Preserving your knees and hips - avoiding the joint replacement syndrome

On my way back from the New Orleans Jazz Festival, I read an interesting article in the NY Times called Caring for Hips and Knees to Avoid Artificial Joints (http://www.nytimes.com/2010/04/24/health/24patient.html).  This is an area of great interest to me because as the article points out, 400,000 of these procedures for bad knees and hips are done yearly.  The article is typical advice that I see from the medical community that thinks inside the box.  They recommend the following which you can read in the article

1. Control Your Weight
2. Go Low Impact
3. Avoid Injury
4. Get Fit
5. Be Skeptical

Overall, most people will read this and since it really is very general, most people will not learn much from this.  Since this is my blog, I will go much further and perhaps, not make too many friends in the orthopedic community.  I will address each of these points and give you much better direction on this.

We are all built differently and body style determines how we are to function throughout our lives and also predisposes us to having problems in our knees and hips.  This is especially true for those of you who are built asymmetrically (most chiropractic clientèle). Early detection and intervention with foot orthotics, education and  even myofascial therapy goes a long way to preserving our body parts.  We can start by screening kids at the age of 6 either in the chiropractors office or teach pediatricians a little about the musculoskeletal system so they can give advice that is better than the typical growing pains diagnosis I hear from many patients.If we addressed body style early on, we could eliminate many of the suggestions in the article.

Control Your Weight - It has been established that being overweight, especially severely overweight will wear down the joints.  While this is certainly true, many overweight people never need joint replacements.  What is different about them?  The bottom line is structure determines function.  If you have poor structure, and you add weight to it, it will fail much sooner.  If you lose the weight, and have poor structure, your joints will likely go bad anyway.  My recommendation is that you address structure first and our office specializes in this.  During the months of May and June, we are having our annual Spring Feet Checkout so people can be looked at for free to determine of foot problems are leaving them prone to having knee, hip and back problems.

Go Low Impact - Many people go high impact and never need joint replacements.  On the other hand, Sports like basketball, especially in adolescent girls is known to damage cruciate ligaments because as they mature, their hips get wider and any foot problems will exacerbate this.  The ultimate cause has to do with the way their core responds to their body style.  Ultimately, girls with these issues have an unstable core which loads the knee joint.  Recommending a sedentary lifestyle is not a great idea.  Why not actually understand, diagnose properly and then come up with an intelligent solution to a functional problem.

Avoid Injury - Duh. Get your body mechanics checked out, get it fixed and then load it up.  Common sense at its best. Certain sports like football take out knees from impact by others upon the knee.  Tackle football is likely not healthy for knees as many pro football players will attest to in their later years.  Many baseball players on the other hand still have their original knees and hips into their golden years.

Get Fit - A stable core will improve knee function.  Foot orthotics will improve knee function.  If your core is unstable, it will load the knee, the legs will tighten and so will your shoulders and neck.  The knee is rarely the problem, and the structure usually is

Be Skeptical - Sure, there are many things like Condriotin Sulfate which have been said to help arthritic knees and other joints as well as other potions.  Taking this further, many people with knee pain going to orthopedic physicians have meniscus surgery again and again and again.  Eventually, at great cost, they replace the once healthy joint with another prosthesis that comes with no warrantee and will likely need replacement again years later.  Since the original body mechanics that destroyed the joint in the first place were never addressed, these joints are likely to fail sooner than later because we addressed the symptom of the bad knee and not the real problem of how did it get there in the first place.

My advice for people with bad knees is not to let that happen to their children.  Make them aware that unless they have themselves checked, they too are likely to suffer from this since they come from the same gene pool and are likely not only looking like you but are walking like you too.

Check out out website at www.backfixer1.com or our site for runners at www.njrunningdoc.com for further helpful information.

Is salt and sugar really making our society ill?

Yesterday, Reuters reported that our intake of salt and sugar is helping to make us ill, raise our cholesterol and our blood pressure (http://www.reuters.com/article/idUSTRE63J69U20100420).  There are many food gurus that have been critical of the american diet for some time.  People like the taste of salty and sugary foods and the food industry has given them what they wanted.  There is a movement in government to attempt to regulate the amounts of this gradually in our foods.  

