Diary of a NJ Chiropractor

I'm taking bigger steps, my wife says

2011-03-09T07:25:00.000-08:00

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The genetics of back pain - is back pain genetic or does a genetic trait cause back problems in families?

2011-03-08T20:46:00.000-08:00

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Lower Back Pain Study Shows Chiropractic is Most Effective Treatment Long Term

2011-03-07T11:43:00.000-08:00

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The US healthcare monopolies, and how cost shifting costs us

2011-03-05T08:11:00.000-08:00

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Better options for tendon problems - Hint; the tendon is a symptom, not the problem

2011-03-03T07:43:00.000-08:00

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New article in NY Times talks about new theories about side stiches

2011-03-01T18:02:00.000-08:00

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The Equation Of Running And Winning Free Of Pain

2011-03-01T10:52:00.000-08:00

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Should children run marathons - something every runner should consider reading

2011-02-25T09:58:00.000-08:00

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Jack La Lane was a chiropractor. I didn't know that and more...

2011-02-22T12:13:00.000-08:00

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USA Track and Field NJ y Open & Masters Indoor Track & Field Championships

2011-02-20T17:28:00.000-08:00

Today, 2-20-11 I was on the medical staff for the USATF open and masters indoor track and field championships at the John Bennett Indoor Athletic Complex in Toms River. As many of my patients already know, I have been their medical director since 1992 and also do my best to make sure that their events have medical staffing which is typically all volunteer.

This particular event features athletes who are at lease 18 years of age and some are in the 80's. Pictured above was the start of the 50 yard dash. Below to the left is one of our patients, Jane Vaneewan who got into track and field when her doctor told her she had some health issues. Rather than take pills, she found track and field and on a given weekend, is a national competitor, often doing at least one if not more events, To the right was an older high jumper. I was watching his jumps which were quite good for his age group. Lastly, the bottom photo was of a high jumper.

I was quite busy today, since we had one runner who I suspect fractured his ankle and another who severely pulled his hamstring. Stuff happens but I was also able to help quite a few runners. When I was packing up and leaving, one of the runners I worked on came over to thank me. I turned out that he had some problems that continually were occurring and he had been through all sorts of therapies which did not work. He ran after I taped his feet and worked on him free of pain for the first time in years. He is planning to visit and bring members of his team he trains with to the office from Pennsylvania because he believes he finally found someone who understands running problems.

It is nice to receive that type of endorsement. I also met a number of coaches who brought over their team members because the liked the way I helped their athletes.I love working with runners and seeing them improve with my treatment. It is quite rewarding which is why I will work for pizza and soda and the occasional T Shirt I receive at an event.

How to stay running injury free this spring

2011-02-17T15:05:00.000-08:00

The weather is finally warming from this deplorable winter and many runners are testing out the roads during some of our warmer February days. As many of our patients who run know, injuries tend to happen when you load up poorly functioning bodies with exercise.

Simple tests to screen yourself and see if your body may require some help before hitting the road.
1. Balance on one leg - This simple test where you balance on each leg, for 30 seconds will tell you if you are likely to have running problems. Lift the leg until your thigh is perpendicular to your body (90 degrees). If you lose your balance on one or both sides, you should visit your chiropractor or muscle therapist to have them find the muscular imbalance and correct it. Often, problems in the back of the calf by the posterior knee are part of the problem as well as the gluteal muscles and the oblique muscles in the abdomen. An imbalance of tension in these muscles will cause you to over and under stride with the net result being pain. Get it checked out by a professional and then hit the road.
2. Crouch down slowly. If you lose your balance or have a hard time getting up from this position unassisted, you are having problems and should have them checked out. Imbalances such as the ones I spoke about in the first test will make it difficult to do this correctly. What will likely happen if you run like this - pain in the hips, shins and the legs will tighten. See a professional before running.

Great warm up exercises before your run
1. Hip Extensions - get on all fours and lift the right leg bent at 90 degrees 10 -20 times. This will help warm up the gluts.
2. Lateral leg raises - While on your side, with the bottom leg bent, lift the top leg straight up for 10 - 20 repetitions.
3. Calf raises - Stand on the stoop on one foot with the ball of the foot on the edge. Let the calf stretch out all the way and then slowly push off and lift your body. Do these 10 -20 times. These are great for warming up the front and the back of the lower leg.
4. Balancing for 30 seconds on each leg - Essentially, this is the same as the test mentioned above. This will help warm up the muscles and prepare them for exercises.

Avoid stretching - little evidence to support this unless we have a young growing child. Exercises is what you should do even if you grew up with the notion that you should stretch before the run. Trust me, you will run stronger with exercises instead.

Other things that may help
1. Foam rollers - especially if the gluts and lateral legs are tight, this will perform a crude form of myofascial release and improve the way you feel during your run. Never do this after exercise, only before
2. Mild stretching after the run to ensure the muscles heal with more flexibility. Gentle, not vigorous.

I hope you find this useful. If you have any questions, or opinions, please forward them to backfixer@aol.com

Fewer scans recommended for lower back pain says a recent NY Times article

2011-02-15T05:54:00.000-08:00

The other day I read about the American College of Physicians recent updated recommendations concerning ordering routine scans such as x rays and MRI for back pain (http://www.nytimes.com/2011/02/15/health/research/15screening.html).

