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09/13/2010 Okay My Extended Summer Vacation Is Over
Having taken a 6 month hiatus from writing my blog ( wow how time flies when you are being distracted and lazy). I now feel energized and reinvigorated. Therefore I am climbing back up on my soap box and starting to scream again. Did you ever notice when you stop focusing on the important things everything starts to slide? I do. Whether it’s my writing, exercise regime, work duties, health, or whatever, I find from time to time I slip. So consider this my gentle reminder it’s time to get back on track and focus on the important things…your health matters!!!. Start taking care of your self!!
Cholesterol, Statin’s, Heart Disease and Pain 3/17/2010
Now most of you know that I practice in a small town. But, even here it never ceases to amaze me that I have so many patient’s taking statin drugs like Lipitor, Crestor and Zocor to name a few. Now the reason this raises a red flag is that when you work with people suffering from physical pain, you can never discount the effects of these medications when you have a complaint of pain in the back or legs.
Even here in my practice I am presented for my consideration the new patient on a weekly basis that is taking a statin. I am left to evaluate whether the patient is suffering from true back pain or is this a side effect of their medication. When the patient started taking the medication last week and the muscular based pain has come on for no apparent reason it’s a pretty clear clue to look at the statin.
Unfortunately the hurdle here is the disbelief of prescribing physician and sometimes the patient that the medication can truly cause this effect. Or the patient is afraid of stopping the medication because of the fear that an imminent heart attack is lurking around the next corner. The truth is that for over 40 million people on these expensive medications for the rest of their lives, they do absolutely nothing. According to Dr. Julian Whitaker in a recent article “Are you over age 65? Not a single study suggests you’ll receive any benefits, even if your cholesterol goes down substantially. A woman of any age? Same story. A man younger than 65 who has never had a heart attack? Ditto, no help at all. For middle-aged men who have had a heart attack, statins may lower risk of a repeat heart attack, but that’s the extent of it”.
Dr. Whitaker continues “an easy-to-understand measure that you’ll never hear about in drug ads. It’s called “number needed to treat,” or NNT, and it describes the number of patients who would need to be treated with a medical therapy in order to prevent one bad outcome. Experts consider an NNT over 50 to be “worse than a lottery ticket.”
Lipitor ads claim that it reduces risk of heart attack by 36 percent. Sounds pretty good until you look at the fine print, do the math (which John Carey did in a great article in Business Week), and figure out that the drug’s NNT is 100. This means that 100 people must be treated with Lipitor in order for just one heart attack to be prevented. The other 99 people taking the drug receive no benefit.
To put this into perspective, the NNT of antibiotics for treating H. pylori, the underlying cause of stomach ulcers, is 1.1. These drugs knock out the bacteria in 10 out of 11 people who take it, making them a reliable, cost-effective therapy. At the other end of the spectrum are statins, which as a class have an NNT of 250, 500, or higher depending on the study you look at. What a deal for drugs that can cost more than a thousand bucks a year and are almost guaranteed to cause problems ”
So there you have it 40 million people taking an essentially unnecessary medication with serious side effects. Not only are the medications unnecessary but the effect can be duplicated by naturally occurring substances like niacin at a fraction of the cost without side effects
First Robin Of Spring Or First Sneeze Of Seasonal Allergies!!
Hard to believe how quickly the weather changes around here! Last week at this time I had no electricity or running water at home. It was snowing 2 inches per hour, the emergency siren’s were blowing and we were all wondering if the winter would ever end. Then in the blink of an eye it almost gets warm. I say almost because when your used to the cold anything above 30 degree’s seems like Florida to me.
Yesterday a patient came into the office and said he saw robin’s feeding on sumac berries at this home. This morning sure enough I spied a few flying around my field in search of food. I wonder why these migratory birds which head south every fall are in such a rush to come back this way? There is snow on the ground a precious little for them to eat?
Every year when this happens it lift’s my spirits just a little the days are finally getting longer when I leave the office in the evening there’s still daylight outside. It’s almost like a weight is lifted off your shoulders. Unfortunately this is followed ( sometimes within days) by a parade of people into the office complaining of Allergies, Sinus Headaches, Coughing, Sneezing and Itchy eyes. It happens every year without fail. We all love the spring until our seasonal allergies catch up with many of us making life miserable.
