Dr. Bill Schumacher's Chiropractic Blog

Hopkins Clinic Celebrates 25 Years

2012-02-03T21:34:12Z

We have reached a milestone this month at the Schumacher Chiropractic Clinics. We are extremely happy to be celebrating our 25th anniversary at our Hopkins office. We have been blessed over the years to serve so many wonderful patients and help them regain their health.

We have made a lot of friends along the way and appreciate the support we feel everyday.
We strive to provide the best care possible and look forward to many more anniversaries to come.

We are having an open house on Friday February 10, 2012 to mark the occasion. Please feel free to stop in from 9:00-12:00 or from 2:00-6:00 for some cake, great food and lots of laughs.

Dr Dan the staff and I would love to see you on the 10th, so we can thank you in person.
Hope to see you then.

Content Copyright 2009/2010/2011 Schumacher Chiropractic Clinics, P.A. All rights reserved. All material on this site is copyrighted by Schumacher Chiropractic Clinics, P.A. except for some material that is copyrighted by others and used here with permiss

Stress Management Tips

2012-01-24T00:20:52Z

My brother Dr Dan found this article on stress at www.stressmanagementtips.com. We liked the suggestions in this article and thought it would be a great blog topic for this week.

All stress isn’t bad. Stress can initiate change, help us focus on the task at hand, and in some cases even save our lives. Yet, when stress builds up, it can result in the opposites— and cause us to spin our wheels, keep us from concentrating, and cause bodily injury and even loss of life.

The first tip in managing stress is to recognize your stressors. The next step is to put each of them in their place. The following stress management tips, based on some old and some new adages, can help you do just that!

Take a Deep Breath and Count to Ten—
Taking a deep breath or two adds oxygen to your system, which almost instantly helps you relax. In addition, taking a moment to step back can help you maintain your composure, which in the long run, is what you need to work rationally through a stressful situation.

Start with “take a deep breath” and…

Count to ten (or more or less as the situation warrants!)
Stand up and stretch. Remember relaxation is the opposite of stress.
Stand up and smile. Try it! You’ll feel better!
Take a short walk. If you’re at work, take a bathroom break or get a glass of water. Do something that changes your focus. When you come back to the problem, chances are it won’t seem nearly as insurmountable.
In the book Gone With the Wind, Scarlett O’hara says, “I can't think about that right now. If I do, I'll go crazy. I'll think about that tomorrow.” Good advice!

Stop and Smell the Roses—
“Things happen” and sometimes “bad things happen to good people”. If we let them, stressful events can build up, wall us in, and eventually stop us from enjoying the good things in life.

Take the time. Too often we put the pleasantries of life on the back burner, telling ourselves we don’t “have time” or can’t “make time” for them. However, actually, time is the only thing we do completely own. While we can’t “make” a day that’s longer than 24 hours, each of us starts the day with exactly that amount of time. Take a part of your time to recognize the good things in your life.
Sleep on it. Every coin has two sides and every issue has both pros and cons. List them both then put the list away and take a second look tomorrow. Sometimes “sleeping on” a situation changes the minuses to pluses.
Every cloud has a silver lining. After all, rain makes things grow! Ben Franklin found good in a bolt of lightning. Find the good in your stressful situation by listing the negative surges and determining what it will take to make them into positive charges!

“A Man's Got to Know His Limitations—”
Knowing yourself and your limits may be the most important way to manage stress effectively.

Dare to say no. One more little thing may be the “straw that breaks the camel’s back”. It’s okay to say “No”, “I can’t”, or “Later”.
Acquit yourself. Sometimes events really are out of control and you really are “Not Guilty”. Quit blaming yourself.
Be pro-active in finding peace. Those who unsuccessfully use the crutches of drugs and/or alcohol to alleviate stress often find themselves in a twelve-step program like A.A. where one of the mainstays is the Serenity Prayer:
“God grant me the Serenity to accept the things I cannot change; The Courage to change the things I can; and the Wisdom to know the difference.”
When you need help, get help. Even Atlas couldn’t bear the weight of the world on his shoulders forever. Whether you need help from kids or spouse in hauling groceries into the house, help from a colleague to solve a work-related problem, or professional help to find the causes of and effectively manage your stress, getting the help you need is in itself a major stress management tip!

Other Tips

Get a good night's rest.
Eat healthily.
Listen to your favorite music.
Exercise, participate in a sport or engage in fun activity.
Plan out your time and prioritize.
Talk to a friend about your problems, don't hold it in.
Get a massage.
Take a nap.
Take a warm bath.
Read a book or watch TV.

Wake-Up Call

2011-12-31T14:03:28Z

I found an interesting article in Experience Life magazine about cell phones and the possible side effects of EMF's. I hope you find it interesting.

The electromagnetic radiation surrounding us – especially from cell phones – may pose unseen dangers to our health. Learn what you can do to reduce your exposure to EMFs.

By Pamela Weintraub / December 2011

My Brooklyn neighborhood is one of the most historic in New York. Up the block, the F. G. Guido Funeral Home, built circa 1840, was a destination of choice for many a Mafia send-off. The Gothic arches of St. Paul’s Church, across the street, have welcomed Episcopalians and music lovers since 1849. Along with hundred-year-old brownstones graced by deep front gardens, these national landmarks are assiduously protected from change. But, one modern feature has silently infiltrated this vintage section of Brooklyn: electromagnetic frequencies, or EMFs for short.

Invisible to the eye, EMFs are powering an ever-expanding thicket of appliances and electric lights, and more recently, a burgeoning network of cell towers, wireless routers and the ever-present cell phones that gird our lives.

Life without cell phones and other wireless conduits has become nearly unthinkable, but a growing chorus of experts now worries that our near constant immersion in these force fields could be endangering our health.

We are exposed “to as much as 100 million times more electromagnetic radiation than our grandparents were,” notes Ann Louise Gittleman, PhD, author of Zapped: Why Your Cell Phone Shouldn’t Be Your Alarm Clock and 1,268 Ways to Outsmart the Hazards of Electronic Pollution (HarperOne, 2010).

Worry intensified this year after the World Health Organization (WHO) analyzed the data and called cell phones a possible carcinogen. The jury is still out on the range of possible effects, but a raft of studies now links EMFs — especially those from cell phones carried close to our bodies — to brain tumors, damaged DNA, fertility problems and autism.

With cell-phone usage surging from a hundred million people worldwide in 1997 to some 5 billion today, even small increases in risk could pose a serious global threat. A Council of Europe committee has even warned that EMFs might bring about a health crisis comparable to those once spawned by smoking and asbestos.

In an effort to lower risk, some communities are taking action to reduce EMF exposures. The National Library of France, for example, has dismantled its wireless system. Germany has advised against wireless technologies in residential neighborhoods.

But when it comes to cell phones, initial change might have to come one person at a time.

“Studies show people would rather leave home without their wallet than their cell phone. The cell phone has become an extension of the body,” says Devra Davis, PhD, former researcher for the National Academies of Sciences and president and founder of the Environmental Health Trust, an organization devoted to educating the public about controllable environmental health risks and policy changes needed to reduce them.

Read on to learn more about EMFs and the best ways to reduce your own exposure risks.

EMFs are Everywhere

What is all the fuss about, anyway? Electromagnetic frequencies — essentially different forms of radiation that vary along what physicists call the “electromagnetic spectrum” (see illustration below) — abound in nature. They build up after thunderstorms and travel through the planet from pole to pole. Light is the most familiar EMF, but modern technology also generates EMFs: x-rays, radio waves and microwaves, to name a few.

What makes one form of electromagnetic radiation fundamentally different from another? In a nutshell: Its wavelength and frequency. Shorter waves have to cycle up and down more frequently to travel a given distance, so they are more energy intensive; some, like x-rays and gamma rays, emit so much energy they can break living tissue apart, a characteristic that has caused experts to label them “ionizing.” By contrast, longer waves, like TV waves, radio waves and microwaves, have to cycle up and down less frequently to travel a given distance. That means they emit less energy; they don’t ionize living tissue and have been widely embraced as safe.

It wasn’t until January 1993, when TV talk-show host Larry King did an interview with a Florida man, that confidence began to erode. King’s guest, David Reynard, had filed a claim against the cell-phone manufacturer NEC and the carrier GTE Mobilenet. According to Reynard, in 1988 he’d given his wife, Susan, a cell phone for her birthday. Seven months later, he told King, she was diagnosed with a malignant brain tumor that closely resembled the size and shape of the phone’s antenna. A month after Reynard filed the lawsuit, Susan was dead.

