I was reading in the news today and read that a federal panel has a familiar prescription to reduce hypertension, something that has the potential to cause heart problems and raise health care costs in this country if untreated (http://www.latimes.com/news/nation-and-world/la-sci-hypertension23-2010feb23,0,4388789.story). They indicate the incidence of hypertension has increase by 25% in the last decade. Many packaged and restaurant foods use salt as a cheap way of adding flavor and as we rely on these types of meals, we exceed the recommended daily allowance of salt by at lease 50%. Many physicians are rushed because of our current health care systems reluctance to pay them for time spent, which has created the quick office visit and the receipt of a script for a drug that will help the kidneys lower your blood pressure artificially (thank you insurance industry for introducing this problematic paradigm - cost effective not!!!!!!!!!). Most physicians would love to spend more time with their patients and would except for the fact it would put them out of business which is why some no longer take insurance and instead charge a fair rate for their time and caring (a better paradigm IMHO).
To summerize, the panel advocates that you
1. Reduce your weight - has a positive effect on blood pressure.
2. Reduce your salt intake.
3. Eat more fruit, vegetables, lean protein.
I would add the following
1. Get evaluated by your chiropractor periodically - studies show problems in the spine will affect blood pressure and getting a periodic adjustment is helpful. Your bodies neurology is part of the equation.
2. Get regular exercise - your cardiovascular system will become more efficient.
Tuesday, February 23, 2010
Sunday, February 21, 2010
Adult Track and Field in Toms River NJ 2-21-10 - Check it out
Saturday, February 20, 2010
Avandia Diabetes Drug, another one bites the dust
The New York Times reported today that avandia (http://www.nytimes.com/2010/02/20/health/policy/20avandia.html) which has been given to those with type 2 diabetes is responsible for 500 heart attacks and 300 cases of heart failure monthly. So much for the drug paradigm under allopathic ideals being safe. Many doctors having seen the writing on the wall for this one have switched to other meds.
Meanwhile, there is a growing amount of evidence that the sweetner corn based fructose may have alot to do with obesity and many of the cases of diabetes that occur. The mayo clinic gives these recommendations (http://www.mayoclinic.com/health/type-2-diabetes/DS00585/DSECTION=treatments-and-drugs) however, their opinions are based on not the why but the management.
It is my opinion that there are larger issues at work to find out why people develop the disease and are there better ways to treat it other than medication on the horizon? I also believe that what you eat determines your health in a big way. There are alternative regimens that offer non drug alternatives to management (http://altmedicine.about.com/cs/conditionsatod/a/Diabetes.htm) which may have as much or more validity that the pharmaceutical model now accepted but is of questionable long term safety. Maybe we need to rethink what we do, what we eat and make those changes a cultural phenomenon.
I do not endorse the sites I posted here but do ask you read everything and form your own opinions.
Friday, February 19, 2010
Steroids for asthma and better alternatives through chiropractic
Today I had read in the NJ Star ledger about the problems with the current inhalers such as advair (see below)
"GlaxoSmithKline (GSK) shares are down about 1.5% after the U.S. Food and Drug Administration warned against long-term use of its asthma treatments, Advair and Serevent. Advair is the British pharmaceutical firm's best-selling product, but could now suffer a serious blow following regulators' call for further study of potential health risks. Advair had total sales of 1.366 billion euros ($1.859 billion) in the fourth quarter of 2009, of which more than half -- 704 million euros ($958 million) -- came out of the U.S.
The new label warning isn't limited to Glaxo's meds; Novartis's (NVS) Foradil and AstraZeneca's (AZN) Symbicort are affected as well. The four widely used asthma treatments belong to a class of drugs known as long-acting beta agonists (LABAs), which open airways. Other steroid-based meds control inflammation. The new label warns that LABAs "should never be used alone in the treatment of asthma in children or adults," and should be used only for the "shortest duration of time required to achieve control of asthma symptoms," then discontinued. These medicines can actually worsen asthma symptoms, the FDA said, "leading to hospitalization in both children and adults and death in some patients with asthma."