This year it’s our goal to stop this before it happens. Acupuncture is very effective in treating and controlling seasonal allergies. Give us a call and stop your allergies in their tracks before it ruins your Spring and Summer!!! Don’t suffer needlessly. Remember Spring Back In to Health!!! Call us now or just schedule an appointment from here on our website!!
Somewhere Deep Inside I Still Like Snowdays 02/23/2010
OK, I Admit It, Somewhere Deep Inside I Still Like Snowdays. Growing up in the northeast had some inherent advantages for me as a child. Perhaps one of the most exciting days for children has always been the elusive snowday. Which by the way is defined quite differently today in the early 21st century then it was when I was going to school in the late 60’s and early to mid 70’s.
Back then to get a snowday you had to earn one. All the school bus drivers knew how to put chains on their tires and if there were less than six or seven inches of snow your had no shot. Once in great while the school would let us out early when it was really coming down. (But then again in those days I personally used to walk seven miles to school uphill in both directions in below zero weather all winter long in waist deep snow). After school activities were rarely canceled we routinely went sledding at home or on the golf course. Often we went skiing up at Mount Cathalia. Where, by the way you could buy a season’s pass for forty dollars. Today you can’t get a single day’s lift ticket at most ski area’s for the same money. It also triggered an opportunity for kids to earn some cold hard cash shoveling sidewalks and driveways. All good things.
Today, all it takes is a forecast to get a snowday. A few errant snowflakes and a full fledged snow emergency is called. A snow emergencyin case your interested is defined as an unexpected shopping opportunity in Middletown, Kingston or Paramus for all employee’s and students of the Ellenville School District. Or a day where you can play on your “Xbox” or “Wii” uninterrupted for at least eight straight hours until your thumbs fall off, or your parent’s get home and ask you to shovel the sidewalks. It can also sometimes be mistaken as a government related stimulus to the retail shopping communities in these distant shopping localities.
For me it generally translates into a morning of canceled and rescheduled appointments. Time to do all that paperwork I’ve been putting off. Dealing with phone calls every five minutes from the boys who want me to come home and entertain them. I wouldn’t call it a wasted day at the office just not a highly productive one. Somehow as we age the little things like snowdays begin to lose their spark and become just another chore, obligation, headache or hassle.
Lately I’ve noticed something, maybe a little bit of that spark that was lost somewhere along the line. When one the boys come racing down the stairs from their lair. Sporting a big smile and a twinkle in their eye, planning whatever it is they will do with their bonus day. I miss that, I have to work only until lunchtime today so I’m taking a half a snowday,
I can’t wait!! For all of you enjoying your snowday be careful shoveling use your legs not just your back. If you do go skiing or boarding today wear your helmet!!!
Why Don’t They Think Before They Open Their Mouth? 2/7/2010
Put this one under the never ending dizzying array of health related stupidity category. While working today a long term elderly (mid Eighties) patient who has spent what amounts to her entire adult life as being over-medicated (for conditions that may or may not have existed), by her physicians came to visit me.
Now she has been that sort of individual that is always susceptible to suggestion whether it is coming from one of her friends or one of her health-care providers. Last week during a visit to one of her irregular Doctor’s ( the ones who see her on an occaisional basis) and ply her with new medications (often unecessary in my opinion), she was a little unsteady on her feet, nervous (a regular occurence for her,) and was trembling slightly. Upon one look at her her physician diagnosed her with Parkinson’s Disease.
Parkinson’s disease (also known as Parkinson disease or PD) is a degenerative disorder of the central nervous system that often impairs the sufferer’s motor skills, speech, and other functions.
Parkinson’s disease belongs to a group of conditions called movement disorders. It is characterized by muscle rigidity, tremor, a slowing of physical movement (bradykinesia) and a loss of physical movement (akinesia) in extreme cases.
What makes this Doctor patient interaction so maddening though is she was being weaned off of Lyrica by her psychopharmocologist. Lyrica is used to control seizures and to treat fibromyalgia. It is also used to treat pain caused by nerve damage in people with diabetes (diabetic neuropathy) or herpes zoster (post-herpetic neuralgia).He never once asked what her other physicians were doing with her or why (as he was one of the proponents of the Lyrica). Her psychopharmocologist’ was trying to get her off of Lyrica due to it’s interactions with her other meds, and she was suffering from some it’s more severe side effects. I have taken the liberty of emphasizing those that were affecting her.