The study states "Routinely ordering X-rays and CT orM.R.I. scans drives up health care costs, and does not help resolve the problem, the college’s “best practice advice” guidelines say. On the contrary, the guidelines suggest, the scans may pick up unrelated abnormalities, leading to additional tests or procedures that are of no benefit, and some scans expose patients to high levels of radiation. The recommendations are the first in a series of papers aimed at helping doctors and patients identify misused medical treatments."

On one hand, I totally agree because many physicians who do not have good evaluation skills for lower back problems will rely on scans that can be expensive in the case of an MRI or CT scan, and the tests either come back negative or show a lesion that may have nothing to do at all with why the person is in pain. A proper evaluation is essential, and requires more than just feeling the muscles, checking reflexes and doing a straight leg raise test, which we are taught in school to do. Many of the newer doctors who specialize in physical medicine such as chiropractors are now using active evaluation methods which tell us much more about what is going on functionally. We can then use a standing lumbar xray to deduce the overall condition of the structures. Unlike many doctors who order lower back films taken on a table, standing films yield more useful information because it shows posture (a component of lower back pain in many cases), alignment as well as other useful information such as the quality of the hip sockets (which can be problematic in older patients).

The big question of course is when is it appropriate. In our office, we typically do not taken plain films in children under 18, unless trauma was involved. Over 18, if I deduce there was trauma or recurrent injuries, films are indicated to determine where the injuries occured and to what extent. Most people over the mid 30's on will likely be candidates for x rays films with trauma or if the problem is recurrent. While we do not perform blanket screenings, the use of plain films is quite helpful, especially in the chiropractic office since we are performing manual work and the films also alert us to anomalies. Recently, an older patient we took films on looked to have a slight curvature in his back. The films showed the curve to be over 30 degrees which is quite significant and alters the way we would treat him. Obviously, this gives us medical necessity.

The article continues by saying "Most lower back pain is caused by strain on bones, muscles and ligaments. It can be treated with over-the-counter painkillers and usually abates within a few days, said an author of the practice guidelines, Dr. Amir Qaseem, director of clinical policy in medical education at the American College of Physicians." Personally, I think this shows the typical lack of true knowledge of what back pain is and why most people are not helped. Pain killers may hide the pain, however, they never fix the body mechanics that create the problem. When you teach legions of primary care doctors that this is what back pain is, which is what typically happens, you get poor patient satisfaction, mediocre outcomes and people developing chronic back problems.

Lower back pain, especially chronic problems, most commonly start at the feet. The more asymmetrical or inefficient your body is designed, the more you tend to suffer from back problems. Our patients know this because they see the results we get, and the way we are able to demonstrate to them where the problems are coming from and how quickly we often can turn these problems around. To dismiss this as strain on bones, muscles and ligaments ignores that all structures against gravity experience this. Not all structures have pain. It is when these structures are overloaded by asymmetrical forces that the back breaks down and joints are damaged. This is why we rarely perform tests such as MRI because
1. most people improve from our care and not only feel better but function better too.
2. Those who do not improve after a reasonable course of care (2-3 weeks) are then referred for MRI or other advanced scans. Since most people improve, few scans are ordered.

This is my opinion based on many years of experience. Of course, I value your opinion too. You can email any questions to backfixer@aol.com

Defying Medical Convention - Dr. Charschan's New Book arriving soon

2011-02-10T06:47:00.000-08:00

Many of our patients know that a few years ago, I decided to write a book on chronic pain for consumers. Like Syms, the clothing chain, they always say " An Educated Consumer is our Best Customer."

In the current american health care system, an educated consumer is their worst customer. This is because the system for many years thrived on people who just took orders from their doctors, took their cholesterol meds because their numbers were not favorable and went for unproven and often ineffective therapies and treatments at great cost that were unreliable, and often dangerous. In many other countries during the healthcare debate that had universal healthcare, where the systems were about the patients and their needs, rather than the systems themselves, they looked at us like we were nuts to not consider universal healthcare. We heard about the horror stories of waits to see specialists, with little mention of the fact that in the end, people who live in these countries will still defend their often imperfect but affordable and cost effective healthcare delivery systems.

One of my biggest frustrations is the way the insurance companies have perverted health care delivery in our country. The American Medical Association has maintained their monopoly on medical practice, owning the coding systems doctors use, making sure care stayed expensive. Doctors were specialized and taught to believe that organs just went bad and that we must find the disease and treat it with the appropriate drug. Tests took the place over the years of good manual (by hand) diagnostic skills and many of these tests come back negative, at a great cost to the system.

In my world or rehabilitation, insurance companies raised the co payments everyone pays, so they essentially pay less and we pay more. In rehab, where people need multiple visits, this makes sense, setting up a financial barrier for the truly needy. With a periodic office visit, a $50 co pay makes sense. With rehabilitation 2-3 times weekly, this quickly creates an economic burden, something insurance was designed to take care of and has now been perverted by the insurance industry so they can make more money for their shareholders. Just recently, Aetna had a great quarter, while they reduced our reimbursements for the umpteenth time and raised your insurance rates.