"GlaxoSmithKline (GSK) shares are down about 1.5% after the U.S. Food and Drug Administration warned against long-term use of its asthma treatments, Advair and Serevent. Advair is the British pharmaceutical firm's best-selling product, but could now suffer a serious blow following regulators' call for further study of potential health risks. Advair had total sales of 1.366 billion euros ($1.859 billion) in the fourth quarter of 2009, of which more than half -- 704 million euros ($958 million) -- came out of the U.S.
The new label warning isn't limited to Glaxo's meds; Novartis's (NVS) Foradil and AstraZeneca's (AZN) Symbicort are affected as well. The four widely used asthma treatments belong to a class of drugs known as long-acting beta agonists (LABAs), which open airways. Other steroid-based meds control inflammation. The new label warns that LABAs "should never be used alone in the treatment of asthma in children or adults," and should be used only for the "shortest duration of time required to achieve control of asthma symptoms," then discontinued. These medicines can actually worsen asthma symptoms, the FDA said, "leading to hospitalization in both children and adults and death in some patients with asthma."
One of the methods that has helped many asthma sufferers is chiropractic care. The reason I believe it is helpful is that the chiropractic adjustment normalizes the bodys neurological response and also makes rib movement improve with the adjustment. In order to properly breathe, the ribs must expand. Rib misalignments and muscular tightness from many attacks can be relieved by chiropractic intervention. The side effects are only some soreness after the adjustment which will typically dissapate quickly. Seeing a chiropractor is much safer and does not cause more attacks of asthma as these drugs do. Most medical providers should consider this as an alternative to the classic urge to recommend steroids for inhalation treatment. The other benefit is that since the musculoskeletal system is part of a system , so as this improves functionally, so do other body functions and mechanisms as well. For instance, it is not unusual for stomach problems to also improve from those same spinal treatments.
The more we hear about drugs and their side effects, the more I recommend people see a chiropractor and make this a larger part of their wellness strategy.
Tuesday, February 16, 2010
Health Care Reform, what is wrong with this picture
Health care reform was attempted by President Clinton and we know how that went. Along comes a new president who believes he has the conviction and the management style to get it done finally. I applaud him for this however there are problems that the current reforms fail to address.
1. Our current system is a monopoly with a drug biased ideology. It is based heavily on Allopathy which is very symptom based. In many areas of the world, there are many types of health care providers who feed the system, both drug and non drug based. In our country, the providers who feed the system (hospitals, specialists, etc are educated and inundated with the philosophy of drug based care supported by pharmaceutical interests. Since there is no true competition (there are provider groups like chiropractors and other complementary providers being used by the public in increasing numbers) to this system, it has become overpriced in many respects and bloated. Many of the preventative regimens are not preventative at all but are invasive and many of these ideas are pushed as part of preventative care. Unfortunately, many of these have not been proven to improve our quality of life long term, while it is of high cost and the social costs as well as the cost of treating the side effects of these interventions has been quite high. Many procedures done to resolve symptoms and many tests done to diagnose them are a result of our lack of understanding of the integrated systems that make up the body. In other words, the body dysfunctions in systems, and we are the sum of our functioning parts which is part of the whole. This differs from what health care has turned into which is overspecialization where doctors look at your parts rather than the hole. In parts of the country with fewer specialists and more primary care, the overall costs are lower and people do better under the healthcare system. Unfortunately, insurance companies have over reimbursed the specailsts and starved the primary care model causing patients to have visits that are more brief even if more time would yield better thought processes, less testing and better doctoring.
