Monday, July 26, 2010

Neurotransmitters and Brain

Greetings everyone! I've just returned from a weekend conference in Atlanta that was conducted by Dr. Shane Steadman, one of the team speakers for Apex Energetics, who proved to me to be one of the most qualified doctors in the field of Functional Neurology today. Quite frankly, his post-graduate credentials are literally too extensive to list after his name, but suffice to say, he is another of these remarkably gifted minds in the chiropractic profession that has dedicated his life's work to unraveling the mysteries of brain and spinal cord (the central nervous system, i.e. CNS) dysfunction. What was addressed this weekend was the seemingly endless array of interactions that can adversely impact anything from the way in which our brain functions in its performance of second-to-second tasks and misfires in certain clinical presentations (eg. ADHD, depression, etc.) all the way on through to the neurodegenerative diseases of the CNS (eg. Alzheimer's disease, CVA's, Multiple Sclerosis, etc.). Topics of this weekend course included the following:
  1. Clinical assessment of neurotransmitter (NT) imbalances.
  2. The interactions between cytokines, hormones, and NT's.
  3. Applications of functional neuroendocrine-immunology to clinical practice.
  4. The interconnections between NT's and dysglycemia, thyroid imbalances, and adrenal gland imbalances (to name but a few).
  5. The clinical application of natural supplements, amino acids, and phytopharmaceutical compounds (i.e., botanical concentrates or herbs) and the seemingly plethora of literature in the peer-reviewed scientific community that documents the clinical efficacy of said supplements.
  6. The validity of NT testing, again, as documented in today's scientific literature.

Dr. Datis Kharrazian is the true genius behind the entire organization and integration of what has rapidly become an avalanche of clinically relevant and scientifically "buttressed" information. He is yet another member of the chiropractic profession that we are truly blessed to have as one of our "own", and another practitioner with literally too many post-graduate credentials to cite. Dr. Kharrazian prefaces the introduction to his instruction manual on this weekend's neurochemistry course with the following statement:

"Everything you have ever experienced, felt, or conducted in life is due to brain function. The ability to enjoy, perceive, sense, and experience life is dictated by the firing rate and health of your brain. It is impossible for a person to become healthy mentally or physiologically without a healthy brain."

Simply stated, the brain and its neurons (nerve cells), which neuroscientists estimate to be somewhere in the realm of 100 BILLION, as in 100,000,000,000!!! (which may incidentally prove one day to be way too low of an estimate), is essential for every aspect of our day to day existence, and therefore our respective life experiences! That is to say, our physiology (cellular functions), our cognition and all cognitive experiences thereof, the emotional experiences that we perceive, and the image that we have of ourselves are all directly related and thereby inextricably linked to brain function! So without further extolling the marvels of this marvel of creation, I invite you to do yourselves both the favor and service of completing the following questionnaire as developed by Dr. Kharrazian, and either bring it in on your next visit, or you can complete one here in the office. The information provided will give me a comprehensive evaluation of your overall brain health and NT assessment, and if warranted, appropriate measures can be taken to keep your minds sharper than a razor's edge as you proceed through your respective journey of life. May God's blessing enrich your lives today and always.

Dr. Bloukos

P.S. I am currently having a problem with the transfer of the questionnaire, it will be posted in the near term for those of you that are currently reading this post.

P.P.S. "Ixnay" to previous post-script; there appears to be no way to attach the NT Assessment Form (NTAF) to this particular blog site, hence for those interested in the NTAF, please send me an e-mail at and I will send you the form to complete and you can either print it up at home or simply e-mail it back to me.

Monday, July 19, 2010

Toxicity and Detoxification

"Toxicity" and "toxic load accumulation" in the human body is such an extensive topic that I am really going to attempt to use the "K.I.S.S." concept on this one, because what is often overlooked when the discussion of toxicity is raised is that these bodies that our souls drive around in all day long are toxic by their very nature. Toxic compounds are the normal products of cellular metabolism and catabolism, and we also assimilate varying amounts of toxic material from the air that we breathe, the food that we eat, from the water that we drink, and from other environmental sources. As you all know, we have 5 major pathways and 7 organs of detoxification and elimination (liver, large intestine/colon, 2 lungs, 2 kidneys, and the skin), each of which play an extremely vital role in the maintenance and optimization of human health. Additionally, each organ of detoxification has auxiliary detoxification potential, i.e., each organ has the capability of behaving as a "back-up" of sorts, in the event of insufficient elimination of toxins through the body's preferential routes of toxin removal at that time. This concept was developed and established in both the fields of homeopathy and naturopathy, and quite frankly since there is "nothing new under the sun" (as King Solomon eloquently mused in the book of Ecclesiastes 1:9), I genuinely do not know which field rightfully deserves the credit for what has come to be known in holistic circles as "vicarious elimination."