The healthcare paradigm in the United States is very broken indeed, and more than ever, cost effective solutions are essential. This is why I wrote this book. I often see inappropriate rehab on a wing and a prayer without consistent results. This is largely because the public does not understand chronic pain or why they experience it. This groundbreaking book explains body mechanics in simple terms, why most people suffer from chronic pain and what you as the public can do to get better and more consistent results. It makes you a smarter patient which the health care abhors and helps you find the practitioners who are about the patient, rather than the system. It also offers some self help advice, and some exercises and helps people understand the health care system better.

I plan to get the book in Amazon.com as an e book within the following month,

The cost of managing chronic pain, are there better options?

2011-02-06T19:07:00.000-08:00

I recently came across an article on the NY times regarding Treating chronic pain and its associated costs (http://www.nytimes.com/2011/02/05/health/05patient.html?_r=1&ref=health).

There are many causes of chronic pain as discussed in this article. Most of them are afford-ably treated in our office but many of them never quite get to us. Whether from a bad lower back disc, or from a bad auto accident, or from functional mechanical pain, many of the patients who have visited us have already seen the neurologist, the orthopedist, the rehab therapist, the rhumatologist, all at great cost from the care, the injections, the medications and other types of interventions, many of which have little worth because quite simply, they are expensive and have little effectiveness.

The big problem for most people is that most doctors know little about body mechanics, believe the pain is a disease process and treat problems that they quite frankly, do not understand. This leads to treatments for the pain, rather than the cause of the pain which more often than not can be explained and proved to be mechanical in nature. Mechanical problems require a mechanical based evaluation to understand the problem and finally, require a mechanically based solution. This is why many medically based treatments simply can't work. They do not find the source of the problem and many doctors recommend muscle relaxants believing inflammation just happens which is just ridiculous.

The benefit of seeing a chiropractor is all their solutions are mechanically based and chiropractic has a long history of helping people with chronic pain. In our office, you have the added advantage of myofascial release treatment and Graston techniques, two methods that address the myofascial system, commonly part of the cause of chronic pain syndromes. Secondly, we check out posture and your feet, often at the root of chronic pain. The best part is that care is based on functional improvements that will become more pronounced from visit to visit, resulting in a marked reduction of pain. The other major benefit that as compared to many of the medical rehab and drug based regimens, chiropractic uses no drugs and the rehab is closely tied to manipulative therapy, improved joint function your body will age better because it functions better. Chiropractic should be on the top of the list of treatments people should explore before doing less conservative methods of medical care because quite simply, its more appropriate in most cases.

Big breakfasts don't help you lose weight, study says.

2011-02-03T10:23:00.000-08:00

A recent study published by the NY times suggests having a large breakfast does not decrease the need for or the desire for food for the rest of the day (http://www.nytimes.com/2011/02/01/health/research/01diet.html?_r=1). The recent German study found that a large breakfast only adds to the amount of foot consumed by someone during the day adding to calories consumed .

The bottom line of the study suggests that to decrease overall calories during the day, either eliminate or markedly reduce the size of the breakfast. This should reduce overall caloric intake.

Personally, I love a big breakfast. Often, when I have a large breakfast, I have no problem skipping lunch and because I view food as fuel (being a chiropractor is a physical job and I need the right type of fuel), I avoid the urge to eat lunch and may or may not have a snack. During the normal work week, when I go to the office, my breakfast consists of coffee with milk and 1/2 regular bagel with creamed cheese. This is sufficient because the creamed cheese has the protein I need and the bagel gives me some carbs to get the day started.

After the holidays, many of us want to shed that unneeded weight and myself included, have decided it was time to shrink myself. Successful diets work or don't work depending on what you eat and how you apply the diet to your lifestyle.

Many diets suggest you should limit portions. My current diet has a reduction of carbohydrates such as breads (cut the usual portion of bread in half, eat half a bagel, use pita bread or have a wrap instead of a hero), making it a practice to leave some food on the plate because we are typically full before our body tells us we are. In other words, leave 1/3 of the food over that you would usually eat. Many of our portions are super sized compared to the rest of the world anyway.

You can also fool yourself into doing this by using a smaller plate and then avoiding second portions. If this sounds like calorie limitation, it is. This is much easier than attempting to measure out four oz of meat.

My result, I have lost 10 pounds since New Years and plan to lose another 8-10. Why starve yourself? Just eat more appropriately, less carbs, more protein.

One last thing... Exercise. Cardio classes are great to burn off weight along with swimming and running. Too much of this will increase your appetite so be careful to mix it up with some other type of exercise such as weight lifting.

Big breakfast - not a problem if you are in control IMHO.

What to you think? As always, I value your opinion.

Fighting colds naturally - Dr. Charschan's cold survival kit

2011-01-19T14:04:00.000-08:00

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.

Doubts about foot orthotics - Do they really help?

2011-01-19T05:32:00.000-08:00

The NY Times published an article on 1/18/11 regarding this subjective and was rather inconclusive, weighing the pro's and cons (http://www.nytimes.com/2011/01/18/health/nutrition/18best.html?_r=1&adxnnl=1&adxnnlx=1295442225-gWl5Mb3DkEtHteTDkRIX8A). Please read the article for yourself as I am a large proponent of these devices.