2. We need tort reform and we need better medical practices. Malpractice rates for chiropractic have always been very low based on safety and risk, however, many medical providers pay very high rates for their insurance because of lawsuits. Some of these are justified however, without limits and large pain and suffering rewards, it has pushed the rate of insurance upwards. Many doctors practice defensive medicine because they can be sued if they avoided a test or for another technicality. In many instances, it is justified, and in others, it is a product of the fact that physicians are penalized financially if they spend too much time with a patient and rewarded if they order or perform procedures. This is not only risky, but also has contributed to more doctors being sued and as we learned from the first section of the blog, it has been shown that less is more with regards to patient care. More specialists costs more but does not make them healthier which leads to further tests, etc. Some things like childbirth are risky and as long as the doctor did not violate community standards during a childbirth, they should not have to fear reprisals if they did everything right and the delivery did not. Most OB's have very expensive malpractice which has deterred many from delivering babies which sends the wrong message. In closing, we need better medical practices that are rewarded for results, not doing more and doctors should be reimbursed for their time, rather than for performing procedures that add further risk.
3. Medical Ethics. When is technology appropriate and when is it not and at what age do certain interventions have little benefit? This is a tough question because there are many babies that would not make it without an incubator and even with it may have horrible chronic problems during the rest of their lives. Other children with genetic malformations or disease processes who would otherwise not survive and kept alive but their quality of life is horrible until the inevitable end. These excesses are horribly expensive and have little benefit. Are we really helping by keeping a dying child alive further torturing the child, the family and financially draining them. This is an ethics question to be sure.
On the other end of the spectrum, when is enough care enough. At what age do cholesterol lowering drugs serve no benefit. Recently, a study suggested that men over 85 should no longer have PSA tests because many of them are positive, and the therapy or surgery caused more problems than they had before at great cost. At what point do we leave them alone? This is another ethics question.
4. Results orientated reimbursement - Now we have a more is better ethos and about 1/2 of our health care resources for a person gets used up in the last year of life with no change in the outcome. Doctors with better outcomes of all types should be rewarded. Cost effectiveness should be rewarded.
5. Paradigm Shift - We need to move from a disease and sickness model to a wellness model. We need to question the benefits of many tests that justify a drug but do not improve a patients quality of life or have a measurable improvement on ones lifespan. With all the information on cholesterol lowering drugs, the long term estimate is that these meds may improve life spans a year or two while having many side effects. Is this type of intervention worth it?
We need to get back to basics, where primary care handles many conditions cost effectively and allow other providers such as chiropractors, natropaths, napropaths, acupuncturists, nurse practitioners and others be point of first contact providers. In my own profession, we are terrific as first contact for musculoskeletal problems, weather in workers compensation or in general care of the population. Most medical providers are less comfortable with this but are more comfortable with diseases and hospital coordination. Provider Groups must work more hand in hand for better patient experiences.
6. Central data bases for health care records with less duplication and better care coordination. Having all patients medical records will allow for better coordination of care between providers of health care both local and across the country. Currently, many tests are duplicated because a provider cannot go into a national data base and pick out what they need. We are closing in on this slowly.
7. Sanity on in and out of network fees. Medicare actually started the upward spiral of medical costs by issuing a blank check in the 1970's when it was young. doctors sent in bills and Medicare paid it. Many medical/surgical fees are outrageous and are supported by the fact we have insurance. Coding for health care has become a game, manipulated by providers and by insurers which has helped health care costs march onward. Insurance carriers have made changes such as primary care doctors no longer being reimbursed for vsiting their patients in the hospital. Many have hired hospitalists who visit you for a minute, charge you handsomely and report to the doctor. Many doctor would prefer to visit their own patients but not if they do not get paid.