For instance, in the event of sluggish removal of intestinal waste, a condition known as "auto-intoxication", the inadequate elimination of putrefactive intestinal waste by the large intestine results in the absorption of at least the water-soluble poisons into the bloodstream. The net effect is that the body must and will shunt the burden of the removal of those water-soluble poisons to the kidneys and even the skin (integument) via the pores. Failure to do so would automatically result in the bioaccumulation of toxins, with consequential resultant "functional" illness (fatigue, fatty and fluid accumulation, headaches, to name but a few). This physiological dysfunction has the potential to quite possibly eventualize as disease if the body chronically accumulates these biochemical and therefore biological poisons.

More than a century has elapsed since this phenomenon was recognized and declared by the forefathers of holisitic detoxification programs, i.e., intestinal waste when chronically absorbed by the body leads to excessive toxemia (i.e., poisons in the circulatory system), consequently producing a myriad of symptoms and health disturbances. The elimination of this bioaccumulation of toxicity became the cornerstone of formative detoxification programs, yet the AMA required nearly 100 YEARS before a formal acknowledgement was made with simple statements regarding dietary fiber intake and its direct relationship to reduced incidence of colon cancer. Here's one excerpt from April 2007 that summarizes this relationship:

Dietary Fiber Decreases Colon Cancer Risk
A study published in Cancer Epidemiology Biomarkers and Prevention looked at the impact of dietary fiber intake on the risk of colorectal cancer. The researchers determined that colon cancer risk (but not rectal cancer risk) decreased as a person's dietary fiber increased. Interestingly, dietary fiber from beans seemed to decrease colon cancer risk the most.

Here are some rather astonishing and simultaneously disturbing facts regarding the environment that we currently find ourselves living in today:

I) Toxic Ignorance

• There are at least 75,000 chemicals in commerce today.
• Approximately 1,000 new chemicals are brought to market each year.
• Less than 30% of the 75,000 chemicals have been adequately analyzed for their full impact on the environment and human health. Most have not even received basic toxicity testing.

II) Toxic Burden In Newborns

• Washington, DC based Environmental Working Group analyzed umbilical cord blood samples of 10 newborns (cost $10K each).
• 287 known toxic chemicals were found in each specimen, including 7 that had been banned in the US for over 30 years.
• 76 of the chemicals are known to cause cancer in humans or animals.
• 94 are known to be toxic to the brain or nervous system.
• 79 are known to cause birth defects in animals.

-- Body Burden-The Pollution in Newborns, The Environmental Working Group; July 14, 2005

III) Toxic Chemicals And Drugs In Our Water Supply

• Associated Press reports that over 271 million pounds of pharmaceuticals are released into our waterways each year (92% are Phenol and Hydrogen Peroxide).
• 22 compounds are found to be both on the EPA industrial chemical list and the pharmaceutical list.
• There has been very limited government tracking.
• Over 250 million pounds of pharmaceuticals and their packaging are thrown away by hospitals and long term care facilities.
--AP - 04-19-09.

And finally, just one more absolutely harrowing finding of yet another industrially generated environmental pollutant that has found its way into this everyday, common, ordinary grocery item in virtually everyone's refrigerator who is reading this and mind-blowingly into the bloodstreams of all breast-fed newborns:

IV) Toxic Milk

• A toxic chemical found in rocket fuel - Perchlorate (Texas Tech University - S Dasgupta, PhD).
• 46 of 47 cow’s milk samples collected from 11 states had perchlorates in them.
• 36 breast milk samples were collected from mothers in 18 states. They had perchlorate levels 5 times higher than those found in the cow’s milk.
• Perchlorates effect iodine uptake by the thyroid.
-- Perchlorates May Be More Widespread Than Thought, Researchers Say; WebMD
Medical News. February 24, 2005

In closing here's a simple questionnaire that was developed by the "think-tank" minds at Apex Energetics, whereby one can readily ascertain your individual degree of exposure to environmental contaminants, and the degree of efficiency that you are presently eliminating those toxic compounds, or not :-(, based upon your symptomatology.