Foot orthotics have become a huge industry, with both custom (hand made or scan made) and non custom orthotics (store purchased). The results as the article suggests can seem quite variable, with people using them at the suggestion of perhaps their podiatrist to use them to treat plantar fasciitis, shin pain, knee pain or in the case of our office, symmetry and alignment issues creating back, neck and human frame issues.

From a purely mechanical standpoint, they improve symmetry and body alignment. In our office, I find that most people who visit us have body style issues which are inherited and passed down through the generations.
The more asymmetrical someone is built, the more problems you will likely have with your back and neck and it is predictable.

I believe, based on years of practice, that the hit or miss approach to treat a symptom with orthotics, whether using off the shelf orthotics or custom is bound to frustrate many, since it shows a clear lack of understanding from the practitioner, who should know more than the patient.

Do they work and what should you expect? I believe that correct expectations is part of the problem.
1. Orthotics are merely a brace, therefore, they will only correct while you wear them. The question is then : what do they do when you don't wear them? The answer is; they are only effective when they are in ones shoes.
2. What do they really do? They correct (if applied with the proper understanding of their function and the way they were made if custom) gait (the way you walk) and improve body symmetry at the ground level. This means that they will level you out, similar to taking a 2x4 and using it to level the foundation of a house. The difference is, they only correct while you wear them. In other words, if they are not in your shoes, they are not doing anything. You also should be advised to wear sandals in the summer with arches and avoid the flat ones (for more year round correction). Also note, if you are wearing heels over 2 inches, you will not need an orthotic since the feet cannot overpronate (turn out) or supinate (turn in) with high shoes which alters your gait.
3. The device did not help my condition. Orthotics do not fix conditions. They merely, create symmetry at the ground level. The myofascia which controls muscle movement (newest information - check out Thomas Meyers book on Anatomy Trains) will mold according to the forces placed upon it. In other words, if your body is a mess because of your body style, and you have plantar fascia because your body's fascial system is a mess (very common), you will not get relief. Podiatrists will commonly treat the foot and ignore the body above it (lunacy) which is why you have the condition. Using orthotics may level the hips but you are still a mess. A good chiropractor who understands a style of myofascial therapy is a must.
4. They need to be worn all the time. If you can correct the problem 70 percent of the time, in combination with body work (chiropractor, massage therapist, both), you are much more likely to get a successful outcome you will be happy with. If your doctor understands the gait process (few do), your results and the orthotics you get whether custom or non will be much more effective (I see many poorly thought out and casted orthotics from other orthotics).

In closing, orthotics are not a one size fits all solution. Your best bet is to see a practitioner who really understands the gait process. Changes we make with either custom or non custom orthotics are provable and reproducible and I do this all the time showing people how running gait predictably improves with the right shoes and device.

What do you think? As always, I value your opinion. Please write me with your questions at backfixer@aol.com and visit our web sites at http://www.backfixer1.com/ or.http://njrunningdoc.com/. Also, stay tuned for my new book on the subject.

The $99 health plan brought to you by Sams Club - What does this really offer?

2011-01-11T08:40:00.000-08:00

News flash: Sams Club offers a preventative health care plan for under $100 (http://money.cnn.com/2011/01/11/news/companies/sams_club_selling_healthcare_service/index.htm).

Sams club today presented a preventative health care plan for $99 which makes use of the internet, applying the concept of what a financial planner does but to healthcare. I applaud them for doing this because many people do not regularly go to doctors for various reasons. Here is a way that puts the consumer in control.

"What you get: For $99, buyers of the program get an annual subscription to a web-based program that includes an at-home blood screening test that tracks an individual's cholesterol, blood sugar and Hemoglobin levels.

That information is then used to create a personalized Prevention Plan that identifies, prioritizes and explains users' health risks and recommends steps to improve their health.

Buyers of the program also get access to a 24/7 nurse line, two health coaching sessions, recommended prevention screenings, schedule and alerts based on age, gender and risks and a physician summary that can be shown to a doctor."

As a chiropractor, I look primarily at musculoskeletal health, which affects organ systems in ways we are just beginning to understand (Thomas Meyers book on Anatomy Trains shows deep muscular and organ connections). While this gives you a light basis for managing your health, it does not substitute for doctors visits and will not cover doctors visits. If you have a problem, you can prescreen and even discuss it with someone on their 24/7 nurse line. The problem I see is that from the medical point of view, which this clearly comes from, these basic screenings tell you nothing about the musculoskeletal system, and most nurses and medical providers have little musculoskeletal training to properly advise you.

The good news is that as always, chiropractic care has always been affordable and the cost of an office visit is relatively inexpensive, when compared to many medical visits and the patient satisfaction continues to stay high.

If you do not go to doctors regularly, this may be money well spent, putting you in the doctors chair able to find out when to go to the regular doctor. If you are using this for advice on back or neck pain or some other complaint, a visit to our office is priceless.

