is a disturbance that causes an individual to feel unsteady, giddy, woozy, or have a sensation of movement, spinning, or floating. The terms dizziness and vertigo have been used to describe a balance disorder; they need to be defined for better understanding.
The word dizziness is used to describe many different sensations, depending on the person experiencing it. The exact type of dizziness symptom is very important to determine.
True dizziness is a lightheaded feeling or a sensation that you are about to faint. People also describe dizziness as feeling they are about to fall; they have difficulty staying balanced, or they actually fall. Some individuals also say ‘dizziness’ when they mean ‘weakness.’
Vertigo is the feeling that the room is moving or spinning, or that the person is moving when he or she is not.
Vertigo is also described as an exaggerated motion of spinning and whirling when moving the head back or rolling over in bed.
Dizziness is the broad term used to explain how we feel when our sense of balance isn’t quite right.
Balance is achieved by a combination of receptors in the skeletal system, input from the eyes, and input from the balance organs in the ears. Many people suffer from dizziness at some point, and there are many causes of temporary dizziness. Although they can be unpleasant, balance problems are rarely life-threatening.
Symptoms of Balance Disorders:
- Unbalanced Feeling
- Falling Sensation
- Blurred Vision
- Pulse Increase/Decrease
In order to feel stable, an individual must be able to keep the image of an object they are looking at precisely in the center of the retina (the part of the eye that gives us vision).
Therefore, it is the monumental task of the inner ear, or vestibular system, to accurately move the eyes in order to maintain visual focus when you are moving. Unfortunately, there are times when the visual image is not projected directly onto the retina. This can result in blurred vision, dizziness or vertigo.
This is called nystagmus. Nystagmus is an involuntary rhythmic shaking or wobbling of the eyes. This back-and-forth movement causes the eyes—more specifically the retina—to lose focus on the environment or the object. This can cause symptoms of vertigo.
Balance issues can arise from various medical conditions, including:
- Damage to the inner ear – infection/labyrinthitis
- Crystals in the inner ear – Benign Paroxysmal Positional Vertigo
- Imbalances in the nervous system
- Cardiovascular disease
- Low blood sugar – hypoglycemia
- Diseases of the nervous system
- Mechanical dysfunction of the spine (subluxations)
- Medication side effects
Dr. Robert Zembroski, Board-Certified Chiropractic Neurologist, utilizes state-of-the art technology called videonystagmography (VNG) to locate the cause of your dizziness or vertigo.
Videonystagmography uses an infrared-camera system that records eye movements during specific testing procedures. Because the eyes are a reflection of brain function, information provided by these tests aids in the discovery of the balance disorder.
Everybody at one time or another has experienced pain—whether it is acute pain, like an injury, or long-term pain. If you, a loved one, or someone you know, suffers from acute or chronic pain, you deserve help. Call the Darien Center for Functional Medicine today.
We will answer any questions you might have in your search for pain relief and resolution. There are many different types of pain, ranging from short-term (acute) pain that disappears within a short period of time, to chronic pain that can persist for years.
While short-term pain may be quickly fixed, chronic pain can be quite difficult to deal with. Frequent visits to the doctor and various prescriptions that just don’t seem to work can be discouraging. At the DCFM, we will work with you to target your specific discomforts and alleviate your chronic pain.
Our pain management is individually tailored for people with:
- Neck/mid-back/low-back pain
- Frozen Shoulder
- Rotator-Cuff Tendonitis
- Bicipital Tendonitis
- Lateral Epicondylitis (tennis elbow)
- Medial Epicondylitis (golfers elbow)
- Carpal-Tunnel Syndrome
- Piriformis Syndrome
- Leg Pain
- Knee Pain
- Patellar Tracking Syndrome
- Ankle Pain
- Heel Spurs
- General Joint Pain
- NeuroHyper Sensitivity
Some signs of chronic pain include:
- Frequent visits to the doctor
- Tight and stiff feelings in the body
- Problems sleeping
- Pain that persists after waiting a decent period of time
- Decreased desire to eat
- Lack of interest in everyday activities
- Shooting or aching pain
- Staying away from previously enjoyed activities
Call for help today—203-655-4494.
Blood testing is a diagnostic method to measure biomarkers that determine the normal functions, or the diseased state, of an individual.