1) Are you now or have you been in the past in contact with toxic material
in your home and/or work place? YES NO
If yes, what kind? ________________________________________.
2) Do you live in a house which is over 25 years old? YES NO
3) Have you had recent remodeling in your house? YES NO
If yes, when? _____, Did your symptoms increase after remodeling?
4) Do you sleep or work in an area close to electronic equipment? YES NO
5) Have you been in contact with toxic materials anytime in the past? YES NO
If yes, what kind? _________________.
6) Please put a percentage next to the food groups that make up your overall diet. YES NO
_____ Fish_____ Chicken _____ Red Meat ______ Vegetables _____ Fruits_______Fast food
7) Do you get blisters/canker sores in the mouth? YES NO
8) Do you have mercury fillings? If so, how many? ______ YES NO
9) Do you have any nerve related symptoms? YES NO
If so, please give details:___________________________________.
10) Are you under emotional stress?______________. If so, what is the predominant emotion which you experience?

Do you get colds easily? YES NO
What sensitivities/allergies do you have?____________________________________________________

Do you have any of the following? If so, please indicate “M” for Mild and “S” for Severe:

Fatigue and Exhaustion
Difficulty concentrating
Joint pains
Autoimmune disorders
Loss of appetite
Memory loss
Digestive problems
Foul breath
Skin rashes
Swollen glands
Numbness and tingling in extremities
Irregular heart beat
Low grade fever
Chest pains and/or pain under the arms
Muscular disorders
Candida/yeast infections
Weight loss/weight gain
Excessive sweating
(Copyright © 2003, Apex Energetics, Inc. All Rights Reserved.)

So, in closing Toxic Load Reduction, both "aspecific" and "specific" (which I will elaborate on in future blogs), has been one of my primary areas of clinical concern and focus since my first introduction to the phenomenon of "toxic bioaccumulation" whilest enrolled in Chiropractic school circa 1982. Through a variety of holistic interventive methodologies employed, the expert release and removal of these toxins can be supervised to facilitate the restoration of your compromised health. Folks, at the end of the day, each and every last one of us had better be a "lean, mean, detoxification and waste elimination machine", or as my clinical experience has shown, you, the patient, will quite simply feel ROTTEN. The great news is that as long as the body has a pulse, it continuously attempts to manage and excrete its internal toxic load. Combinations of dietary modification, lifestyle, homeopathic remedies, herbal formulations, and juicing, just to name a few, can quite dramatically CHANGE both your quality of life and longevity, thereby adding not only years to your life, but ADDING LIFE TO YOUR YEARS!

May God bless each and everyone of you on this night.

"Dr. B"

Tuesday, July 6, 2010

Some of Recent Webinars Attended with Respective Content

Greetings all. Since many of you are aware of my in-office attendance of the continuous stream of "Webinars" that are orchestrated and conducted by APEX ENERGETICS over the course of the last several months, I thought it might be apropos to share with you some of the topics presently being covered. A brief overview of the material that is being both addressed and discussed is condensed beneath each heading. The subject matter currently being taught is done so by a variety of holistic practitioners that I have found to be amongst the most knowledgeable doctors in the fields of Functional Medicine and Bioenergetic Medicine in the world today. Either a cursory browse OR an extensive perusal will swiftly reveal the applicability and relevance of the current body of clinical research that exists today, and more to the point how it may in fact pertain to your unique health care needs. I am certain that many of you will find the subject matter to be an "eye-opening" experience, as you discover the current modalities that exist in the field of holistic health care that can positively impact and restore your health naturally! I am continuously thrilled at the prospect that we have at our fingertips as comprehensive, "total-person", holistic health care practitioners such an extensive array of science-based tools that can and will resolve some of the most challenging clinical presentations. I trust that you will find this both informative and enlightening. May God richly bless you all. Good night.

Emotions – The Psychosomatic Connection

In this unique webinar, we will explore some of the important relationships and influences that emotions have on the body. A complete psychosomatic model will be presented to help address emotions effectively along with an invaluable, easy-to-use, emotional layer testing procedure. As with all our webinars, we will be having a “Q&A” section with the presenter, at the end of the session.