Could the cell phone really have been the culprit? Experts like Davis hypothesize that it could have been. The effect on the brain and other vulnerable tissue is much like snapping a rubber band, she explains. “Snap it once, and it stays intact, but snap it constantly and irregularly, and the rubber band falls apart.”

Given how widespread cell-phone usage is, and how quickly Susan Reynard’s cancer (a rare, malignant astrocytoma) developed, lawyers couldn’t prove that her cell phone was to blame. Yet studies and counter-studies have cast an increasingly disturbing — though uncertain — light on the damage that nonionizing wavelengths might cause.

In 1994 University of Washington scientists exposed live rats to cell-phone-like radiation and then examined their brains. DNA from brains of exposed rats was damaged, while DNA from unexposed rat brains remained intact.

Many consider a series of studies from Lund University in Sweden to be the pivotal evidence to date. By 2003 the Swedish researchers were reporting that cell-phone radiation breached the blood-brain barrier, the vascular and immune barricade keeping toxins out of the brain. In one study, the Swedish scientists exposed 32 rats to cell-phone radiation for just two hours, varying intensity among the rats in order to reflect the types of exposures human cell-phone users might receive. When the rats were euthanized roughly 50 days after exposure, and their brains studied, scientists found significant blood-vessel leakage and shrunken, damaged neurons. The higher the level of radiation, the more damage was done.

Ever since the Swedish study, increasing numbers of people have been claiming a link between their brain tumors and their cell phones. Countless studies, most of them small, have shown evidence of harm. But these studies have been countered by just as many studies finding no risk at all.

To help get to the truth, a multinational study called INTERPHONE compared cell-phone usage in brain-tumor patients with usage in a healthy control group without brain tumors. Results, reported in 2010 in the International Journal of Epidemiology, were mixed. According to researchers, risk of getting a brain tumor was higher for those using cell phones the most — 30 minutes a day or more for at least 10 years. On the other hand, people using cell phones for shorter periods of time were reported to have less risk than those using only landlines; for these moderate users, the study implied, cell phones had a protective effect.

Writing an editorial on the study in the same issue of the journal, Rodolfo Saracci, MD, of the National Research Council in Pisa, Italy, and Jonathan Samet, MD, of the University of Southern California in Los Angeles, tried to shed some light. Addressing the tepid findings on risk for heavy users only, they commented that, in contrast, “none of today’s established carcinogens, including tobacco, could have been firmly identified as increasing risk in the first 10 years or so since first exposure.”

As for the so-called protective effect, they found no biological mechanism to explain it. Given that, most experts say it probably reflects a flaw in the design of the study — and not a benefit
from EMFs.

This year’s critical WHO report labeling EMFs a “possible” carcinogen followed fast on the heels of the INTERPHONE study. According to Samet, who led the WHO working group that reviewed the evidence, the cancer–cell-phone link cannot be dismissed.

“The evidence is credible,” he comments. But Samet also points out that without a known mechanism for how cancer is induced, it’s impossible to elevate the risk label to its next level of concern: from “possible” to “probable.” More research will be required.

Young Brains and Cell Phones

Could there be too much of an emphasis being put on brain cancer, which is still a rare diagnosis? “A much larger concern is damage to neural connections in the developing brain and to the reproductive health of men and women,” says Davis.

When it comes to reducing EMF-exposure risks, every millimeter of separation between a cell phone and the brain is protective. With thinner skulls and smaller ears, children are closer to the radiation source. In fact, researchers have long reported significantly higher absorption rates of radiation for children — about twice as much for those under age 8.

When it comes to disruption of neural connections, compelling research published in the Journal of the American Medical Association this year shows that 50-minute cell-phone calls increase glucose metabolism in the area of the brain closest to the phone antenna — specifically, the orbitofrontal cortex and temporal pole, regions involved in sensory integration, language, decision making, and social and emotional processing.

Although the study’s lead author, psychiatrist Nora D. Volkow, MD, of the National Institute of Drug Abuse at the National Institutes of Health, does not know whether the metabolic increases can cause damage over time, she does say that, if they do, children and adolescents (because they have the most neuroplastic brains) would be at greatest risk. “As of right now, we don’t know what happens when you get repeated exposures. What happens over the course of 10 or 15 years?” she wonders.

Research presented at a conference held in Istanbul this May underscores Volkow’s concerns. After Turkish researchers exposed adult rats to mobile-phone-like emissions, they found damage to the cerebellum, a part of the brain important for language, attention and motor control. After exposing pregnant rats to similar radiation during gestation, the researchers documented cell loss in the newborn rats’ hippocampus, a part of the brain pivotal to memory formation.

It appears that cell phones can also threaten fertility. Research from the University of Athens showed that cell-phone radiation could cause DNA fragmentation in the ovarian cells of insects, drastically reducing reproductive capacity.

At the same conference, research was presented from Jawaharlal Nehru University in New Delhi, where researchers exposed rats to two hours of cell-phone radiation a day for 35 days. At the end of that period, exposed rats had high levels of free radicals that resulted in an increased risk of infertility and cancer.

The news is disturbing for humans as well: Research from the Cleveland Clinic in Ohio recently suggested that cell phones may lower sperm count in men — especially those who kept the phone on “talk” mode, and carried it on their body, most often in their pants pocket.

Communities React

The most specific findings come from studies of rodents, hardly the highest level of evidence. But right now, that is the best evidence available. Cell-phone technology is new, and definitive human evidence won’t emerge until decades of use enable long-term follow-up and the kind of epidemiological evidence true proof demands.

Some communities aren’t content to wait those decades for consensus when they can do something now. The San Francisco Commission on the Environment called for a review of cell-phone safety standards, safety warnings at the state and federal levels, and safety information at the point of sale. The mayor and town council of Jackson Hole, Wyo., have voted for a cell-phone safety-awareness campaign for the city and the public schools.

For its part, the cell-phone industry insists on more research before it issues warnings or changes its products in any way. Some compare this to the tobacco industry’s resistance to conceding risk and issuing warnings that smoking can cause cancer. “Whilst the vast majority of scientific studies have not shown any adverse health risks, there are some studies that have raised questions that need to be addressed by further research,” according to the Mobile Manufacturers Forum, an international association of telecommunications-equipment manufacturers established in 1998.

Most cancer advocacy organizations insist on better evidence as well. “Studies thus far have not shown a consistent link between cell-phone use and cancers of the brain, nerves, or other tissues of the head or neck. More research is needed because cell-phone technology and how people use cell phones have been changing rapidly,” according to the National Cancer Institute in Washington, D.C.

The furious yin and yang of the debate continues as this article goes to press. In July the Journal of the National Cancer Institute published a study comparing 352 Western European children who had brain tumors with 646 without tumors; cell-phone use, the researchers reported, created no increased risk for the disease.

Still, Davis calls those conclusions “astonishing and deeply disturbing.” The research, conducted from 2004 to 2008, couldn’t possibly capture the quadrupling of cell-phone use over the last few years, she says. “And how,” she wants to know, “can a study lasting just four years answer questions about tumors that can take a decade to form?”

Although Davis agrees that we have not yet proven harm to the standards that science demands, she says that shouldn’t stop us from taking cautionary measures now. “The need for research should not be allowed to become an excuse to carry on as though everything is fine, until we have incontrovertible proof that it is not,” she writes in her book, Disconnect: The Truth About Cell Phone Radiation, What the Industry Has Done to Hide It, and How to Protect Your Family (Dutton Adult, 2010). We may not yet have an epidemic of brain tumors in countries that have used cell phones for little over a decade, she points out. “But 10 years after cigarettes began to be heavily smoked, we also did not have an epidemic of lung cancer. Years from now our grandchildren will look back and ask: Did we do the right thing and act to protect them, or did we harm them needlessly, irresponsibly, and permanently, blinded by the addictive delights of our technological age?

The Vitamin D Debate

2011-12-07T21:27:46Z

I found this article about the Vitamin D debate in the December 2011 issue of Experience Life magazine.I thought the author, Jack Challem, did a nice job addressing the various issues related to Vitamin D deficentcy, suggested RDA's and benifits of supplementing your diet with Vitamin D. I Hope you find this article helpful.