COMMON side effects when using Lyrica include:
Blurred vision; changes in sexual function, constipation; dizziness; drowsiness; dry mouth; gas; headache; lightheadedness; stomach pain; trouble concentrating; weight gain.
SEVERE side effects of Lyrica include:
Rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloating or swelling of the hands, feet, or ankles; changes in vision; confusion; fast or irregular heartbeat; fever; inability to control urination; loss of coordination; mental or mood changes; muscle aches, pain, tenderness, or weakness (especially if this occurs with a fever or general feeling or discomfort); speaking problems; sudden, unexplained weight gain; suicidal thoughts or actions; unusual tiredness or weakness.
In other words Lyrica’s side effects are often the same as the conditions it is supposd to treat. (Very Interesting)
Anyway getting back to the story, this poor woman comes into the office the next day convinced she is dying immediately from Parkinson’s and is highly aggitated. From my perspective all the hard work I and other health professional’s have put into her trying to get her self sufficent and able to believe in her own ability to heal and be healthy was thrown out the window by this unthinking idiot with a medical degree.
Now, I don’t want you to think that Parkinson’s Disease isn’t a possiblity here, it certainly is. However at 84 or 85 years old, a slight trembling of the hand isn’t the end of the world. The reason she couldn’t walk well in the Doctors’ office is ANXIETY. Which is the major limiting factor in her life. To make matters worse this Doctor knows it. He just never bothered to take the time to think before he opened his mouth and put his foot in it.
So here we go again with this poor woman suffering from anxiety attacks stemming from two sources. the first being the actual process of weaning her off Lyrica. The second being her Doctor who never learned how to treat people compassionately with wisdom.
Children’s Fitness Levels Continue to Decline; Today’s Kids are Weak and Unfit 2/2/2010
All to true, When I take a look at the children who come into the office these days, I can generally break them down into two classifications athletes and video athletes. You know the ones who spend virtually every free moment they have outside of school, working out with their thumbs on video game controllers, cursing and screaming at the television screen while engaging their opponents who may be in the room or across the globe somewhere.
When I look at this headline I find it very disturbing. When I look around the village I find it even more troubling. When I look at my own kids, I know why I throw them out of the house to play outside or participate in school sports. Playing video games is like almost smoking crack, highly addictive with no known benefits. My teacher friends tell me that they have noticed a disturbing trend, when a new hot video game is released on a weeknight say at midnight for marketing purposes the next day you can bet your attendance will suffer among highschoolers. Around the village look at the playgrounds, basketball courts, baseball fields and tennis courts. with few exceptions during the daylight hours ther use is way down. When was the last time you saw a kid with a baseball mitt on his bicycle wheeling around town?
Speaking from my ancient historical point of view as a kid and even a teenager we were forced to look outside of our houses for recreation and entertainment. I know technology has rapidly changed the world in which we live in but at some point we as parents have to put limits on how our kids spend their free time.
This is why I expect my kids to play a school sport every season, in the same fashion they are expected to do their homework every night. Coming home to hang out and play video games or surf the web isn’t acceptable on a daily basis. I understand it is different today, and yes we do have a video gaming console upstairs in the boys lair. But even though I rarely sensor (or even check) what they are playing. The only times they play is after homework and sports are done or on the occaisional bad weather or snow day. .
Certainly, when we push our kids to be more physically fit there are injuries, aches and pains involved. Thankfully most are minor and respond quickly. The downside of an unfit child is an unfit adult who suffers from poor health his or her entire life.
Now which life style would you choose for your child?
Treating Amnesia 1/20/10
Amnesia (Greek) is a memory condition in which memory is disturbed. In simple terms, it is the loss of memory.
Every now or then a patient will enter the office that I classify as the amnesiac patient. Now, typically you wouldn’t consider chiropractic or acupuncture as the first treatment of choice for a person suffering from amnesia. But, the amnesiac’s I treat are suffering from selective amnesia generally exhibiting a partial memory loss.