Topics Include:
· Homeopathics vs. Flower Essences vs. Release Techniques
· Psychosomatic Anchors - What it means to the success of your therapies
· Advanced clinical protocols and Flower Essence technologies

Presented by:
William Kneebone, DC, CNC, DIHom, FIAMA, DIACT

Advanced Detox Strategies

This complimentary webinar introduces a clear and defined model of health designed to integrate nutrition and modern homeopathy. Dr. Kneebone, equips attendees with invaluable clinical jewels, which can be used right away in their practice.

Topics include:
· The Apex Model of Health, Causal Chain(TM) Therapy
· How to look at the bioenergetic root of a problem
· Principles of Modern Homeopathy, Detox and Drainage
· European plant-based drainage technology
· Acute and Chronic symptom relief
· Effective prioritization for best results
· The key effects of certain formulas
· The E-Tox(TM) kit for checking bioenergetic disturbances

Presented by:
William Kneebone, DC, CNC, DIHom, FIAMA, DIACT

Part 1 - K-Line Product Knowledge

We will be discussing the first half of our K-Line (K01 – K25). Learn about our top selling nutritional line to support metabolic pathways such as:
· Blood Sugar Balance
· Adrenal Health
· Hormone Balance
· Detoxification Support
· Much more

Health Questionnaires provided by Apex Energetics and common lab tests are used to guide healthcare practitioners into the most appropriate product to support each nutritional deficiency. Listen to this webinar while Mark Flannery, one of our weekend seminar speakers explains the best clinical application for these products. Don’t miss this opportunity to ask your questions to Dr. Flannery, LIVE on the webinar.

Presented by:
Mark Flannery, DC

Cardio, GI, and Immune Axis

Cardiovascular disease remains the number one killer in America today despite the number of people taking medications to lower cholesterol and blood pressure.

The truth is, there are numerous mechanisms contributing to heart disease that few practitioners are aware. For example, did you know that H. Pylori and certain viral infections have been correlated with key cardiovascular risk markers?

And what about cholesterol? Is it the villain it’s been made out to be, or has cholesterol been falsely accused? It turns out it’s both. There are times when elevated cholesterol may be an issue and other times when it is not.

You can learn about these topics and much more in a cutting-edge webinar called Cardio, GI, and Immune Axis, which will teach you the intimate connectio ns between these systems. More importantly, how to evaluate and support these systems in clients concerned about cardiovascular disease.

Topics covered will include:

· Recent research related to intimate connections between the cardiovascular and gastrointestinal immune panels
· Advanced laboratory testing to assess these pathways
· Natural medicine protocols that can support these models in relation to inflammation, immune dysregulation, virology, autoimmunity, and bacteriology
· How to incorporate advanced models into your practice to support healthy cardiovascular function.

Speaker: Steven Noseworthy, DC, DACNB, DCCN, BSc (Hon), BComm (Hon)

How to Incorporate Neurotransmitter and Brain into Your Practice

This webinar is exclusively for practitioners who have attended the Neurotransmitter and Brain weekend course, sponsored by Apex Energetics.

The Neurotransmitter and Brain weekend course provided participants with cutting-edge information on how to approach some of your more challenging clients. The next step is implementing the information into practice.

Concepts reviewed during the webinar:

1. A concise review of all the main concepts learned during the weekend course including:
· Neurodegeneration
· Immune-Brain Connection
· Energy-Linked Excitotoxic Model of Neurodegeneration
· And more . . .
2. Step-by-Step flow charts for incorporating Neurotransmitter and Brain into your practice
3. Methods of how to reach clients who may need to improve brain health

Presented by Dr. Bryan P. Walsh, ND

Part 2 - K-Line Product Knowledge

We will be discussing the second half of our K-Line (K26 – K54). Learn about our top selling nutritional line to support metabolic pathways such as:
· Various Autoimmune Conditions
· Stomach Health
· Neurotransmitter and Brain Support
· Much more

Health Questionnaires provided by Apex Energetics and common lab tests are used to guide healthcare practitioners into the most appropriate product to support each nutritional deficiency. Listen to this webinar while Mark Flannery, one of our weekend seminar speakers, explains the best clinical application for these products. Don’t miss this opportunity to ask your questions to Dr. Flannery, LIVE on the webinar.