There’s been a lot of controversy lately about vitamin D recommendations. If you’re confused about how much you should be taking, you’re not alone.

By Jack Challem / December 2011

Nutrients Department,

Put 10 doctors in a room, goes the old joke, and you’ll get 10 different opinions. Unfortunately, that has become the story with vitamin D — and it’s no laughing matter. All the conflicting advice about how much to take has left many of us unsure of what to do.

The stakes are high. Inadequate vitamin D levels can increase your risk of dozens of serious health problems, including cancer, heart disease, osteoporosis, asthma, Alzheimer’s disease, and even the common cold and influenza. And apparently, nearly all of us are at risk of vitamin D deficiency.

Adit Ginde, MD, MPH, of the University of Colorado Denver School of Medicine, found that nearly three of every four Americans have either deficiencies or borderline deficiencies of the vitamin. But some experts contend the situation is far worse. “Ninety-five percent of Americans are deficient in vitamin D — that’s how big the problem is,” says John J. Cannell, MD, who heads the nonprofit Vitamin D Council. “It’s very difficult to overstate the seriousness of the situation.”

The main reason most of us lack adequate vitamin D is that we aren’t soaking up enough sun. When the sun’s ultraviolet (UV) rays strike the skin, they stimulate our bodies’ production of vitamin D. These days, though, warned about the risk of skin cancer, many of us don sunscreen whenever we go outside, inhibiting vitamin D production. And we don’t go outside nearly as much as we used to.

“Society has changed, and a lot of these changes have pushed us indoors,” says Robert P. Heaney, MD, of Creighton University in Omaha. “Our parents and grandparents spent significant amounts of time working or doing other activities outdoors. Until recently, children spent a lot of time playing outside. All of this enabled people to build up enough vitamin D reserves for wintertime, when it’s nearly impossible to make vitamin D in most parts of the country. Now, though, people go from homes to their cars to their work, and spend very little time exposed to sunlight. Computers, PlayStations and other electronics, along with 500 television channels, keep us occupied indoors,” he says.

Other changes have occurred as well: “In the 1930s, vitamin D was considered a miracle vitamin,” explains Michael F. Holick, MD, PhD, of the Boston Medical Center. That’s because researchers had just discovered that the vitamin prevented rickets, a near-epidemic bone-deforming disease among children in industrialized northern states and northern Europe. Dozens of foods were fortified with vitamin D, even hotdogs and beer. Then, in Great Britain during the 1950s, doctors started seeing cases of high blood calcium in young children that they mistakenly thought was due to overfortification of milk with vitamin D. As a result, doctors became wary of vitamin D, and Britain and most other European countries banned vitamin D fortification of foods.

Fast forward to the 1980s. That’s when doctors in India treated six tuberculosis patients with 3,800 international units (IU) of vitamin D daily for three months. The patients developed dangerously high blood levels of calcium. The doctors blamed the vitamin D, but they never measured the patients’ blood levels of the vitamin, or acknowledged that super-high calcium levels could be common in people with tuberculosis. That study added to the stigma, and five years later, based on the available evidence, the U.S. government warned that as little as 1,000 IU of vitamin D daily could be toxic.

All this shaped doctors’ feelings about vitamin D for years to come — and set the stage for today’s controversy about how much of the vitamin to take.

Reconsidered Recommendations

The tide of opinion started to change in 1999, when Reinhold Vieth, PhD, a University of Toronto researcher, questioned the Indian study. Writing in the American Journal of Clinical Nutrition, Vieth noted that up to 10,000 IU of vitamin D daily appeared to be safe. Indeed, that’s approximately how much vitamin D a person in a bathing suit, sans sunscreen, would make after spending 15 minutes in the summer sun.

Then, in 2004, there emerged a new wave of vitamin D research that continues today. Leading experts, including Cannell, Heaney and Holick, were recommending that adults routinely take at least 1,000 to 2,000 IU — and maybe even up to 5,000 IU — daily of vitamin D in specific circumstances. These recommendations were getting wide coverage in medical journals, magazines and newspapers, and vitamin D was again enjoying a renaissance.

But at the end of 2010, the federal government’s Institute of Medicine (IOM) issued more cautious recommendations. Although the IOM increased the recommended amount of vitamin D for most adults from 200 to 600 IU (up to 800 IU for those 71 and older), it also stated that most Americans have adequate vitamin D levels and that there was no need to take more than 600 IU of vitamin D daily to maintain healthy bones.

In our headline-driven world, this became big news, but the fact that the report focused on bone health was often lost. The IOM report did not address, in any substantial way, that larger amounts of vitamin D appeared to reduce the risk of infection, cancer and other diseases. Instead, the IOM noted that insufficient research prohibited recommending vitamin D to help prevent these diseases.

A firestorm of criticism ensued, mostly in medical journals and blogs, much of it coming from doctors who had anticipated the IOM would recommend larger amounts.

“The IOM report made absolutely no sense at all,” says Cannell. “If you take the report at face value, a baby and a 300-pound football lineman both need only 600 IU of vitamin D daily.”

The other view: “The IOM committee did its work without any preconceptions. It’s the data — the totality of data — that led to the numbers,” says Catharine Ross, PhD, a professor of nutrition at Pennsylvania State University, and the chair of the IOM committee. “The RDAs are for the general population, and from all the studies to date, there isn’t support for values higher than those that the report specifies.”

Cannell contends that the IOM report was filled with contradictions. “The IOM report acknowledged that people could safely take up to 4,000 IU of vitamin D daily. This amount of vitamin D will boost blood levels of vitamin D to 40 ng/ml (nanograms per milliliter of blood), but the IOM also stated that 40 ng/ml was potentially dangerous, which it isn’t,” he says.

“The IOM report doesn’t actually say ‘dangerous,’” responds Ross. “It says there is no solid evidence of benefit going above 20 ng/ml, and it raises caution that new data suggest that for some people, higher levels may increase risk.”

In June 2011 the Endocrine Society, whose members are hormone specialists, weighed in with its clinical guidelines for physicians. Considered the Holy Grail of vitamin D recommendations, the Society’s guidelines generally suggested larger daily amounts of vitamin D to prevent and treat vitamin D deficiency than did the IOM: 400 to 1,000 IU for infants less than 1 year old, 600 to 1,000 IU for older children and teenagers, and 1,500 to 2,000 IU for adults. The Society also advised doctors that obese adults might need up to 10,000 IU daily for two months to correct a deficiency.

“I never see a patient whose vitamin D I don’t measure, mainly because deficiencies are so common, especially in people with serious diseases,” says Ron Hunninghake, MD, chief medical officer of the nonprofit, nutrition-oriented Riordan Clinic in Wichita, Kan. And if a patient does show up deficient in the nutrient? “I won’t let them out of the office without recommending vitamin D.”

Top 3 Benefits of Vitamin D

So, what exactly makes vitamin D so important to our health? Quite simply, it directly and indirectly influences most of what happens in our bodies every second of every day.

To understand, you have to shift your thinking a bit. Vitamin D isn’t actually a vitamin. Rather, it’s a hormone precursor that our biological ancestors made from being in the sun. When exposed to UV rays, a chemical cousin of cholesterol in the skin converts to vitamin D, which travels to the liver and is changed to the prehormone calcidiol. Calcitriol (the actual hormone) attaches to more than 2,700 sites on the human genome, and it turns on more than 1,000 genes, prompting them to do their jobs.

Creighton University’s Robert P. Heaney, MD, points out that vitamin D is a key part of the biochemical machinery that opens up our entire genome, so cells can tap into the vast information it contains. In a remarkable feat of biology, individual cells synthesize calcitriol, which then turns around to regulate those cells’ activities. It’s these fundamental roles of vitamin D that affect our risk for so many different diseases. In fact, says Heaney, “Vitamin D probably affects every disease.”

The evidence is particularly strong when it comes to vitamin D’s role in resisting infection, maintaining bone and muscle, and reducing cancer risks. (For other potential benefits, see “Vitamin D: Good for What Ails You?” sidebar.)