I’m sure you are familiar with standard blood testing for cholesterol (LDL, HDL), red and white blood cells, and glucose. Most blood testing is used as a general way to assess the health of an individual, but the value of blood work goes far beyond just the ‘standards of care.’
Biomarkers found in blood are placed into reference ranges that span from low to high. When a marker is outside the reference range, it is then classified as a problem.
However, biomarkers should be used to determine patterns of disease or dyfunction over time, not just as a single snapshot in time. Also, if a biomarker is slightly out of range, that may be normal for you rather than an indication of a dysfunction that needs intervention.
A Functional Approach to Blood Interpretation
The typical approach to interpreting blood work focuses on an individual biomarker with a myopic interpretation for its elevation. A good example of this is cholesterol.
Elevated cholesterol by itself is not diagnostic of any major disease or pathology. High cholesterol is one biomarker—one puzzle piece—within the internal landscape of an individual.
The high cholesterol could be a consequence of long-term blood-sugar problems, a thyroid dysfunction, or a familial (genetic) dysfunction. Because cholesterol is a liver-function test, digging deeper into your physiology through blood work will aid in determining the reason for the elevated cholesterol.
Thyroid-stimulating hormone (TSH) is a second example. TSH is released from the brain, which then tells the thyroid to release more thyroid hormones—T3 and T4. High TSH is an indication of a low-active thyroid, not conclusive of an underactive thyroid. Evaluating TSH, free T3, free T4, and TPO antibodies provides a greater look into thyroid function.
Blood testing considerations:
- Knowing your history, gender, lifestyle, symptoms, condition and your goals determines what part of your physiology needs to be evaluated, and which biomarkers should be evaluated.
- Interpretation is the most important step. Often, you are told all is OK, when clearly it is not. Treatment may be determined based on a single biomarker that is high or low. The key to understanding blood work is to realize how all the biomarkers provide information about the whole person. Each biomarker is one piece of the puzzle; all pieces are needed for a correct diagnosis.
- During treatment, periodic testing determines the effectiveness of that treatment.
- After treatment is completed, further blood testing determines the prognosis (prediction of your outcome).
Note: Medically treating one high biomarker instead of treating the whole individual is a serious error.
Dr. Zembroski uses state-of-art laboratories to determine the reason for your chronic health issues. Whether you are looking for a general screening, testing to determine the stage of your arterial and heart health, or uncovering an autoimmune dysfunction, proper blood testing with a focused interpretation can and will help guide you back to health, or indicate the need for some form of intervention.
Special Blood Tests
Depending on your specific needs and health issues, Dr. Zembroski may order special lab work to dig deeper into your physiology to better understand why you have a specific health problem and where it came from.
During treatment, periodic testing determines the effectiveness of that treatment. After treatment is completed, further blood testing determines the prognosis (prediction of your outcome).
Note: Medically treating one high biomarker instead of treating the whole individual is a serious error. Dr. Zembroski uses state-of-art laboratories to determine the reason for your chronic health issues.
Whether you are looking for a general screening, testing to determine the stage of your arterial and heart health, or uncovering an autoimmune dysfunction, proper blood testing with a focused interpretation can and will help guide you back to health, or indicate the need for some form of intervention.
To be healthy, your body must break down and process food in order to produce cellular energy. This energy is then used for many other metabolic pathways.
If you have unique genetic requirements, or your diet either lacks certain vital nutrients or your body can not assimilate them, your healing and energy levels can fail.
Improper healing and energy production can be caused by a processed, nutrient-deprived diet, genetic alterations, and your exposure to toxic environmental chemicals. Metabolism is the process by which your body converts the food you eat into energy.
Vitamins and minerals are responsible for running the multitude of chemical pathways that make up your metabolism. The Comprehensive Organic Acids Test is an in-depth test to uncover any weaknesses in your metabolism.
Through urine testing, the Comprehensive Organic Acids Test looks at:
- Your energy production;
- Carbohydrate and fat metabolism;
- Your ability to produce energy and modify specific genetic mechanisms through B-vitamin metabolism;
- How well you produce neurotransmitters;
- Oxidative (free-radical) damage and your ability to make antioxidants;
- Your ability to detoxify harmful environmental chemicals; and
- The balance of the bacteria that may grow from food residues in your digestive system.
Dr. Z, with full knowledge of your health history and goals, can use this comprehensive report to provide you with an optimized nutritional program. The organic acids that are measured high in the range indicate low levels of the vitamins needed to correct that imbalance.