8. Insurance companies have blown managed care and instead of cost savings, they have squeezed consumers into more restrictive plans for their benefit, not the benefit of the patient. This yearly bait and switch has allowed insurance carriers to be very profitable and pay themselves and their investors instead of paying for care. They have become owners of parts of the market and the patients and physicians are merely pawns. We need a public option run by a non insurance entity who can help explore an evidence based paradigm for better care in the future. We also should have this paid for by a VAT (value added tax) so it is properly funded rather than our current recommendations which make us partners with the people who created the problem in the first place. It also makes it so if you lose your job, you still have insurance. Doctors should be paid fairly for their services, and their patients should be charged fairly for what is done in their best interest. This is different from the free for all money care we have now. It is also simpler to have one insurance with one set of rules rather than a medicaid (paid for partially by the states with low reimbursement), medicare (for seniors over 65 mostly, and has better reimbursement for most primary care and point of contact physicians ) and the regular insurance which is all over the place but generally pays poorly in network and way too handsomely out of network. How about one carrier, properly funded that works toward a model of preventative care that helps the puiblic.
These are some of my questions and thoughts. I know the problem is more complex but our paradigm is broken and is making people broke. If it does not get fixed (the current proposals do little to fix the paradigm but does address some of the problems of coverage and affordability), the costs will continue to balloon and we will all find ourselves paying cash for care. This will force the current model into a tailspin and many doctors will likely leave the profession if they cannot earn a living. If the current model does collapse, it could mean true reform of the painful kind. Hopefully, our government can come together after tuning out some of the noise and put together a better system for all of us. Health care dollars should go toward healthcare, not corporations and americans should not be drug addicts without realizing they are. Perhaps, we will find a better way.
1. Our current system is a monopoly with a drug biased ideology. It is based heavily on Allopathy which is very symptom based. In many areas of the world, there are many types of health care providers who feed the system, both drug and non drug based. In our country, the providers who feed the system (hospitals, specialists, etc are educated and inundated with the philosophy of drug based care supported by pharmaceutical interests. Since there is no true competition (there are provider groups like chiropractors and other complementary providers being used by the public in increasing numbers) to this system, it has become overpriced in many respects and bloated. Many of the preventative regimens are not preventative at all but are invasive and many of these ideas are pushed as part of preventative care. Unfortunately, many of these have not been proven to improve our quality of life long term, while it is of high cost and the social costs as well as the cost of treating the side effects of these interventions has been quite high. Many procedures done to resolve symptoms and many tests done to diagnose them are a result of our lack of understanding of the integrated systems that make up the body. In other words, the body dysfunctions in systems, and we are the sum of our functioning parts which is part of the whole. This differs from what health care has turned into which is overspecialization where doctors look at your parts rather than the hole. In parts of the country with fewer specialists and more primary care, the overall costs are lower and people do better under the healthcare system. Unfortunately, insurance companies have over reimbursed the specailsts and starved the primary care model causing patients to have visits that are more brief even if more time would yield better thought processes, less testing and better doctoring.
2. We need tort reform and we need better medical practices. Malpractice rates for chiropractic have always been very low based on safety and risk, however, many medical providers pay very high rates for their insurance because of lawsuits. Some of these are justified however, without limits and large pain and suffering rewards, it has pushed the rate of insurance upwards. Many doctors practice defensive medicine because they can be sued if they avoided a test or for another technicality. In many instances, it is justified, and in others, it is a product of the fact that physicians are penalized financially if they spend too much time with a patient and rewarded if they order or perform procedures. This is not only risky, but also has contributed to more doctors being sued and as we learned from the first section of the blog, it has been shown that less is more with regards to patient care. More specialists costs more but does not make them healthier which leads to further tests, etc. Some things like childbirth are risky and as long as the doctor did not violate community standards during a childbirth, they should not have to fear reprisals if they did everything right and the delivery did not. Most OB's have very expensive malpractice which has deterred many from delivering babies which sends the wrong message. In closing, we need better medical practices that are rewarded for results, not doing more and doctors should be reimbursed for their time, rather than for performing procedures that add further risk.
3. Medical Ethics. When is technology appropriate and when is it not and at what age do certain interventions have little benefit? This is a tough question because there are many babies that would not make it without an incubator and even with it may have horrible chronic problems during the rest of their lives. Other children with genetic malformations or disease processes who would otherwise not survive and kept alive but their quality of life is horrible until the inevitable end. These excesses are horribly expensive and have little benefit. Are we really helping by keeping a dying child alive further torturing the child, the family and financially draining them. This is an ethics question to be sure.