1. Cold and Flu Protection
Is it a coincidence that the vast majority of cold and flu outbreaks occur during the winter, when people have less sun exposure and lower levels of vitamin D? Probably not. In 2009 researchers analyzed patterns of deaths and disease complications (typically pneumonia) during the influenza pandemic that raged through the United States in 1918 and 1919, killing at least one-half million people. The researchers reported that the fewest flu deaths and complications occurred in southern cities, where the sun shone brighter throughout the year and, presumably, people had higher vitamin D levels. In contrast, the most deaths occurred in northern cities, where there was less sun exposure.

Granted, this association doesn’t prove cause and effect, but it’s certainly suggestive, and other evidence does support the protective role of vitamin D. Over the 2008–2009 winter months, doctors gave 1,200 IU of vitamin D daily to Japanese school children. Compared with children getting placebos, those taking vitamin D were 42 percent less likely to contract the flu and 83 percent less likely to suffer asthma attacks.

The underlying mechanisms are now understood. Numerous immune compounds depend on vitamin D, including PCL-gamma1, a molecule that activates immune cells so they’re capable of fighting infections. In addition, lung cells are among those that secrete 1a-hydroxylase, an enzyme that converts inactive vitamin D to its active form, helping fight respiratory infections. The vitamin D then turns on genes involved in immunity and boosts levels of cathelicidin, a powerful germ-fighting compound.

2. Stronger Bones and Muscles
Vitamin D has long been recognized as essential for normal bone formation, largely because it is essential for calcium utilization. Numerous studies have shown that the majority of seniors hospitalized for hip fractures are deficient in vitamin D.

But the problem might not be just weak bones. Heike Bischoff-Ferrari, MD, of University Hospital in Zurich, and others have made the case that weak muscles lead to falls and broken bones. The argument has its merits. Vitamin D is needed for normal muscle production and strength, and a lack of the vitamin leads to muscle weakness, a reduced range of motion, and increased physical frailty. With each passing year, seniors are more likely to be affected by sarcopenia, the age-related loss of muscle, along with osteoporosis. After analyzing 20 studies, which included more than 44,000 patients, Bischoff-Ferrari wrote in Osteoporosis International that 1,800 to 4,000 IU of vitamin D could greatly reduce the risk of falls in seniors. In contrast, the IOM recommended only 600 to 800 IU daily.

3.Lower Risk of Cancer
In 1980 epidemiologists reported that low vitamin D levels were associated with a greater risk of developing colorectal cancer.

Since then, researchers from around the world have linked low vitamin D levels to a higher risk of breast, ovarian, kidney, pancreatic and aggressive prostate cancer.

Would vitamin D supplements or greater sun exposure help protect against these cancers? The answer is yes, according to research by Cedric F. Garland, DrPH, of the University of California, San Diego.

Garland and his colleagues calculated that the incidence of colon cancer in the United States and Canada could be cut in half if people took 2,000 IU of vitamin D daily, and that women would reduce the incidence of breast cancer by half if they took 3,500 IU of vitamin D daily

How Much Should You Take?

So all this comes back to the questions: Should you take vitamin D? And if so, how much? Here’s the best advice culled from experts.

• The ideal approach is to ask your doctor for a vitamin D blood test, which will eliminate the bulk of the guesswork — but not all of it. Because of individual differences in absorption and use, people may need to take differing quantities of vitamin D to achieve a healthy blood level. Make sure your doctor orders a “25-hydroxy vitamin D” test. Other tests might result in a false normal. Although levels below 30 ng/ml indicate a deficiency, many physicians haven’t kept up with the research on vitamin D and believe that this level is just fine. The optimal level is at least 40 ng/ml and perhaps 50 ng/ml, says Heaney. But higher amounts, within reason, aren’t necessarily bad. Surfers, lifeguards and people who spend a lot of time outdoors typically have levels of 70 to 90 ng/ml.

• If you don’t currently have a significant deficiency, and if during the summer you spend a lot of time in the sun, with at least your arms and legs exposed, and you are not always slathered with sunscreen, you probably don’t need to take vitamin D supplements. Holick, who wrote The Vitamin D Solution (Hudson Street Press, 2010), suggests getting approximately 10 minutes of sun exposure (depending on time of day, season, latitudinal location and skin pigmentation) before applying sunscreen. Vitamin D made from the sun actually lasts longer in the body, compared with vitamin D from supplements or foods (also note that with the exception of wild salmon and shiitake mushrooms, most foods aren’t great sources of vitamin D).

• If it’s fall, winter or early spring, if you don’t get a lot of sun exposure, or if you know you are D-deficient, you should definitely take vitamin D supplements (most health pros recommend vitamin D3, also known as cholecalciferol). Your need will be greater if you are north of the latitude of Atlanta, since you will make little if any vitamin D from sun exposure during the months of November through March.

• If you have not taken a vitamin D blood test and you’re looking for general guidelines, Holick suggests that children take 1,000 to 2,000 IU and adults take 2,000 to 3,000 IU daily. “The bottom line for me is that there is probably no evidence that these amounts pose any risk,” he says. Cannell’s recommendation: Don’t drive yourself crazy with all the qualifications. “Just take 5,000 IU a day, unless you’re going outside to work or to the garden or beach.” The higher amount might be particularly helpful for people with a chronic illness, such as fibromyalgia, arthritis or lupus, adds Hunninghake. “These high doses of vitamin D, while generally safe, should be monitored with follow-up blood level [tests],” he says.

And what of the risks? For most people, vitamin D toxicity occurs after taking more than 40,000 IU daily for months, says Cannell. So as long as you’re being moderate in your intake, don’t sweat it.

Jack Challem is the author of more than 20 books on nutrition, including No More Fatigue: Why You’re So Tired and What You Can Do About It(Wiley, 2011), and is a member of the American Society for Nutrition.

Sidebar

Vitamin D: Good for What Ails You?

Although small amounts of vitamin D (e.g., 600 IU daily) might be enough to reduce your risk of rickets or broken bones, larger amounts are more likely to support overall optimal health. Here are some conditions that larger doses of vitamin D appear to help.

• Allergies. Vitamin D deficiency is associated with a greater risk of allergies, such as to pollens.

• Back pain. Many studies have shown that in patients with chronic lower-back pain, vitamin D supplements led to either a partial or complete elimination of pain.

• Fibromyalgia. Low vitamin D levels are typical in this disease, and boosting vitamin D reduces symptoms.

• Heart disease. Low vitamin D levels are associated with up to a 50 percent higher risk of heart attack.

• Mental health. Low wintertime vitamin D levels may be a factor in seasonal affective disorder (that is, seasonal depression), as well as in schizophrenia.

• Multiple sclerosis. The risk of multiple sclerosis increases progressively in populations living at latitudes farther from the equator. A growing body of research suggests that adequate vitamin D might slow its progression, at least in the early stages of MS.

• Skin cancer. Some research suggests that for certain populations, vitamin D, in combination with sun exposure or calcium supplementation, might offer some protection against skin cancer.

• Type 2 diabetes. Considerable research indicates that vitamin D, often in combination with calcium, helps regulate blood sugar and may reduce the risk of type 2 diabetes.

• Vaginal infections. Bacterial vaginosis affects nearly one of every three women. Maintaining normal vitamin D levels might reduce the risk of this type of infection.

Arthritis Prevention and Chiropractic

2011-11-25T18:45:03Z

I found this article on the web about chiropractic care and arthritis, This research indicates that spinal manipulation has the potential to increase joint space and break up intra-articular adhesions which can slow the progression of arthritis. I hope you find this article interesting.

Chiropractic prevents arthritis in accident victims, the elderly and the sedentary

By Mark Studin DC, FASBE(C), DAAPM, DAAMLP

According to the Arthritis Foundation (2007), "Forty-six million [46,000,000] Americans are currently living with arthritis, the nation's leading cause of disability, and we are all paying a high price for it. The Centers for Disease Control and Prevention (CDC) announced that the annual cost of arthritis to the United States economy was $128 billion in 2003 and increased by $20 billion between 1997 and 2003.

CDC attributes the dramatic increase to the aging of the population, predominantly baby boomers, and increased prevalence of arthritis. CDC also estimates an additional 8 million new cases of arthritis will be diagnosed in the next decade" (http://www.arthritis.org/cost-arthritis.php).

Arthritis, A.D.A.M., Inc. (2010, February 5), "...is inflammation of one or more joints, which results in pain, swelling, stiffness, and limited movement. There are over 100 different types of arthritis...