In the restaurant industry, items that do not sell do not last.  If foods that have excess sugars, starches and salt is what sells, it is only natural for them to produce what people want.  Unfortunately, we pay for it years later with higher medical costs which may have been prevented.  It has been recommended that the U.S. Food and Drug Administration begin to regulate the amounts of this in food.  While I applaud their ideas and their efforts, this is just a small part of a greater problem.  Most processed foods are full of salts and sugars, with one of the worst being corn based fructose sweeteners, which our body does not understand and cannot process well. We pay farmers to grow corn for the purpose of making corn sweeteners and pay them not go grow other things.  People who are poorer often do not buy certain foods that are healthy for them because of their cost.  On the other hand, Kraft macaroni and cheese which is all chemicals and salt is dirt cheap.  Even when I was a student and much poorer, I would often use this this as a cheap meal.  What would happen if we asked farmers to grow food and then made it so the cost was less in the supermarket, perhaps less than Kraft macaroni and cheese?  My guess is people would eat food that is better for them.  

I also think that we can make prepared meals healthier as well by using less salt and other preservatives.  We probably need a different model for todays busy lifestyle so the fast food we purchase not only tastes good but is good for you.  If we think of all the money we spend on disease, doesn't it make sense that preventing it with better diets will be a better way to live.

Since it is spring, I am again trying to create a successful garden in my back yard.  Many of us were disappointed last year because of the weather but this year can be a winner.  The best food is that which is right off the plant.  If you have never tried to create your own garden, perhaps, this may be your calling for better food, which you now control since it came right from your garden.

What do you think? I value your comments.

Expanding Chiropractic Services Under Medicare - The Effective Truth

I had just read about the report to congress on the evaluation of the demonstration of coverage of chiropractic services Under Medicare.   For those who are covered by Medicare and have never understood why chiropractic was so poorly covered by Medicare, your ship may be arriving shortly. Chiropractic was hastily added to the Medicare program in the 1970's with the inclusion of spinal manipulation only.  Our patients know that manipulation without working the muscles of the body which attach to them is often of minimal benefit however, politics has so far prevented full inclusion as it did in the 70's.  Our profession has lobbied hard for full inclusion because it is a detriment to the public's welfare to leave things the way they are.  Most seniors do not or cannot understand why other doctors are covered for all their services yet, their visit to the chiropractor is more expensive because of this. It makes little sense, especially after the study I will tell you about in the following paragraph.
 
The government ran a study a while back giving chiropractic full benefits in three areas of the country a couple of years ago.   They study showed  that under medical treatment, 11% of the people reported relief of pain.  When you compare this to 60% of the respondents who used the chiropractors reporting relief of pain, without the use of drugs, convincing seniors to visit chiropractors first for back pain, neck pain, and other problems should be a priority. How can the government not cover chiropractic services fully after study results such as these?   The current coverage is a vestige of the 1970's when chiropractic was less accepted.  With statistics like these, the government should be racing to get this passed into law.  Statistics are statistics and the truth is coming out about the effectiveness of chiropractic especially with senior populations.  Stay tuned and hopefully, we will see chiropractic fully covered in Medicare.  I will let you know when this occurs.

N.J. hospitals treating more patients for prescription drug overdose, report says

I just read this article in todays star ledger (http://www.nj.com/news/index.ssf/2010/04/nj_hospitals_treating_more_pat.html).  One of my peeves is the success of pain killers, especially prescription pain killers.  Many are quite addictive. In my experience, many people turn to these because their doctor thought pain relief was the best way to handle their pain.  In my opinion, dealing with the symptom which is pain rather than dealing with the underlying cause of the pain is going to have long term effects that will degenerate their joints and make other problems more chronic.  Today, I saw an older woman in horrible pain in her back and the solution from her orthopedist for what ails her in her knee, hip or back is a cortisone shot.  Finally it came to a head and she could barely stand in my office as I tried desperately to help relieve her discomfort.  There is a better way...

In my world, I look at the person, not just the painful parts.  I get an understanding of their level of function and then try to find the cause.  No drugs, no short cuts, just good medicine.  It is always good medicine to know what you are treating before you treat it.  It is bad medicine to offer pain relief of something you do not understand while pretending you do, only to have the person get much worse because the original problem was neglected.  Some of those people who take the pain relieves do get hooked on them and drug makers know they are not treating but just relieving pain.  Granted, there is a great market for this stuff and there are many people who buy into the drug model, to their peril.  In the end, health care costs go up, our insurance pays for the hospital visit to detox us and as we get older, we are less well.

Prescription drug overdose - a symptom of a health care system that needs to rethink its goals, its training and its purpose.

What do you think?  I value your opinions.

The Rise and Fall of Patented Genes - The patent office has really done it this time.