This is the part I don’t understand. This particular amnesiac suffers from loss of the memory of what worked before. They usually are a former chiropractic or acupuncture patient, (not necessarily my own) who is suffering from some sort of physical pain. Pain that they have suffered from before. Pain successfully treated with either chiropractic or acupuncture. Then for whatever reason it happens the pain reoccurs again some time later. Instead of doing what works, this patient has an amnesiatic (I think I just coined a word) episode. He or she forgets what works.
They then seek treatment from a health professional who is probably better suited for treating undiagnosed jungle diseases, mysterious upper respiratory ailments, chronic hemorrhoids or giving you useless swine flu vaccines (sorry, I couldn’t help but take my shot at that one). The patient of course is given some sort of pain medication which is worthless at best and addictive at worst. Of course it doesn’t work. After a week or two they are then subject to all sorts of medical imaging, mostly unnecessary since for the most part unless you are suffering from something really out of the ordinary (read tumor or disease process ) this will have little effect on the course of treatment. Generally their medication is changed to something a little stronger (more addictive). And if your physician really frustrated you are referred to physical therapy to do exercises for 8 to 12 weeks. The kicker here is that you can do these exercises at home by yourself after one instructional session. At this point you are 10 to 14 weeks into your treatment.
It’s usually somewhere along this time-line the patient wakes up from their episode of amnesia and schedules an appointment with me. With few exceptions in a week or two these folks are on their way back to normal. They are being treated in a safe effective manner and are taught how to take care of them selves through the use of chiropractic, acupuncture and self care at home that includes stretching, exercise and the proper use of heat or ice.
All that time effort and money spent on ineffective treatment. Listen, I know coming regularly to my office for a while can be a drag. Especially with the pace of our lives in the 21st century. But at the end of the day you only really get out what you put into taking care of your health. And if you think the magic pills your physician is pushing on you are the answer I hate to be the one to tell you that are sorely mistaken.
Moral of the story is do what really works unfortunately there are rarely any shortcuts that work with regard to physical pain.
So next time a pain reoccurs don’t suffer from amnesia and make matters either worse or more complicated. Do what works and is safe.
Just When You Think You Have Heard It All 1/14/2010
Just when you think you have heard every wacky excuse from a patient for taking prescription pharmaceuticals some one will come up with a new twist. Those of you who follow or know me at all know how dead set against the abuse ( or even use) of prescription pain medications, I am. I just got off the phone after having a conversation with a new patient. This gentlemen came into the office Monday morning complaining of lower back pain. As with any new patient I examined, diagnosed and began treatment. He was scheduled to return the next day and was a no show, the girls tried to get in contact with him and were unable to reach him. On occaison this happens, people come and go in a busy practice sometimes for reasons we are unaware of. This morning a get a buzz while sitting at my desk from Jackie to pick up the phone and speak with this gentleman. So of course he proceeds to tell me he’s sorry he missed his appointment yesterday, but he has spent the last day and a half home sick in bed.. I then asked whats going on and he said after he left the office ( feeling much better by the way) he proceeds to take oxycontin, aka hillbilly heroin when he gets home just in case. I said just in case what? He said, “ in case the back pain got worse.” I’m saying to myself, huh? What type of sense does this make? None of course. This is the whole point of this story, he reacted to taking the oxycontin by getting violently nauseous and spending the next few hours throwing up. And what do you think he does before he goes to sleep? That right folks he takes another one.
So, I ask him where he got the pills from and he said some other Dr. Prescribed them to him for another injury some time ago. I asked him did he react to the oxycontin then? He said “a little.” I said knowing this why would even consider taking this medication again? . His answer, “because my doctor prescribed it to me”
So here I am left to deduce that that people are willing to knowingly poison themselves with addictive medications they know they will react strongly to.
I don’t know maybe it’s just me, but I never seem to understand why people are so willing to do things they know won’t help them, particularly while they are in pain. I understand when you are hurting you want to get better yesterday,. Why are we as a society so willing to jump from the frying pan into the fire without so much as even a second thought? I see this time and time again.
Another one of my favorites is when people come in after trying every possible medical procedure and medication which fails. Then say they don’t want to begin a safe rational course of treatment because their GP, Pain Clinic, Neurologist wants to recycle the same failed treatment for the sixth or seventh time. What makes you think the tenth attempt at epidural shots is going to be any more successful than the last nine tries or maybe the third spinal surgery is going to have a good result on the same spot after the last two have failed? I hate to inform you but the odds are against it.