Causes, incidence, and risk factors

Arthritis involves the breakdown of cartilage. Cartilage normally protects the joint, allowing for smooth movement. Cartilage also absorbs shock when pressure is placed on the joint, like when you walk. Without the usual amount of cartilage, the bones rub together, causing pain, swelling (inflammation), and stiffness.

You may have joint inflammation for a variety of reasons, including:

- An autoimmune disease (the body attacks itself because the body immune system believes a body part is foreign)
- Broken bone
- General wear and tear
- Infection (usually cause by bacteria or viruses)...　

With some injuries and diseases, the inflammation does not go away or destruction results in long-term pain and deformity. When this happens, you have chronic arthritis. Osteoarthritis is the most common type and is more likely to occur as you age. You may feel it in any of your joints, but most commonly in your hips, knees or fingers. Risk factors for osteoarthritis include:

- Being overweight
- Previously injuring the affected joint
- Using the affected joint in a repetitive action that puts stress on the joint (baseball players, ballet dancers and construction workers are all at risk)

Arthritis can occur in men and women of all ages. About 37 million people in America have arthritis of some kind, which is almost 1 out of every 7 people" (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002223). With hypomobility (less mobility or movement), adhesions occur in a joint (the region where 2 bones connect).

According to A.D.A.M., Inc. (2010, March 30), "Adhesions are bands of scar-like tissue that form between two surfaces inside the body and cause them to stick together. As the body moves, tissues or organs inside are normally able to shift around each other. This is because these tissues have slippery surfaces.

Causes, incidence, and risk factors

Inflammation (swelling), surgery, or injury can cause adhesions to form almost anywhere in the body...Once they form, adhesions can become larger or tighter over time. Symptoms or other problems may occur if the adhesions cause an organ or body part to twist, pull out of position, or be unable to move as well.

Adhesions may form around joints such as the shoulder...or ankles, or in ligaments and tendons. This problem may happen:

- After surgery or trauma
- With certain types of arthritis
- With overuse of a joint or tendon

Symptoms

Adhesions in joints, tendons, or ligaments make it harder to move the joint and may cause pain...Adhesions in the pelvis may cause chronic or long-term pelvic pain.

Signs and tests

Most of the time, the adhesions cannot be seen using x-rays or imaging tests" (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002462).

Over time, with a sedentary lifestyle as seen in many portions of the population and increasingly with the elderly, joints become hypomobile. Hypomobility is also seen in trauma-related cases and repetitive use injuries, such as reading while looking down for extended periods, carrying heavy items, holding the phone between one's shoulder and ear, prolonged use of hands, wrists, back and neck, excessive use of computers, etc. As time progresses, internal scar tissue or adhesions continue to develop and further increases the loss of mobility.

Cramer, Henderson, Little, Daley and Grieve (2010), cite previous studies that have shown that adhesions have been found in numerous hypomobile (loss of normal movement) joints and that spinal adjusting separates the articular surfaces of the joint. The researchers inquired as to whether connective tissue adhesion developed in lumbar articular joints as a consequence to intervertebral hypomobility and utilized animal studies. They concluded that "...hypomobility results in time-dependent [adhesions]..." (Cramer et al., 2010, p. 508). In other words, internal scar tissue (arthritis) developed within the joints over time.

Cramer et al. (2010) sited previous studies that found the spinal adjustment separates the joints which could break up intra-articular adhesions. In other words, in their animal studies, spinal adjustments/manipulation increased the "Z gap" or spacing between the joints/bones and the mobility of the joints. If this applied in humans, the adjustments would then prevent further development of adhesions and degeneration and osteophytes, which is how the arthritic process progresses.

While arthritis affects approximately 1 in 7 Americans, the prevention of and/or correction of arthritis would relieve a great strain on our economy. While not all arthritis is a result of hypomobility, much of it is. If every person was under chiropractic care, we could not only positively affect the lives of every American, we could potentially rescue the economy of the United States and every other country and insurer in the world that assumes risk for an aging and hypomobile society.

References:

1. Arthritis Foundation. (2007, January 17). Cost of arthritis increases to $128 billion annually. Retrieved from http://www.arthritis.org/cost-arthritis.php

2. A.D.A.M., Inc. (2010, February 5). Arthritis. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002223

3. A.D.A.M., Inc. (2010, March 30). Adhesion. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002462

4. Cramer, G. D., Henderson, C. N. R., Little, J. W., Daley, C., & Grieve, T. J. (2010). Zygapophyseal joint adhesions after induced hypomobility. Journal of Manipulative and Physiological Therapeutics, 33(7), 508-518.

Chiropractic Approach to Ear Infections

2011-11-02T21:35:43Z

We are getting into the cold, flu and ear infection season. I found this article at the American Chiropractic Associations website, acatoday.org. I really liked the article and thought it would be a great topic for this weeks post. Enjoy!

Ear problems can be excruciatingly painful, especially in children. With 10 million new cases every year, ear infections (otitis media) are the most common illness affecting babies and young children and the number one reason for visits to the pediatrician—accounting for more than 35 percent of all pediatric visits.

Almost half of all children will have at least one middle ear infection before they're a year old, and two-thirds of them will have had at least one such infection by age 3. The symptoms can include ear pain, fever, and irritability. Otitis media can be either bacterial or viral in origin, and frequently results from another illness such as a cold. For many children, it can become a chronic problem, requiring treatment year after year, and putting the child at risk of permanent hearing damage and associated speech and developmental problems.

Standard treatment for most cases of otitis media is with antibiotics, which can be effective if the culprit is bacterial (antibiotics, of course, do nothing to fight off viruses). But, according to many research studies, antibiotics are often not much more effective than the body's own immune system. And repeated doses of antibiotics can lead to drug-resistant bacteria that scoff at the drugs, while leaving the child screaming in pain.

Frequent ear infections are also the second most common reason for surgery in children under 2 (with circumcision being the first). In severe cases—for example, when fluids from an ear infection haven't cleared from the ear after several months, and hearing is affected—specialists sometimes prescribe myringotomy and tympanostomy, more commonly known as "ear tubes." During the surgical procedure, a small opening is made in the eardrum to place a tube inside. The tube relieves pressure in the ear and prevents repeated fluid buildup with the continuous venting of fresh air. In most cases, the membrane pushes the tube out after a couple of months and the hole in the eardrum closes. Although the treatment is effective, it has to be repeated in some 20 to 30 percent of cases. And this kind of surgery requires general anesthesia, never a minor thing in a small child. If the infection persists even after tube placement and removal, children sometimes undergo adenoidectomy (surgical removal of the adenoids)—an option that is effective mostly through the first year after surgery.

Before yet another round of "maybe-they'll-work-and-maybe-they-won't" antibiotics or the drastic step of surgery, more parents are considering chiropractic to help children with chronic ear infections. Dr. Joan Fallon, a chiropractor who practices in Yonkers, New York, has published research showing that, after receiving a series of chiropractic adjustments, nearly 80 percent of the children treated were free of ear infections for at least the six-month period following their initial visits (a period that also included maintenance treatments every four to six weeks).

"Chiropractic mobilizes drainage of the ear in children, and if they can continue to drain without a buildup of fluid and subsequent infection, they build up their own antibodies and recover more quickly," explains Dr. Fallon. She'd like to see her pilot study used as a basis for larger-scale trials of chiropractic as a therapeutic modality for otitis media.

Dr. Fallon uses primarily upper-cervical manipulation on children with otitis media, focusing particularly on the occiput, or back of the skull, and atlas, or the first vertebra in the neck. "Adjusting the occiput, in particular, will get the middle ear to drain. Depending on how chronic it's been and on where they are in their cycle of antibiotics, children generally need to get through one bout of fluid and fight it off themselves." That means, for the average child, between six and eight treatments. If a child's case is acute, Dr. Fallon will check the ear every day, using a tympanogram to measure the ear and track the movement of the eardrum to make sure that it's draining. "I'll do adjustments every day or every other day for a couple of days if they're acute, and then decrease frequency over time."

Dr. Fallon, whose research garnered her the acclaim of childrearing magazines like Parenting and Baby Talk, often sees great success when she treats a child for otitis media. "Once they fight it themselves, my kids tend to do very well and stay away from ear infections completely. Unless there are environmental factors like smoking in the house, an abnormally shaped Eustachian tube, or something like that, they do very well," she says.