Safe Methods For Snow Removal

2011-01-10T13:27:00.000-08:00

Follow some simple tips to protect yourself while shoveling snow.
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.www.backfixer1.com

Another study shows chiropractic is much less expensive and more effective for lower back problems

2011-01-04T09:32:00.000-08:00

I came across a study that was in the December 2010 issue of JMPT (journal of manipulative therapeutics) that shows after adjusting for risk adjustment ( a fancy way of saying severity), the cost of chiropractic intervention was markedly less than going the traditional medical route (http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=55052)

One of the major cost drivers we experience in our office is when our patient decides to go to the emergency room for care. Typically, they are given pain killers or a shot of toradol for the pain which does nothing for the problem.

In many managed care plans, the medical doctor must give the referral. To their credit, many tell their patients that they can only offer medication and then refer them to someone like me for further intervention. Others, find themselves being sent from specialist (often orthopedics) to rehab, without having the problem that created the back issue ever resolved. I treat many patients who tell me they are fine as long as they do the exercises and then get ready in bed to be able to move. This tells me their problem is now subacute and have never been resolved. This causes periodic exacerbations, spinal, hip and knee degeneration and of course, they become less active and avoid painful activities.

In our office, we look for the cause and use tests that show the mechanical faults leading to back pain. Through active evaluation (a process of treat, test and treat), we get to the root of the back problem and other problems such as the hip, foot and knee improve as well, since these are merely symptoms of the gait issue that created them. Perhaps, the greater level of understanding chiropractors have avoids costly MRI and other tests that come with increasing severity.

Many studies really need to compare not just the episode, but with chiropractic care, do people have far fewer episodes of back pain. Also, foot orthotics are quite helpful as well as myofascial treatment to the region, which is becoming a larger part of many more progressive chiropractic practices as they move away from the less effective and more expensive model of heat, ultrasound and passive care and move toward the model of exercise, myofascial and active modes of care.

What do you think? As always, I value your opinion.

Dead Butt Syndromes and other fairy tales affecting those who run

2011-01-04T09:18:00.000-08:00

A few weeks ago, I read an article that was posted on the NY Times web site regarding something called Dead Butt Syndrome (http://well.blogs.nytimes.com/2010/12/21/when-the-diagnosis-is-dead-butt-syndrome/). Apparently, this is a problem with the gluteus medius (one of the larger muscles in the butt) which as this person. The person who wrote this article is a veteran runner and as she said “For people who have persistent pain, it’s healing gone wrong,” Dr. Bright said. “That gluteus medius isn’t firing the way it’s supposed to. You’re getting an inhibition of the muscle fibers. It’s kind of dead.”

The problem with this all encompassing diagnosis of Dead Butt Syndrome is the same with many of the attempts to globally diagnose and then come up with a cure without fully understanding the mechanisms involved.

Over the past year, I have been reading and reviewing Thomas Meyers book on Anatomy Trains (available through Amazon.com) which shows the myofascia actually controls motion, not the muscles making this diagnosis a part of the problem rather than the solution.

As many of our patients know, I diagnose through active evaluation, treat the fascial restrictions and then retest the firing patterns involved. Sometimes my first impressions are right on but I do a number of maneuvers until I figure out how to restore a more normal firing pattern. Often, tight hip capsules (fibrous tissue surrounding the hip) can cause this problem, as well as foot overpronation and gait asymmetry. It does not just happen to nice people like this author. The Fascia surrounding the muscles tighten, cause the gluteus medius to recruit in other muscles such as the obliques , hamstrings, other gluteal muscles, erector spinae and even affect the upper back as the problem worsens.

My concern is the piecemeal type of diagnosis this is, only addresses the symptom, which is really a gait issue. This person was over and under striding (one leg is tight in back, the other tight in front causing a short stride one one side and a longer stride on the other) way before the symptoms appeared and likely ran and stretched through it. Like most things mechanical, you can run it until it dies or fix it so it wont. The net effect is it torques the pelvis, causing a loss of leverage and your legs tighten. Your stride shortens, you pull muscles, have problems in the calves and you mechanically have some real issues. To fix this, you need to understand that this diagnosis of dead butt is just a symptom, rather than the problem. You cannot, as many our runners know after visiting many practitioners who were not effective enough, fix this with a quick itis or osis diagnosis which sounds medically intelligent but hardly will lead to a solution, because of the lack of understanding of the gait mechanism that created it. Enough said.

There is no such thing as a dead butt. There is a thing called foot overpronation or supination or asymmetric gait which will cause this type of a problem. For those looking for a solution, you can email me directly at backfixer@aol.com. I would be most happy to give you cost effective guidance on problems like this.

What do you think? As always, I value your opinion

Study Favors Chiropractic over Surgical Discectomy for Sciatica

2010-11-21T10:40:00.000-08:00

I recently came across a study in the JMPT (Journal of Manipulative Therapeutics) regarding Maniopulation (mostly done by chiropractors) Vs. Microdiscectomy (micro dissection surgery) that is becoming very common and has quick recovery times. There are many times I see patients going to their doctor and having tests such as MRI done and then waiting for the dreaded decision. As many of you know, we often resolve back problems before MRI is required and before a referral is ever needed. The fact is, often, our care costs less than the MRI. The reality is that the way we walk (gait) determines the way we function and also determines our likelihood in developing a herniated disc requring surgery in the first place. Even though the study shows outcomes are similar between manipulation and microdiscectomy, the overall management of the gait issue assures a much better outcome thant manipulation or surgery.
I have had many people avoid surgery with our approach. I often see people who are in severe pain make rash decisions when they are irritable and scared like visiting the emergency room for back pain or immediately undergoing an MRI and taking pills that do not improve function. For Sciatica, see us first. You will get better faster, more safely, with less intervention with care centered on long term resolution of your problem, rather than just the symptom of back pain.