By correcting the imbalances shown on the test results, your energy, metabolism, and ability to heal and stay healthy will noticeably improve. This approach has been shown to lower your risk of obesity, heart disease, fatigue, and many other conditions.
When the main imbalances are corrected, you may be able to make simple dietary changes in order to maintain metabolic balance for your lifetime.
Orthotics and Gait Analysis
Orthotics are customized insoles worn in the shoe and intended to correct abnormal or irregular walking patterns.
If a person’s foot is not functioning correctly, the bones and ligaments experience micro-trauma that can lead to all kinds of foot deformities and pain.
Additionally, if the foot is not functioning correctly, the ankles, legs, knees, hips, and lower back are not aligned correctly, and problems can develop throughout the entire body, including lower-back pain.
Orthotics perform functions that make standing, walking, and running more comfortable and efficient by slightly altering the angles at which the foot strikes a walking or running surface.
The Footmaxx System is a computer connected to a force plate (electronic mat) which uses special software to analyze the way a patient walks. The system is available for use exclusively by licensed practitioners.
Patients simply walk back and forth across the force plate and the computer scans the foot and step. What makes the Footmaxx System so unique?
The Footmaxx System allows a doctor to dynamically assess the way a patient walks while bearing the weight of the body, which is when patients usually experience pain. Also, this is the only computerized system of its kind because the proprietary software, Metascan, takes the digital patient data and generates a gait-and-pressure analysis, then specifies a prescription for custom orthotics if they are necessary.
Why is the Footmaxx System considered an advancement? The Footmaxx System is considered an advancement for several reasons.
Any doctor can use this system and get an accurate patient assessment, but the most important difference is that the patient assessment is dynamic and weight-bearing, and the orthotics are manufactured from the digital data, not a mold of the shape of the patient’s foot.
After all, it’s not the shape of the foot that causes the problem; it’s how the foot functions while bearing the weight of the body. If you suffer from any of the conditions below, you might find relief from custom orthotics.
- Achilles Tendonitis
- Ankle Pain
- Shin Splints
- Hammer Toes
- Plantar Fasciitis
- Low-Back Pain
- Plantar Ulcers
- Intermetatarsal Forefoot Pain
- Heel-Spur Syndrome
- Iliotibial-Band Syndrome
- Rocker-Bottom Feet
- Peripheral Vascular Disease (P.V.D.)
- Peripheral Polyneuropathy
Does everyone need orthotics?
No, definitely not. That’s another reason why this system is revolutionizing the orthotics industry. Because the system measures foot function and not foot shape, the Metascan software can generate a gait-and-pressure analysis which contains diagnostic information and offers a conclusion as to whether or not the gait-and-pressure pattern analyzed is outside of normal values.
If the gait pressure is not outside normal values, then the report will specify that orthotics are not necessary. This is a significant advancement because, if orthotics are not indicated, the doctor knows right away to look for alternative treatment methods.
Do you suffer from foot, ankle, knee, or lower-back pain? Are you a diabetic? If your answer is yes to any of these questions, then you should have a computerized gait-and-pressure analysis test to determine if your feet function correctly.
This five-minute test is available at the Darien Center for Functional Medicine. Many foot, knee, and lower-back conditions can be successfully treated with orthotic therapy; a gait-and-pressure analysis test will tell you if you are a candidate for orthotics.
Orthotics are covered by many extended healthcare plans and can be worn in all types of shoes. A variety of orthotics, including dress, sportmaxx, non-prescriptive, and even sandals, can be custom ordered. We also have an extensive line of custom products, including diabetic and arthritic orthotics.
Make an appointment today and take a step toward pain relief!
Digestive Function & Stool Testing
Functional stool testing is an invaluable microscopic assessment of your digestive health and the status of your gut flora (bacteria). The digestive function examination includes enzyme levels, and reveals how well you digest and break down carbohydrates and fats.
It also examines the gut’s immune function, inflammation markers, and overall intestinal health. Essentially, stool testing is used to diagnose the presence or absence of a condition or disease process.
Functional stool testing also detects the presence of pathogenic (disease-causing) bacteria, parasites and yeast, which could be contributing to your chronic illness and neurological dysfunction.
Stool testing also provides clues behind the cause of autoimmune disorders, one of which is “leaky gut.”