"I have two large pediatric groups that refer to me on a regular basis. In the winter, when otitis is most prevalent, I see five or six new children each week from each group," says Dr. Fallon. "It's safe and effective and something that parents should try, certainly before inserting tubes in their children's ears."

Content Copyright 2009/2010/2011 Schumacher Chiropractic Clinics, P.A. All rights reserved. All material on this site is copyrighted by Schumacher Chiropractic Clinics, P.A. except for some material that is copyrighted by others and used here with permiss

Headache Solutions: Save Billions With Chiropractic Care?

2011-10-21T23:08:08Z

I found this article in one of my professional journals. I hope you find it interesting.

By Mark Studin, DC, FASBE(C), DAAPM, DAAMLP

It was reported by Doheny in 2006 that migraine headaches cost U.S. employers more than $24 billion annually, including direct health care costs and indirect expenses such as absenteeism

Doheny went on to report that according to Michael Staufacker, director of program development for StayWell Health Management in St. Paul, Minn., "The programs are so few and far between because many companies 'don't perceive it as a priority.'"¹

Much of the public perceive headaches and migraines as normal occurrences. For example, a patient will enter a doctor's office and report that they experience "normal" headaches, not realizing that pain is never a normal occurrence. Symons, Shinde and Gilles emphasized the nature of pain, quoting this statement from the International Association for the Study of Pain: Pain is "'an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage."² As a result of the public not taking many types of headaches as potential serious problems, they let the condition linger, leading to negative sequella.

According to Munakata, Hazard, Serrano, Klingman, et al., "neuroimaging studies have provided compelling evidence that suggests progressive brain changes in persons with migraines ... migraine frequency is associated with posterior circulation infarcts and diffuse white-matter lesions ... Welch, et al., showed that impairments in iron homeostasis in periaqueductal grey areas that were associated with migraine duration and chronic daily headache."³

Munakata, et al., also reported that the economic impact of migraines in both direct health care costs and indirect costs of absenteeism is a huge economic burden.³ The direct cost of migraines ranges from $127 to $7,089 per victim, and the indirect cost due to absenteeism $709 to $4,453 per victim, making migraines an economic burden to the individual, the insurer, the employer, as well as local, state and federal entities who experience a lowered tax base from lost wages. It was also reported that between 2005 and 2006, there were 1,729,555 physician office visits, 186,603 advanced imaging procedures, 59,589 other diagnostic procedures, and 22,168 hospital days with a primary diagnosis of migraine or headache; all of which are paid by private or public insurers, or out of the pockets of individuals. In short, the costs are staggering and a burden to the economy.

Friedman, Feldon, Holloway et al., reported that acute headaches account for 5 percent of emergency department (ED) visits in hospitals. They also reported: "[T]he ED environment that may also contribute to unsatisfactory treatment response include limited physician contact time that may preclude a detailed history, overuse of ED by patients with substance abuse problems, the need for rapid triage, the competing distraction of patients with life-threatening conditions, and directives (or lack thereof) for care dictated by the referring physician. ...Thus, the treatment of migraine patients in the ED appears to be suboptimal and the high rate of recurrent headache may be attributed to underutilization of relatively 'migraine specific' treatment."⁴

Nelson, Suter, Casha, et al., reported on randomized clinical trials that took place over an eight-week course of treatment. The results showed there was minor statistical differences in outcomes for improvement during the trial period for chiropractic care, amatriptyline or over-the-counter medications for treating migraine headaches. It was also reported that there was no statistical benefit in combining therapies. However, the major factor to consider is that in the post-treatment, follow-up period, chiropractic was 57 percent more effective in the reduction of headaches than drug therapy. In addition, it was reported that, with the drug group, "58% experienced medication side effects important enough to report them. In the amatriptyline group, 10% of the subjects had to withdraw from the study because of intolerable side effects. Side effects in the SMT (Spinal Manipulative Therapy) group were much more benign, infrequent, mild and transitory. None required withdrawal from the study."⁵

Although this study was conducted 13 years ago, a more current study by Chaibi, Tuchin and Russell reported that massage therapy, physiotherapy, relaxation and chiropractic spinal manipulative therapy might be equally as effective as propranolol and topiramate in the prophylactic management of migraine,⁶ supporting the previous findings. Although more research is desperately needed, the above conclusions suggest a clear direction when it comes to managing migraines and headaches.

Using the 57 percent increased effectiveness that chiropractic has over drug therapy (leaving out the overlap that chiropractic could help without drugs) and the $24 billion U.S. employers pay for headaches and migraines annually, the savings from chiropractic care would approach $13.7 billion annually. Now imagine the reduction in the staggering costs currently incurred by the public, government and other entities for headache/migraine if that same percentage (57 percent) were applied. In addition, if chiropractic reduced the necessity for emergency room visits by 57 percent, ED doctors could focus on what their primary purpose is, to save lives in urgent scenarios.

With these cost savings, chiropractic benefits the federal government, local government, employers, private and public insurers and the public. It eases the burden on emergency rooms and prevents unnecessary side effects of drugs that are not clinically indicated, with a more viable and proven drugless solution. Although much more research is desperately needed to explore the benefits of chiropractic for migraines and headaches, the available research suggests chiropractic offers immediate solutions.

References

Doheny K. Recognizing the financial pain of migraines. Workforce Management, 2006;85(16):10-12.
Symons FJ, Shinde SK, Gilles E. Perspectives on pain and intellectual disability. Journal of Intellectual Disability Research, 2009;52(Pt 4):275-286.
Munakata J, Hazard E, Serrano D, Klingman D, Rupnow MFT, Tierce J, Reed M, Lipton R. Economic burden of transformed migraine: results from the American Migraine Prevalence and Prevention (AMPP) Study. Headache, 2009;49(4):498-508.
Friedman D, Feldon S, Holloway R, Fisher, S. Utilization, diagnosis, treatment and cost of migraine treatment in the emergency department. Headache, 2009;49(8):1163-1173.
Nelson CF, Bronfort G, Evans R, Boline P, Goldsmith C, Anderson AV. The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headache. Journal of Manipulative & Physiological Therapeutics, 1998;21(8):511-519.
Chaibi A, Tuchin PJ, Russell MB. Manual therapies for migraine: a systematic review. The Journal of Headache and Pain, 2011;12(2):127-133.

Dr. Mark Studin is a 1981 graduate of New York Chiropractic College. He is the co-founder and former executive director of the New York Chiropractic Council. Currently, he is president of CMCS Management. Contact Dr. Studin with questions and comments regarding this article at drmarks380@aol.com .

Chiropractic Care Saves Money

2011-10-14T21:02:59Z

I found this article about how much more cost effective chiropractic care is verses medical care for simulair conditions. It is amazing to see that in the study below estimates a cost savings of over 15 billion dollars a year choosing chiropractic care over unnecessary surgeries.

Chiropractic Saves Federal and Private Insurers

$15,897,840,000 and Adds $692,160,000

in Wages to Americans

by Mark Studin DC, FASBE(C), DAAPM, DAAMLP

It was reported by Zigler in 2011 that 200,000 spinal fusion surgeries are performed each year, just in the United States alone. An equal number of microdiscectomies are performed as reported by Mayer (2006), which is considered by many to be a conservative number. Let's consider the chiropractic impact of exposing the public to treatment that could avoid needless surgeries, using the 400,000 disc surgeries as a conservative number, not to mention how this could change the unnecessary cost to government and private insurers and lost revenue to both governmental agencies and workers from absenteeism. Allen and Garfin (2010) reported that spine-related health care expenditures totalled over $97.5 billion (2011 inflation adjusted), a 65% increase from 1997. With an aging population, this trend, based on the biomechanics of the aged, will continue.

It was reported by McMorland, Suter, Casha, du Plessis, and Hurlbert in 2010 that over 250,000 patients a year undergo elective lumbar discectomy (spinal surgery) for the treatment of low back disc issues in the United States. The researchers did a comparative randomized clinical study comparing spinal microdiscectomy (surgery) performed by neurosurgeons to non-operative manipulative treatments (chiropractic adjustments) performed by chiropractors. They compared quality of life and disabilities of the patients in the study.