Macro vs.Micro - Getting to the source of your problems

2010-11-01T06:50:00.000-07:00

   Do you see your problems with your body as the big picture or from a small point of view. This is something I have discussed with many of our patients because it is how we are able to get superior results in solving many peoples problems. Many doctors see the micro, meaning your elbow hurts while playing tennis, so lets look at the elbow and treat it, or the person who has knee pain and your doctor as well as you are obsessed with treating that problem. Over the years, I have learned never to take things at face value when it comes to mechanical problems in the body. Doing so assures expensive care that frankly is usually ineffective. Looking at the micro makes us miss what is really happening in your body. Obsessing about the herniated disc and treating it as if it created itself because things just happen is fooling ourselves and setting you up for years of exacerbations and even surgeries.
    I look at the macro or the big picture because this is where you find the cause of peoples problems, looking past the obvious. A great example of this is a tennis player I saw this weekend. We started with some elbow, shoulder and flexibility issues which have markedly improved.  This weekend, she said she still felt some elbow pain however,   the ball is hitting the net alot. Looking at the micro, she suggested it was her shoulder. Looking at the macro, the left side was tight, recruiting into the left oblique restricting motion in the right shoulder, aggravating the elbow. After properly treating the problematic core muscles, she notices a marked improvement in the way her shoulder worked on the right side. She should notice her power return during this weeks game and the ball will be going over the net.
    The majic sauce in our approach is looking at you, not just the symptoms you arrived with. We do this for you, your family, friends and co workers who are only aware of the elbow or body part hurting, and are likely visiting doctors who also see things that way. The only way to get a better diagnosis, and consequently, more cost effective and appropriate care is to get it right on diagnosis, which yields more appropriate care. Things are rarely what they seem at first glance in the human body which is why I look beyond your symptoms and think about function. I also dig deeper and ask the right questions to uncover those valuable clues which help me solve the equation of why you hurt. Think of me as the Sherlock Holmes of the musculoskeletal system. My goal is to get it right the first time, fix your true mechanical problem and as many of our patients already know, a number of other chronic problems that are affiliated with that complaint go away too.
   It is all about finding the cause and fixing that, and the symptoms and the future exacerbations are much less likely.  Its not majic, its getting healthcare right.

Running Shoes - Do they fit right and how to know?

2010-10-29T14:45:00.000-07:00

Recent studies show that the cost of a running shoe does not assure satisfaction (http://www.nytimes.com/2010/10/23/health/23patient.html?_r=1&scp=1&sq=shoe%20fit&st=cse). A recent article in the NY Times reports that athletes sometimes spend as little as $25 on shoes and are quite happy. Although in my experience, a good middle of the line shoe (usually $80 - 120 retail), will give you great cushioning and support, you can often find that level of support in a less expensive shoe. This may not work for everyone because not all feet are created equal, especially if they are flat.

The best and most advanced way to assure the best fit for a running shoe is to
1. follow my instructions on Howcast at http://www.howcast.com/videos/259469-How-To-Properly-Fit-a-Shoe. Here are detailed instructions I published a while ago to make sure your shoes fit properly.
2. Go to a running store with a treadmill - Stores like roadrunner sports or our local chain The Running Company can make the process more accurate. You can see how you impact the ground using their treadmill and assure a better fit for your style of foot. Different brands of shoes fit differently and sometimes the treadmill can save you money by helping you pick the right shoe for you.
3. If you have low arches or overpronated feet that flare out causing asymmetry in your gait, you can also use the treadmill to see the difference an insert makes. Rather than buying a more expensive shoe that is stiffer and less comfortable, put in an insert and you will likely feel and run better. Most stores will allow you to try them out. I am personally unimpressed with some of the supposedly custom inserts some stores will upsell you. Often, I find the less expensive off the shelf versions actually work better. If you have a more severe foot problem, visit a professional such as a chiropractor or podiatrist and have custom inserts made. If done properly, they are more corrective and do last longer.

Cortisone - Does this cure make problems worse?

2010-10-29T14:27:00.000-07:00

I recently came across and NY Times article which questions the wisdom of Cortisone Shots (http://well.blogs.nytimes.com/2010/10/27/do-cortisone-shots-actually-make-things-worse/?scp=1&sq=cortisone&st=cse). Often when people are in pain, they are irritable and also impatient because of what the pain does to their normal daily activities. The cortisone shot has been used for the quick fix for heel spurs, knee pain, shoulder pain, bursitis and other maladies. It is usually administered by an orthopedist or a physiatrist.