Autoimmune Thyroid

An autoimmune response to the thyroid is the most common cause of an under-functioning thyroid gland in areas of the world where iodine levels are sufficient. Why is this significant? Because supporting the thyroid when it’s an immune issue will affect the physiological outcome tremendously. Individuals with an autoimmune response to their thyroid gland must have their immune system balanced, not their thyroid.

Today’s clinician must learn how to manage these clients from an immune-based nutritional model. Doing so will significantly increase success with these clients over other outdated models.

This webinar will provide you with the latest cutting-edge information on how to assess and physiologically improve the health of these individuals.

In this webinar you will learn:
· The physiology of an under-functioning autoimmune thyroid and how these clients will present symptomatically
· Appropriate lab testing to identify these specific types of cases
· The latest scientific research abstracts regarding under-functioning autoimmune thyroid and how to implement this information clinically
· How to support these patterns using scientifically-guided nutritional strategies

Individuals that have an under-functioning autoimmune thyroid are falling through the cracks of conventional medicine. Learn how to practically and effectively support these specific cases using sound, clinically-proven methods that very few practitioners are using.

Speaker: Steven Noseworthy, DC, DACNB, DCCN, BSc (Hon), BComm (Hon)

Intro to Blood Nutrition

Imagine a patient brings you their blood work and asks for your opinion on it. How confident are you that you could interpret it for them?

Reading blood work is easy, right? Well, yes and no. Interpreting blood work is easy once you know what to look for, and it goes well beyond understanding individual blood chemistry markers.

The key to understanding blood work is to look for patterns. Patterns will tell you more about a client’s biochemistry and symptoms than any other testing available.

Did you know that laboratories create their reference ranges by compiling data from unhealthy people? If someone’s blood work falls within the laboratory reference range, it’s saying they are as healthy as 95% of people that go to the doctor. To us, that’s not health.

We have an answer for that. It’s called Functional Blood Chemistry Analysis, and it teaches you not only how to quickly and easily interpret blood work, but it also gives you a set of reference ranges that assess health no matter what lab you use or where you live. Interpreting blood chemistries is much easier than you might think and can literally transform a “good” practice into a great one.

If learning more about Functional Blood Chemistry interests you even somewhat, we have a really easy way for you to learn more about it. We have an upcoming webinar entitled “Intro to Blood Nutrition”.

In this webinar, you will not only learn about Functional Blood Chemistry Analysis, but also the 5 most common patterns encountered in a practice and how to effectively manage them. You’ll also get to see case histories, which will show you just how simple this is and how easily you can incorporate it into your practice. Even if you aren’t interested in running blood work in your practice, you can still learn how to interpret it for those times a patient asks you to look at theirs.

Monday, July 5, 2010

Functional Endocrinology and its Impact on Your Health: Concluded

I previously left off our discussion on Functional Endocrinology's (FE) core theme being the fundamental question that ALL excellent diagnosticians and clinicians SHOULD ask, and that is "WHY?" is this hormonal disturbance or imbalance occcurring in the first place? This hormonal imbalance concept is not reserved exclusively for the cycling female that experiences a wide range of symptoms throughout her menstruating years or the post-menopausal woman that is suffers erratic shifts in mind, mood, and energy levels. Other hormonal disturbances of concern that are generally functional in their cause include but are not restricted to insulin surges, cortisol elevations, thyroid hormone imbalances, and male hormonal deficiencies, to name a few.

Remember, the primary objective of FE is directed at the RESTORATION of function to the endocrine system, and not merely to DOMINATE over the body's physiology with Hormone Replacement Therapy (HRT). Unfortunately for all too many a hormonally imbalanced patient today, his/her hormonal disorder tends to be viewed and treated as though his/her body no longer has any restorative capabilities, which is exactly how HRT's of today tend to view body physiology.(Incidentally, HRT has its place and its purpose clinically, but this is not the clinical scenario that I am presently addressing.) What a clinician like myself is interested in achieving with the patient is to attempt to restore function to improve the patient's physiology, thereby enhancing the patient's ability to synthesize whatever hormone that they may have been deficient in (if synthesis is the cause of the deficiency), and subsequently improving those hormonal levels that may have been depressed in the first place. Incidentally, there are also cases where the patient experiences an oversupply of a particular hormone or hormones, i.e. an excess, so I want to be abundantly clear on the fact that not every case of hormonal imbalance is necessarily one of deficiency.