The study was limited to patients with distinct one-sided lumbar disc herniations as diagnosed via MRI and had associated radicular (nerve root) symptoms. Based upon the authors’ review of available MRI studies, the patients participating in the study were all initially considered surgical candidates. Both the surgical and chiropractic groups reported no new neurological problems and had only minor post-treatment soreness. 60% of the patients who underwent chiropractic care reported a successful outcome while 40% required surgery and of those 40%, all reported successful outcomes. This study concluded that 60% of the potential surgical candidates had positive outcomes utilizing chiropractic as the alternative to surgery.

Let's do the math. If we take the 400,000 disc surgeries (adding cervical surgeries to the equation) done each year as discussed in the opening paragraph and apply McMorland et al.'s (2010) findings that 60% of surgical candidates had successful outcomes with chiropractic as an alternative to surgery, 240,000 patients yearly could avoid needless surgery if they sought chiropractic care.

According to Sherman, Cauthen, Schoenberg, Burns, Reaven and Griffith in 2010, the 2010 inflation adjusted amount per case in Medicare dollars is $13,243.82 per patient once you take into consideration the complications, but exclude many other variables such as repeated MRI's, myelograms, and many hospital charges. Allen and Garfin (2010), taking into account total charges, including mean hospital charges for a single level, uncomplicated, minimally invasive surgery, reported the cost to be $70,159 for all payors. They also went on to report that for 2-level disc surgeries the complication rate increased by 25% with significantly more costs.

If you consider 240,000 preventable surgeries at $70,159 per patient, that equates to $16,838,160,000 healthcare dollars that did not have to be spent. MEDSTAT, as reported by Chiropractic Lifecare of America (2009), estimated that the average cost of chiropractic care per patient per case is $3,918 (2011 inflation adjusted dollars.) If you take this amount and apply it to the 240,000 unnecessary surgeries, you have a net savings of $66,241 per patient. The net savings to the Medicare system and private insurers is $15,897,840,000.

According to Fayssoux, Goldfarb, Vaccaro, James (2010) who studied the indirect costs associated with surgery for low back pain, the average lost productivity related to absenteeism resulted in lost wages of $2,884 per patient for the first postoperative year. "The findings demonstrate the significant, though not surprising, impact of spinal disability on productivity, and the importance of including measurement of lost productivity and return to work..." (Fayssoux et al., 2010, p. 9). This equals an additional $692,160,000 in wages to Americans per year by taking the necessity of absenteeism out of the equation with no surgeries to recover from.

Chiropractic offers solutions to the federal government, local government, and public and private insurance companies by avoiding unnecessary surgeries. Chiropractic offers solutions to the economy of local, state and federal governments by increasing the tax base and productivity in the marketplace as a result of keeping workers at work and circulating money into local economies with increased paychecks at the end of the year. The research is conclusive and chiropractic has solutions to many of the economic and societal problems in the United States and worldwide.

References:

1. Zigler, J. (2002). Lumbar artificial disc surgery for chronic back pain. spine-health. Retrieved fromhttp://www.spine-health.com/treatment/artificial-disc-replacement/lumbar-artificial-disc-surgery-chronic-back-pain

2. Allen, R. T., & Garfin, S. R. (2010). The economics of minimally invasive spine surgery: The value perspective. Spine, 35(Suppl. 26), 375-382.

3. Mayer, H. M. (Ed.). (2006). Minimally invasive spine surgery: A surgical manual. Germany: Springer.

3. McMorland, G., Suter, E., Casha, S., du Plessis, S. J., & Hurlbert, R. J. (2010). Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. Journal of Manipulative and Physiological Therapeutics, 33(8), 576-584.

4. Sherman, J., Cauthen, J., Schoenberg, D., Burns, M., Reaven, N. L., & Griffith, S. L. (2010). Economic impact of improving outcomes of lumbar discectomy. The Spine Journal, 10(2), 108–116.

5. Chiropractic Lifecare of America. (2009). The MESTAT Project. Learning. Retrieved from http://www.clahealthcare.com/learning/index.html

6. Fayssoux, R., Goldfarb, N. I., Vaccaro, A. R., & Harrop, J. (2010). Indirect costs associated with surgery for low back pain—A secondary analysis of clinical trial data. Population Health Management, 13(1), 9-13.

ICE OR HEAT

2011-10-06T13:17:08Z

One of the most common questions I get is whether ice or heat is best for pain and injuries. Well, it depends. Both can be beneficial at different times. The following are some guidelines on when to utilize each.

The safest choice for treatment of injuries is ice. This method is best for injuries or pain that is less than 24 hours old, or any injury that continues to produce swelling. Ice decreases pain and provides vasoconstriction (closing of small blood vessels). This helps limit the amount of swelling that occurs immediately after the injury. It also has a calming effect on nerves, which can decrease pain. Ice or cold packs should never be put directly on the skin due to the risk of frostbite. In fact, cold packs can be even colder than natural ice. Neither ice nor cold packs should be used for longer than 30 minutes. To get added results for treatment of swelling, elevate the area being iced.

Ice Tips:

Rub the ice cube over the affected area until it melts completely.
Soak a thin washcloth in cold water. Wring it out and place over the affected area. Place a bag of frozen vegetables or bagged ice on top. If you want, use an Ace wrap to hold it in place.
For hands or feet, soak in a bucket or bowl of icy water for 10-15 minutes.

Heat promotes muscle relaxation, and is best used on postural muscles like those along the lower back, mid-back and neck. Muscle soreness and spasms are the most common symptoms treated with heat. This method can also help with osteoarthritis to increase range of motion and, therefore, decrease pain. Heat should also be applied for only 30-minute intervals.

Know that, when heat it is applied over an area of acute injury, active inflammation or swelling can get worse, as heat causes vasodilatation (opening of the small blood vessels), the opposite of ice. Another danger of using a heating pad is burning the skin. Commonly, a person will fall asleep on the heating pad or simply leave it on too long.

Moist heat is the most effective form. Chiropractors use a machine called a hydrocollator that keeps the hot pack in 160 degree water. Several layers of towels are used between the hot pack and the skin.

Heat Tips:

Use an electric heating pad.
Apply for no more than 30 minutes.
Place a cloth layer between the heating pad and the skin. The first few times the heating pad is used, check the skin every 5 minutes to make sure there is no burning.
The setting on the heating device should be at the minimum level where you still feel heat. A higher setting is not better, just more likely to burn.

INFORMATION FROM DISCOVERY HEALTH

What is Wellness?

2011-09-16T23:12:22Z

My brother Dr Dan, found this great article on the American Chiropractic Associations website about wellness that I wanted to share with you. Enjoy!

“Wellness” has become a buzzword among the public, health care practitioners and legislators alike. But what exactly does it mean, and how can people benefit from it? The American Chiropractic Association (ACA) defines wellness as “an active process that promotes health and enhances quality of life.”

“With the enactment of health care reform legislation earlier this year, the public is going to hear more and more about the importance of wellness, staying healthy and ultimately reducing health care costs caused by chronic diseases such as heart disease and diabetes,” says ACA President Dr. Rick McMichael. “It’s time for people to understand that they have the power to take charge of their health and be well enough to do the activities they enjoy."

Dr. Scott Bautch, a doctor of chiropractic from Wausau, Wis., explains wellness further. “We consider wellness the act of adding potential to people’s lives,” he says. “Whether that potential is the ability to avoid cholesterol problems, quit smoking, or exercise more — it’s all individual to each person. In other words, wellness is about giving people specific skills that will help them flourish in life.”

Finding a wellness coach

“If you’re interested in health and wellness, a good place to begin is by talking about it with a doctor of chiropractic,” notes Dr. McMichael. “Our doctors are well known for their expert care of back pain, neck pain and headaches, but they also offer patients a variety of conservative recommendations and counseling on general health and wellness." (link to: http://www.acatoday.org/healthtips)

You may ask, “What can a doctor of chiropractic offer that is different from a medical doctor?” The answer lies in the way the two professions approach wellness. To achieve “wellness” in traditional terms, a medical doctor will simply screen you for diseases, explains Dr. Bautch. “You might be examined or have lab tests. For medical doctors, wellness is about staying ahead of diseases.”

A doctor of chiropractic (DC), on the other hand, will screen you for diseases, but he or she also will talk to you about your lifestyle and behaviors that may put you at risk for injury or illness. It’s important to note that chiropractic’s approach is drug-free; instead of writing a prescription, a DC offers spinal adjustments, rehabilitative exercises, nutritional counseling and lifestyle modifications to move patients toward optimum function and wellness.