On the other end of the spectrum, when is enough care enough. At what age do cholesterol lowering drugs serve no benefit. Recently, a study suggested that men over 85 should no longer have PSA tests because many of them are positive, and the therapy or surgery caused more problems than they had before at great cost. At what point do we leave them alone? This is another ethics question.
4. Results orientated reimbursement - Now we have a more is better ethos and about 1/2 of our health care resources for a person gets used up in the last year of life with no change in the outcome. Doctors with better outcomes of all types should be rewarded. Cost effectiveness should be rewarded.
5. Paradigm Shift - We need to move from a disease and sickness model to a wellness model. We need to question the benefits of many tests that justify a drug but do not improve a patients quality of life or have a measurable improvement on ones lifespan. With all the information on cholesterol lowering drugs, the long term estimate is that these meds may improve life spans a year or two while having many side effects. Is this type of intervention worth it?
We need to get back to basics, where primary care handles many conditions cost effectively and allow other providers such as chiropractors, natropaths, napropaths, acupuncturists, nurse practitioners and others be point of first contact providers. In my own profession, we are terrific as first contact for musculoskeletal problems, weather in workers compensation or in general care of the population. Most medical providers are less comfortable with this but are more comfortable with diseases and hospital coordination. Provider Groups must work more hand in hand for better patient experiences.
6. Central data bases for health care records with less duplication and better care coordination. Having all patients medical records will allow for better coordination of care between providers of health care both local and across the country. Currently, many tests are duplicated because a provider cannot go into a national data base and pick out what they need. We are closing in on this slowly.
7. Sanity on in and out of network fees. Medicare actually started the upward spiral of medical costs by issuing a blank check in the 1970's when it was young. doctors sent in bills and Medicare paid it. Many medical/surgical fees are outrageous and are supported by the fact we have insurance. Coding for health care has become a game, manipulated by providers and by insurers which has helped health care costs march onward. Insurance carriers have made changes such as primary care doctors no longer being reimbursed for vsiting their patients in the hospital. Many have hired hospitalists who visit you for a minute, charge you handsomely and report to the doctor. Many doctor would prefer to visit their own patients but not if they do not get paid.
8. Insurance companies have blown managed care and instead of cost savings, they have squeezed consumers into more restrictive plans for their benefit, not the benefit of the patient. This yearly bait and switch has allowed insurance carriers to be very profitable and pay themselves and their investors instead of paying for care. They have become owners of parts of the market and the patients and physicians are merely pawns. We need a public option run by a non insurance entity who can help explore an evidence based paradigm for better care in the future. We also should have this paid for by a VAT (value added tax) so it is properly funded rather than our current recommendations which make us partners with the people who created the problem in the first place. It also makes it so if you lose your job, you still have insurance. Doctors should be paid fairly for their services, and their patients should be charged fairly for what is done in their best interest. This is different from the free for all money care we have now. It is also simpler to have one insurance with one set of rules rather than a medicaid (paid for partially by the states with low reimbursement), medicare (for seniors over 65 mostly, and has better reimbursement for most primary care and point of contact physicians ) and the regular insurance which is all over the place but generally pays poorly in network and way too handsomely out of network. How about one carrier, properly funded that works toward a model of preventative care that helps the puiblic.
These are some of my questions and thoughts. I know the problem is more complex but our paradigm is broken and is making people broke. If it does not get fixed (the current proposals do little to fix the paradigm but does address some of the problems of coverage and affordability), the costs will continue to balloon and we will all find ourselves paying cash for care. This will force the current model into a tailspin and many doctors will likely leave the profession if they cannot earn a living. If the current model does collapse, it could mean true reform of the painful kind. Hopefully, our government can come together after tuning out some of the noise and put together a better system for all of us. Health care dollars should go toward healthcare, not corporations and americans should not be drug addicts without realizing they are. Perhaps, we will find a better way.