This stool test is unlike any your conventional doctor uses. Functional stool testing is done to:
- Help to identify diseases of the digestive tract including the pancreas, stomach and liver. Enzymes, including elastase and trypsin, can be evaluated to determine how well the pancreas is functioning.
- Help to identify inflammation and immune dysfunction that may be the cause of, or the fuel behind, your health condition or disease.
- Identify the cause of symptoms affecting the digestive tract including nausea, reflux, gas, bloating, loss of appetite, abdominal pain, diarrhea, cramping, fever and chills.
- Look for parasites such as Giardia lamblia, Entamoeba histolytica, and Blastocystis hominis.
- Look for infections such as yeast, and Helicobacter (H pylori).
- Check for blood that may indicate a disease process.
- Check for nutrient absorption.
Following a consultation with you, Dr. Z will recommend functional stool testing based on your individual needs.
Measuring Hormone Levels in Men and Women
Hormone testing through saliva and blood spot (capillary blood) provides you with many of the answers that you have been looking for.
In the privacy of your own home, you can accurately test important and vital hormone levels to see how those levels correspond to your current symptoms. These levels can then be used to determine a therapy that would work best for you.
The testing also comes with an explanation which allows you to better understand exactly where you stand. You are now able to affordably take charge of your health. ZRT Laboratory saliva-and-blood-spot testing helps to uncover the reasons for disruptive symptoms and chronic health problems that may have kept you from a life you love.
The hormones tested are based upon profiles or panels created by experts to provide the most consistent and complete look at hormone levels.
When hormones are unbalanced, they are often the source of undesirable symptoms found during menses, peri-menopause, menopause, andropause (male menopause), and similar conditions.
The quick and easy hormone testing for men and women offered by the DCFM provides reliable results, as well as a solid foundation on which to start bio-identical hormone therapy paired with customized nutrition supplementation, fitness programs, and personalized lifestyle modifications.
Which hormones do we test?
- Cortisol – the stress hormone measured four times in one day
- Thyroid Hormones – T4, T3
- TSH – Thyroid-Stimulating Hormone
- Vitamin D
- Other Hormones – Based on your symptoms, the doctor may suggest other tests.
The test results below include a comprehensive look into the female hormones.
The test results below include a comprehensive look into the male hormones.
Serum, saliva and/or blood-spot hormone tests are used to:
- Detect hormone imbalances prior to the appearance of patient signs or symptoms
- Identify hormone imbalances associated with symptoms
- Establish hormone baselines prior to beginning therapy
- Monitor hormone levels while supplementing
- Track treatment progress with follow-up reports
What is bio-identical hormone-replacement therapy?
“Bio-identical” describes hormones that are designed chemically to match the hormones created by the human body. Many of these bio-identical hormones (e.g., estradiol, progesterone, testosterone) are commercially available in several well-tested, FDA-approved, brand-name prescription drugs.
Because they are created just like our own, bio-identical hormones are much safer than synthetic hormones. Synthetic hormones are different from natural hormones; they are structurally changed so they can be patented.
According to the New England Journal of Medicine, a study done by The Women’s Health Initiative and sponsored by the National Institute of Health examined the relationship between traditional, synthetic, hormone-replacement therapy and breast cancer, coronary-artery disease, bone fractures, endometrial cancer, strokes and blood clots.
This study was to last eight years, but was stopped prematurely in July 2002 after only five years! Why? Because the women in the study on HRT had health risks that exceeded the benefits! After just 5 years! The study found that women on synthetic hormone-replacement therapy of combined estrogen plus progestin (PREMPRO) had:
- 41% INCREASE in strokes
- 29% INCREASE in heart attacks
- 100% INCREASE in the rate of blood clots
- 22% INCREASE in total cardiovascular disease
- 24% INCREASE in breast cancer
- 100% INCREASE in the rate of Alzheimer’s Disease (in women over 65)
The Women’s Health Initiative also concluded in 2003 that there were no clear benefits on “Quality of Life” measures for those taking the combined estrogen plus progestin HRT!
Contact the DCFM today about measuring hormone levels and beginning a program to balance your hormones. Our distinct approach resolves your hormone-based health problems, returning you to a vibrant life!
Drug Metabolism Testing
Today I feel like a much better person overall. I have more energy when I get up. I feel like I’m ready to take on whatever tasks are asked of me. I try to tell everybody. It’s like night and day. I will keep coming to see Dr Z. until the underlying dysfunction is completely resolved, and it is almost there.