Typically, when a new patient visits a DC, one of the first things the doctor will assess is functional capacity. The DC will focus on decreasing pain and returning the patient to normal daily activities, including exercise. In the intermediate stage, a chiropractor will continue therapeutic care, but also begin to address factors that may have led to the patient’s pain by recommending lifestyle modifications. An example of intermediate care might include managing the patient’s obesity with counseling on diet and exercise. In the final stage of wellness care, a DC will help the patient take responsibility for his or her own health through patient education, enabling the person to independently maintain and even advance the level of wellness achieved.

Adjust your attitude

“The first thing I work on with a patient who is interested in living well is life skills in terms of thinking and dealing with life’s ups and downs,” says Dr. Bautch. “Research shows that coping skills and the ways that people deal with stress can be huge factors in whether or not someone is well.”

You can boost your attitude in a variety of ways: enjoying nature, looking for humor in life’s mishaps, listening to relaxing music and creating a support system of people who you can turn to in times of trouble or stress.

Start moving

Next, Dr. Bautch works with patients to increase their daily movements. “Americans today take significantly fewer steps than previous generations, and they spend a great deal more time in sedentary positions,” he says. “Adding more motion to your life can be a huge step toward living well.”

Simply taking a 30 minute walk each day is a great way to recoup the steps that are missing from your day. Experts generally agree that to be considered “active,” adults should take about 10,000 steps each day. Wearing a pedometer is an easy way to track your progress.

Food for fuel

Once the first two components of wellness are addressed, Dr. Bautch will address a patient’s diet. It’s surprising for some to learn that making even a few simple changes, such as eating more raw or organically grown foods, drinking more water and consuming 25 to 30 grams of fiber per day, can positively impact your health and help prevent a variety of adverse health issues in the future.

Cervical and Lumbar Disc Herniations and Chiropractic Care

2011-09-09T21:03:46Z

I have been looking for recent research articles that talk about the effectiveness of chiropractic care. I found this article about cervical and lumbar disc herniations and how well they respond to chiropractic care. This study demonstrated that 63% of the discs treated were reduced in size or completely resolved. I hope you find this as interesting as I did. Enjoy!

80% of the chiropractic patients studied had good clinical outcomes

By
William J. Owens DC, DAAMLP
Mark Studin DC, FASBE (C), DAAPM, DAAMLP

The term "herniated disc," refers to localized displacement of nucleus, cartilage, fragmented apophyseal bone, or fragmented annular tissue beyond the intervertebral disc space.[1]Simply stated, the annulus, or outer part of the disc has been torn completely through the wall allowing the inner portion, or the nucleus pulposis material to escape the inner confines in a “focal” or finite direction. Unlike a bulging disc, which an entirely different physiological process and diagnosis, caused by degeneration, a herniated disc is traumatically induced phenomena.

The highest prevalence of herniated lumbar discs is among people aged 30–50 years, with a male to female ratio of 2:1. In people aged 25–55 years, about 95% of herniated discs occur at the lower lumbar spine (L4/5 and L5/S1 level); disc herniation above this level is more common in people aged over 55 years.[2]

Symptoms of a Cervical Herniated Disc

A cervical (neck) herniated disc will typically cause pain patterns and neurological deficits as follows:[3]

C4 - C5(C5 nerve root) - Can cause weakness in the deltoid muscle in the upper arm. Does not usually cause numbness or tingling. Can cause shoulder pain.
C5 - C6(C6 nerve root) - Can cause weakness in the biceps (muscles in the front of the upper arms) and wrist extensor muscles. Numbness and tingling along with pain can radiate to the thumb side of the hand. This is one of the most common levels for a cervical disc herniation to occur.
C6 - C7(C7 nerve root) - Can cause weakness in the triceps (muscles in the back of the upper arm and extending to the forearm) and the finger extensor muscles. Numbness and tingling along with pain can radiate down the triceps and into the middle finger. This is also one of the most common levels for a cervical disc herniation.
C7 - T1(C8 nerve root) - Can cause weakness with handgrip. Numbness and tingling and pain can radiate down the arm to the little finger side of hand.

Symptoms of a Lumbar Herniated Disc

The most common symptom of a lumbar disc herniation is pain. The pain is usually described as being located in the buttock with radiation down the back of the thigh and sometimes to the outside of the calf. The specific location may vary and depends on which disc is affected (and thus which nerve root is affected). The pain (and other symptoms and signs) come from pressure on the nerve root. The pain frequently starts as simple back pain and progresses to pain in the leg. When the pain moves to the leg, it is not unusual for the back pain to become less severe. Straining such as bowel movement, coughing or sneezing are all things that tend to cause the leg pain to worsen. Very large disc herniations may cause something known as the "cauda equina syndrome". This is a rare syndrome caused by a very large disc herniation putting pressure on many nerve roots. Signs and symptoms include urinary problems (either retention or incontinence), loss of leg or foot strength, "saddle" anesthesia (loss of sensation in the area of the body that would be in contact with a saddle), decreased rectal sphincter tone and variable amounts of pain (ranging from minimal to severe).[4]

A research paper published in a Peer Reviewed Medically Indexed Journal (scientific journal,) was conducted to evaluate how patients with disc herniations responded to chiropractic care. The authors stated “all patients were evaluated before commencement of chiropractic care by MRI scans for presence of disc herniations. Pre-care evaluations also included clinical examination and visual analog scores [asking them to rate their pain by using a number from 0 to 10]. Patients were then treated with a course of care that included traction, flexion distraction [a specific Chiropractic technique], spinal manipulative therapy, physiotherapy and rehabilitative exercises. All patients were re-evaluated by post-care follow-up MRI scans, clinical examination and visual analog scores. Percentage of disc shrinkage on repeat MRI, resolution of clinical examination findings, reduced visual analog pain scores and whether the patient returned to work were all recorded. This is an important study because it shows MRI scans pre-care and post-care.

The paper goes on to report “Clinically, 80% of the patients studied had a good clinical outcome with post-care visual analog scores accompanied with resolution of abnormal clinical examination findings. Anatomically, after repeat MRI scans, 63% of the patients studied revealed a reduced size or completely resorbed disc herniation (completely resolved.) One significant finding was “seventy-eight percent of the patients were able to return to work in their pre-disability occupations.”[5]

This study shows that Chiropractic care can be a very important part of treatment in patients, when clinically indicated with disc herniations. Injuries such as disc herniations can have a negative impact on the ability to work and complete personal tasks. Evaluating treatment options is paramount when deciding how best to fix the problem especially the non-surgical approach that Chiropractic offers to patients. If you have an injury to your spine, the first step is making sure that you are diagnosed effectively and efficiently, and then engage in treatment as quickly as possible. Although Chiropractic is effective in treating conditions in the early and late phases it has been shown to be most effective when started immediately.[6]

This study, along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions to herniated discs. To find a qualified doctor of chiropractic near you, go to the US Chiropractic Directory at www.USChiroDirectory.comand search your state.

[1]http://www.asnr.org/spine_nomenclature/discussion.shtml

[2]http://clinicalevidence.bmj.com/ceweb/conditions/msd/1118/1118_background.jsp#incidence

[3]http://www.spine-health.com/conditions/herniated-disc/cervical-herniated-disc-symptoms-and-treatment-options

[4]http://www.cinn.org/spine/herniation-lumbar.html

[5]Magnetic resonance imaging and clinical follow-up: study of 27 patients receiving chiropractic care for cervical and lumbar disc herniations. J MANIPULATIVE PHYSIOL THER, 1996 Nov-Dec; 19(9): 597-606

[6]Donald Aspegren, DC, MS, Brian A. Enebo, DC, PhD, Matt Miller, MD, Linda White, MD, Venu Akuthota, MD, Thomas E. Hyde, DC, and James M. Cox, DC. FUNCTIONAL SCORES AND SUBJECTIVE RESPONSES OF INJURED WORKERS WITH BACK OR NECK PAINTREATED WITH CHIROPRACTIC CARE IN AN INTEGRATIVE PROGRAM: A RETROSPECTIVE ANALYSIS OF 100 CASES. J Manipulative Physiol Ther 2009;32:765-771.