The problem with this solution is that while it can cause a significant amount of relief, it will also cause bone loss and problems with healing at the site of injection if overused. The other problem is that this injection will resolve the problem because the problem is that the area is painful. This misunderstanding is natural since most people believe no pain, no problem. Since inflammation rarely just happens, and it is usually due to a mechanical problem, it requires a mechanical solution. Injecting an area that is inflamed, even though we do not understand why is not a mechanical solution. It really is a shot in the dark, with the hope that it gets rid of the pain. If you and/or your doctor have little understanding as to the mechanism of pain (hint; rarely is inflammation a mechanism however it is a response to unusual stress and irritation), you are likely to have the problem continue to reoccur and develop other related problems at other times and think these are also just pain. The reality is, symptoms are just a warning that something is wrong. Years later, that degenerated joint warned you about what is eventually coming down the road.

In our office, we look at symptoms, dig for facts and try to understand and the explain the mechanism of inflammation and then get to the mechanical cause. The benefits of this approach are:
1. Real long lasting solutions.
2. Your joints are less likely to wear out because we are resolving the forces damaging the joint.
3. You are less likely to develop other related problems because the true cause has been resolved.
4. You enjoy a better quality of life and fewer doctors office visits with less pain.
5. You will rarely ever need a cortisone shot.

High level activity in older adults is very beneficial - I see this with many of our patients

2010-10-20T05:10:00.000-07:00

I came across this article (http://www.investorplace.com/20701/physical-activity-beneficial-at-advanced-ages/) regarding patients who are older. Apparently, older people who stay active and are most likely to have better vitality later in life into their 80's and beyond a new study shows.

We have many people in our practice family who stay active and many still compete athletically. This compares with previous generations who were more sedentary and as they got older, developed many health conditions secondary to deconditioning. Check out the article. Very thought provoking

New Obamacare benefits begin today - These are good changes - check them out

2010-09-23T07:12:00.000-07:00

According to Web md in their article published on line today (http://www.webmd.com/medicare/news/20100922/latest-round-of-health-reform-benefits-kicks-in), some of the new health care requirements kick in today. These are good for Americans.

Highlights include

Removing lifetime dollar limits on essential benefits
Giving people a right to appeal to an external party if denied coverage for a treatment
Preventing insurers from dropping coverage of people when they get sick
Limiting the use of annual spending limits of health plans
Allowing consumers to use ob-gyns in their networks without needing a referral
Prohibiting extra charges for using emergency care that is out of network
Guaranteeing full coverage of many preventive services, such as mammograms and colonoscopies, without a co-pay, co-insurance, or deductible

These are wonderful for the public. Personally, just the idea that preventative costly procedures such as colonoscopy will finally be more affordable is great, since many people are finding this preventative service is expensive and with many newer plans, often put off due to afford-ability because it costs thousands due to high . Great news.

For many people with job-based coverage, the insurance changes will arrive Jan. 1, 2011, at the start of the new benefits year.

At the same time, the resistance is notching up. This week, as the consumer protections kick in, media reports have revealed that some major insurers, at least in part, will sidestep one new provision: denying coverage for children under age 19 who have pre-existing medical conditions.

Why anyone in government (you know who you are) would want to prevent this or repeal this is beyond me.

What do you think? As always, I value your opinion.

Osteoporosis drugs causing fractures - another promise that does not add up

2010-09-17T10:05:00.000-07:00

I was reading in the Star Ledger about how the often prescribed osteoporosis drugs like Boneva and Fosamax have been found to create fractures (http://www.allvoices.com/contributed-news/6786125-osteoporosis-drugs-like-fosamax-and-boniva-linked-to-hip-fractures).

Years ago, we would spot osteoporosis on an x ray and it would tell us that certain people are prone to having possible problems with fractures. Hip fractures in the elderly can be devastating. Earlier generations in many ways were less active in retirement ( I remember my grandmother and her card games as activities vs. my parents who played tennis and go to the gym.). We had less sophisticated tools to look at this such as x rays vs. our Dexxa Scanners that are much more sensitive to detecting early bone loss. The drug companies worked on medications they could sell us as being preventative for bone loss when loss was occurring as per these very sensitive scanners and they sold doctors on the idea through their drug reps. Many people now found their doctors managing their health by the numbers on the scan. I have seen hundreds of people who were placed on these drugs to prevent the yet disease (the one that did not happen or may never happen yet). Many of our patients who went on these drugs promptly went off when the side effects hit. I am sure these numbers are underreported.

The bottom line is that this is clearly interventional, not preventative and dispite the billions made by the drug companies on this supposedly preventative health regimen, in the end, it is side effects, over doctoring and then having pecuilar types of fractures that may not have occurred if you were not on the drug.

I have a better protocol; Stay active, eat right and play the odds (very few people actually have problems related to osteoporosis when considering the entire populace) In other words, leave it alone.

What do you think? As always, I value your opinion

USATF evaluates if stretching prevents running injuries - Science says it doesn't, their study agrees and more

2010-09-02T16:16:00.000-07:00

Yesterday, the NY times reported on a study performed by USA Track and Field, the organization that credentials the race's and many of the running events throughout NJ (http://well.blogs.nytimes.com/2010/09/01/phys-ed-does-stretching-before-running-prevent-injuries/)

I have been working with runners and have been involved with USATF in NJ and I have always maintained that stretching does not prevent injuries. For years, stretching had been the gold standard and even today, many running coaches who were brought up with this concept continue to teach stretching to their new and developing athletes.