Did you see the 60 minutes piece on patented genes (http://www.cbsnews.com/video/watch/?id=6362525n&tag=contentMain;cbsCarousel). This was a real eye opener. A number of years ago, the patent office allowed bio tech companies to patent the genes in your body if they uncovered possible links to functional diseases. One of the most used/abused was the BRAC1/BRAC2 genes which are linked to breast/ovarian cancers. In the back of the minds of most women in our society is the fear of a cancer being discovered. These genes, if mutated, increase the likelihood causing women to prophalactically remove their breasts and their ovaries. Having these mutations does not mean you will get cancer, but it does say the likelihood is increased. This disturbing trend was just curtailed by a lawsuit challenging the decision to patent genes which has not only made the cost of doing the test ridiculous ($3200), but if you wanted to get a second opinion, you couldn't because only one company could do it, namely, the company who owns the patent. I personally do not believe we understand the true underlying cause of cancer so rash decisions made under the fear of possibly or possibly not getting sick and dying does not empower us to make great decisions. The patenting of something occurring in nature is a perversion of the patent process and should become a thing of the past. I believe it hampers research and unnecessarily raises the cost for gene mapping which may have an increase value as we understand it better and come up with better solutions on how to improve humanity with the new information we now have at our finger tips.

Check out the 60 minutes report at the above link. While I believe some people do believe in competition, this is clearly people using the patent office to monopolize genes their research has discovered. True, a company who paid for the research deserves to be compensated for the risk/reward but how can one patent something that occurs in nature that we just happened to discover as we become more knowledgeable about genetics? I understand the company that patented the BRAC1 and 2 genes has appealed this decision. I hope they lose because they have already been paid handsomely for this patent and because genes should simply not be patentable. Cures for genetic ailments on the other hand should be because the cure is not naturally occurring in nature and this is a process someone or some entity created to get a curative result. In my opinion, they should be able to profit there and we would not have patents standing in the way of more effective cures and research.

One more thing is that we need to find the underlying cause for cancers and understand what cancer is, vs what we do now which is scaring, scarring and testing and scaring people to death of death from an entity we still really do not understand and using chemo which is a crap shoot treatment which helps some, and ignoring other inventive ways that are not as profitable to administer or seem heretical at the time but get to the heart of the problem.

What do you think? I welcome your comments.

Florida doctor tells patients who voted for Obama to go elsewhere - What are your thoughts?

I read yesterday that a doctor in florida (Mount Dora) had a sign in his office telling his patients who voted for our president to go elsewhere (http://www.palmbeachpost.com/news/state/health-care-reform-starts-now-for-mount-dora-509473.html). Is this really freedom of speech and is this really appropriate for a health care provider? Apparently, the doctor was against the health care reform process and decided to alienate anyone who may have disagreed with him.

Read the article, which has a photo of the sign. In my opinion, healthy discussion about health care reform is inevitable however this, on the other hand is inappropriate. One should wonder why so many doctors did not want reform.

As a health care provider, In my opinion, reform may render doctors such as this obsolete, since the trend will be toward primary care and away from treating the body as the individual parts instead of the sum of its parts and the integrated systems that encompass it. Maybe this is why so many high end specialists are scared of reform? Could the writing be finally on the wall for those who focus on tests and procedures, rather than on cost effective care and results.

What do you think?

I welcome your opinions

Is toughing out a sports injury a good idea?

Yesterday, the NY Times published an article called Sports Injuries: When to Tough It Out(http://www.nytimes.com/2010/04/01/fashion/01best.html). I this article to be interesting because it interviewed a number of physicians who shared their philosophy and most recommended not seeing a family doctor for these types of injuries. It seems they believe their own profession is most likely to take athletes out of their activities and many recommend that you just try to train through it.

Our offices are filled with athletes who tried to just train through it. The fact that medical professionals do not trust medical professionals with sports injuries that are of gradual onset is telling. The question of course is who do/should you trust? In the minds of most athletes, the answer has commonly become chiropractic sports physicians. The International Olympic Committee has a director who is a chiropractor and this year two chiropractors were officially at the games for the american team and the athletes want it that way.

What should you do with an athletic injury: Trust a family doctor with minimal training for this or a chiropractor athletes rely on? I welcome your thoughts.

Chocolate and Your Heart - Some delicious news

A recent study published in the NY Times yesterday (http://www.nytimes.com/aponline/2010/03/30/health/AP-EU-MED-Heart-Healthy-Chocolate.html)states that people who had an average of six grams of chocolate per day -- or about one square of a chocolate bar -- had a 39 percent lower risk of either a heart attack or stroke as per a new study to be published Wednesday in the European Heart Journal. My wife will love the implications of this study since it vindicates other previous studies that has come up with similar determination with the exception being this one has been done over a much longer period of time.

Overall, this is not a direct recommendation to eat tons of chocolate however, it does show that small amounts of the stuff is beneficial in our diets. Read the article. I welcome your comments.