Tuesday, February 09, 2010
Snow and how to move it safely.
1. Use a fencers stance when pushing or lifting snow. It will help you protect your lower back.
2. If the temperature is in the low 20's the snow will be powder like and light. If the temperature is closer to 30, the snow flakes will be larger, wetter and heavier. Push and lift accordingly.
3. Snow that has been pushed against your driveway by the plow is always heavier. Dig , push and lift with caution.
4. If you are getting out of breath and are older, take frequent breaks. People suffer heart attacks moving snow and you do not want to be a statistic.
5. If you are sore and it is getting worse after shoveling, call us.
Sunday, February 07, 2010
The Ultimate Cold Fighting Regimen
There are many people who have colds, and I am one of them. You can however, get more control over how you feel and how long these symptoms persist with my simple plan that I have outlined below. Most people who have colds can benefit from this regimen.
1. Echinacea (helps fight cold viruses as the body is being attacked)
2. Amino Lysine 400 IU
3. 5000 mg vitamin c powder - one level tsp taken with orange juice
Take this as follows
At the onset of symptoms, take a tablet of Echinacea per ever two hours for 3-4 doses total. Echinacea is only effective at the onset. If you are well into the symptoms, don't barther.
Vitamin C powder - take ever two hours. If you begin to get diahrea or feel gassy, stop taking it. This means you have saturated your body. Vitamin C powder acidifies your system and gives it a fighting chance. Typically, colds make your body basic. If you are on medications that are altering your body chemistry, check with your pharmacist first. You can then take doses of this periodically as the symptoms begin to abate.
Amino Lysine is anti viral and can be taken with the vitamin C powder.
This regimen will shorten colds, get you feeling better faster. If you have a really nasty virus, you may find that it takes many doses of vitamin C to get to the point of diahrea or gassiness. If it is mild, you may reach this with one or two doses.
1. Echinacea (helps fight cold viruses as the body is being attacked)
2. Amino Lysine 400 IU
3. 5000 mg vitamin c powder - one level tsp taken with orange juice
Take this as follows
At the onset of symptoms, take a tablet of Echinacea per ever two hours for 3-4 doses total. Echinacea is only effective at the onset. If you are well into the symptoms, don't barther.
Vitamin C powder - take ever two hours. If you begin to get diahrea or feel gassy, stop taking it. This means you have saturated your body. Vitamin C powder acidifies your system and gives it a fighting chance. Typically, colds make your body basic. If you are on medications that are altering your body chemistry, check with your pharmacist first. You can then take doses of this periodically as the symptoms begin to abate.
Amino Lysine is anti viral and can be taken with the vitamin C powder.
This regimen will shorten colds, get you feeling better faster. If you have a really nasty virus, you may find that it takes many doses of vitamin C to get to the point of diahrea or gassiness. If it is mild, you may reach this with one or two doses.
Wednesday, February 03, 2010
Jerry Rice and Chiropractic - A Top NFL Receiver Credits Much of His Success to Chiropractic Care
Former NFL wide-receiver Jerry Rice says, ""If I had everything in alignment, I knew I could play my best football." His training routine included twice-weekly chiropractic adjustments, which helped his body recover from all the hard hits and countless tackles. Because he firmly believed in the benefits of chiropractic, his teammates began to favor this natural care over the medications that trainers traditionally give. "I wanted to set the standard within football," said Rice. "I knew if chiropractic helped me put up outstanding numbers, it could help my teammates do the same."
Read more at: http://www.chiroeco.com/chiropractic/news/8892/52/jerry-rice-reveals-secrets-to-long-healthy-career-/
Read more at: http://www.chiroeco.com/chiropractic/news/8892/52/jerry-rice-reveals-secrets-to-long-healthy-career-/
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