Anyway, I needed to vent, I’d like to know what you think
SOMETIMES IT JUST CLICKS 01/11/2010
We skied again this past Sunday. I was following my two younger boys down the hill and found myself smiling. Seeing my 13 year old, David stylishly ski down an expert slope is nothing new this season. He simply has it when it comes to looking good while skiing, The change with Jason, my eight year old really startled me. Over the course of a week or so the self proclaimed king of the snowplow was now carving turns and skiing down the steeps like he was born doing it. Apparently something just clicked. All those lectures Julie and I have given him (along with a few lessons as well) that he chose to ignore over the last season or so have finally paid off.
Today, Monday morning while in one of my treatment rooms, I found myself smiling again, I was talking with one of my patients who suffers from Fibromyalgia about his condition. It has been a typical busy winter Monday, busy with patient and office issues that have been brewing since the end of last week and over the weekend. The interesting thing was, while there was no miraculous change in this gentleman’s condition. For me, I find the miracles come from hard work. I was simply there in real time conversing, feeling content, doing what I do. Working with him guiding him some of the time, but just as often I find he guides me.
Then it just clicked, interestingly enough being a chiropractor clicks happen all day every day if you get my drift. With adjusting people all day either by hand or using the activator a good portion of my day I hear clicking. But this isn’t the clicking I’m talking about. Every now and then, doing what I do just makes sense, it just clicks. This is what I do, what I’m supposed to be doing and where I’m supposed to be doing it. Sometimes, I even do it well.
THE ELLENVILLE DIET. 01/08/2010
Ok, as usual after the holidays I was feeling like the GOODYEAR BLIMP. I was little off course with my diet eating all those things I love, egg sandwiches for Breakfast, Lunch from the local deli’s and of course for dinner, eating takeout food during the week and going out to eat on the weekends. Even with working out regularly with my personal trainer (workout terrorist) I was packing the pounds on. Though I must say in deference to her, I have become one of the stronger fat men you will ever meet.
With the internal alarm going off in my head that it is time to do something, I had come to the realization (again) that I was traveling down that road that leads to nowhere good. In a moment of what I’d like to consider divine inspiration I began my New Years Diet (hello meal replacement shakes again). However this time I’ve tried something a little different while surviving on those delicious (not) drinks. I’m never hungry during my workday, generally it’s around dinner time I do my damage.
Since all three of my boys are involved in wrestling at one level or another this winter, their matches are generally in the late afternoon or around dinner. So being the dutiful parent I go to lot of wrestling matches, usually drinking my evening dinner on the way. Funny thing though, after a couple of evenings I noticed, like being at work when I was out and involved with the boys, talking to other parents, friends and the coaches I wasn’t hungry or thinking about food. I am out there busy with my family and involved.
On Tuesday this week lo and behold there was nothing on my schedule. I arrived home from work and walked into a kitchen with all the good smells of dinner. Triggering my hunger. I had been reading about how good the Ellenville High School Girls Basketball team is for a number of weeks now and they were playing this evening. Sensing trouble was near for my diet, I promptly told Julie I was going to the school. She asked, “ For what?”, the boys are at home tonight. My answer was that I knew that but the girls weren’t. She looked at me kind of strangely (knowing not to mess with a hungry bear) and said “Go!”. She knew it was better for me to get out of the house and away from the food. I went.
The girls who have a really good team this year they were a pleasure to watch. None of my boys cared to join me. So I was there alone at the school enjoying a game, not feeling like I was in food hell ( this when you are dieting and at home watching Diner’s Drive in’s and Dives wishing you could eat that chicken fried steak at some dump in Texas). And then it finally struck me , I CAN SAVE ME FROM MYSELF and be more INVOLVED IN OUR COMMUNITY, getting out and supporting all of our kids.
This is my goal for the new year (hate resolutions). Support myself, support my family, support my community. I can lose those pounds, have fun, help our children feel a little bit better. Now, I know I can’t make all the games and meets but I will get to all that I can. So if your feeling up to it come join me on the ELLENVILLE DIET. Help yourself, and help restore that sense of community that can make small town life so special. By the way I lost 8lbs. over the last 4 days.