For example, a 45 year old male presents to my office with a chronically reduced serum testosterone level that has a variety of clinical impacts, none of which have to do with libido, sexual performance, or sperm count according to the patient. HRT for this individual resulted in him being placed on AndroGel, which according to Androgel's formal website claims to be "the #1-prescribed testosterone replacement therapy." For this patient not only did it have very little impact on his serum testosterone levels after 30 days, it may have actually compounded his problem of mid-abdominal weight gain and fatty accumulation despite an intensive exercise regime of both heavy aerobic training (5 miles jogging 5 times/week) AND anaerobic as well as anaerobic threshhold training (weight training and martial arts)!

A review of this patient's previously taken blood chemistry reports and prior investigation into the "free fractioned non-protein bound hormones" via salivary sampling, quickly revealed that this particular patient was experiencing an adrenal gland stress pattern known as "Adrenal Fatigue." Additionally he suffered from a low Secretory IgA (SIgA) level, which is one of the body's primary immunoglobulins (better known as "antibodies"), that is secreted by various mucosal surfaces, such as the linings of the airways and your gut, which has a very crucial role in the protection of the body from bacterial and/or viral invasion along these surfaces. He also demonstrated a moderate to severe intolerance to gliadin, a food-allergy that is very common in today's "grain-happy" consuming populations, and happens to be found in wheat, rye, oats and barley to name a few. Yet quite interestingly, his male hormone profile (ie, testosterone and all of its related counterparts), was generally good...SO, what's the upshot to this patient's clinical concern, as to WHY (remember in FE we always want to ask the fundamental questions "WHY?") is he experiencing the accumulation of mid-abdominal fat and an increased waist-to-hip ratio despite such an intensive fitness regimen?

Based upon my analysis of this patient's blood and salivary testing data, it is evident that he is exhibiting a number of clinical concerns, each of which is functional in nature. Firstly, this patient demonstrates slightly reduced testosterone synthesis; secondly, he is demonstrating "up-regulation" of the enzyme "aromatase"(which is responsible for the conversion of testosterone into estrogen); and lastly, he is suffering from what is known in the FE community as Adrenal Stress Syndrome (which in this patient's case manifested as adrenal gland hypofunction). He additionally has a significant food sensitivity (gliadin) that will certainly compound his Adrenal Stress Syndrome and produce a number of very vicious cycles that will only aggravate his condition. The remedy for his complaints was to prescribe a number of specific formulations by Apex Energetics to produce the following effects:

  1. To enhance endogenous testosterone synthesis (i.e. to make more of it from within)
  2. To"down-regulate" the aromatase enzyme, thereby reducing the overactivity of this enzyme by inhibiting its action and preventing the conversion of testosterone into estrogen.
  3. To provide proper nutritional support to his intestinal mucosa to help heal any damage to his gut lining and to ensure proper digestion by providing a full complement of digestive enzymes in conjunction with probiotic organisms to support healthy intestinal absorption. The additional intended consequence of restoring proper gut function to this patient is to eliminate the Adrenal Stress Syndrome which will automatically restore his exhausted cortisol and DHEA levels.

I now await the outcome of these recommendations, as indicated by both the patient's presentation subjectively and objectively, in conjunction with follow-up laboratory testing.

So in closing, my intent with this brief discussion and minor review of a single case history of one patient's endocrine data illustrates how from a functional approach we in FE tend to diagnose and treat the body, thus meeting the body's needs as opposed to running over it roughshod with dominant replacement therapies that offer little, if any, restorative capabilities. My primary objective is to facilitate your ability to modulate and regulate your own endocrine system, hence allowing your series of glands to release your own hormones, which are your intercellular chemical messengers. In turn, these chemical messengers act as your communication agents, instructing your body on how to respond and perform those specific actions that will give you optimal vim, vigor, and vitality all day long!

At the risk of appearing redundant, I think it now abundantly clear that we are addressing YOUR unique and specific endocrine requirements and allowing YOUR body to make the correction in truly holistic fashion, as opposed to giving you exogenous replacement hormones, which is not only narrow-minded and myopic, but potentiates doing more harm than good in the long run.


Theodore J. Bloukos, D.C., P.A.