Years ago, when I was in chiropractic college in Illinois, a company called SPRI who performed rehab and the owners, Richard Dominguez, Robert J Gajda, wrote about their methods in a book entitled Total Body Training. The book, written in the 80's told about how exercises rather than stretching gets the best performance out of athletes. SPRI now produces tubing kits for exercise as well as other products. Many other studies have also shown that stretching has little benefit and now the USATF study also shows that those who stretch and those who do not have about the same amount of injuries.

An interesting note in all this is that those who were used to stretching and then stopped had an increase in the amount of injuries that had the endure.

Looking past the surface of this, there is a benefit to stretching which is in young and developing children. As bones grow, so do muscles in response to that growth. Stretching during those young years will yield greater flexibility in adulthood which is why I will never be able to perform a split while my daughter who has done gymnastics since she was 4 years old can.

When we look at the motivation of stretching which is injury avoidance, I believe those who did it regularly and then stopped and experienced more problems had bio-mechanical issues which likely were never properly identified. In our office, patients find out that it is firing patterns, myofascia and muscular coordination of movement which actually are the reasons for tightness. Once these issues are properly addressed, the person tightens much less, has much greater flexibility and their overall gait improves. The more efficiently they move, the more flexible they are and the fewer injuries they sustain. The discussion should not be about weather or not to stretch. The argument is about body mechanics and its relationship to injuries in runners.

What do you think? As always, I value your opinion

Doctors are seeking new ways to prevent muscle loss - buyer beware..

2010-08-31T12:55:00.000-07:00

I was reading an article today published by the NY Times regarding aging and muscle loss (http://www.nytimes.com/2010/08/31/health/research/31muscle.html). As people age, it is presumed that we lose muscle tone and strength due to many factors such as activity, fatty infiltration in the muscles, hormonal changes and they have even created a new medical term for this called sarcopenia, a fancy medical way of saying muscle loss. The concept is patterned after the idea of osteopenia, which is a loss of bone in medical terminology.

I say buyer beware because drug companies would love to bottle this and sell this as the next life threatening malady that afflicts us which can be bottled, and then sold, side effects and all with the blessing of insurance companies who become convienced this is a true malady that is life threatening.

The reality is that people need to remain active and stimulated. People who work into their late 70's and 80's tend to be sharper mentally and physically, they move better although we have the problems of gravity, our body mechanics, degenerative changes in the spine leading to spinal stenosis which will cause muscular wasting (you cannot solve that in a pill) and there are of course, degenerative processes due to hormonal changes and also changes at the cellular level which are likely not to be helped by a pill.

My solutions are for people to have more active lives (many people are overweight and less active - a problem the army is experiencing with new recruits), to eat better (lets get away from our unhealthy food production methods and corn doping of many things we eventually eat) and to take care of biomechanical problems when we are young (true preventative care). Trying to give someone a pill for a problem that in most cases is because biomechanical issues have been ignored for years because doctors did not understand them is absurd, and will also likely if history repeats itself will be expemsive and give us problems we dont have and are not likely to develop without the pharmaceutical companies help.

We need to embrace aging as a normal process, not a disease and people will have healthier muscles with a properly functioning body, and myofascial system, rather than the next pill to fix a problem that is a natural part of aging, given that most health care practitioners really do not understand human body mechanics very well.

What do you think? As always, I value your opinion.

Parents in NJ are finding reasons to forgo vaccinations. Food for thought

2010-08-22T14:51:00.000-07:00

I was reading in the NJ Star Ledger about the below average rates of vaccination in NJ children (http://articles.moneycentral.msn.com/news/article.aspx?feed=AP&date=20100822&id=11932980). Like many of our patients, my children have received vaccinations and although on the surface this regular medical service that is part of our preventative healthcare and supported by the CDC. Even in a state thought to be as affluent, and educated as in NJ, many middle and upper class parents are forgoing vaccinations because in many cases, based on some of the concerns in the media regarding the link between autism and mercury that is used in the vaccines may be harming their children. I must admit, I still wonder weather my sons aspergers syndrome was linked to vaccines. I will likely never know but I cannot go back in time, avoid vaccinations and then see how he turned out. I just does not work that way.

Recently, there have been reports that whooping cough may be returning to our population, even though that population has largely been vaccinated. Could it be that vaccinations are over hyped, religiously pursued by the NJ legislature because of the medical lobby as well as pursued by drug companies trying to cash in on the next flu scare (remember swine flu, H1N1) (http://www.chetday.com/fluscaregame.htm). Our memories are as short as the media but someone made a ton of money scaring the public into getting vaccinated against the maybe disease. In the case of H1N1, our government spent a ton of money, the public did not receive this scare with open arms and they were left with tons of expiring vaccines that were not worth the bottles they were printed on. What is a scare weary public to do?

The thing that really scares me is that one day, when we have a real scare, few people will listen and the chicken little effect will occur (few people will believe it when the sky really is falling). I think that day is nearing and NJ vaccination rates are a symptom of that malaise.

We really need to rethink many of our health policies, since they often amount to scare tactics with little or no health benefit and in many cases, side effects (cholesterol lowering drugs anyone). Somehow, people in other countries have a healthier outlook without having all the stuff done to them. With regard to vaccines, this blog post is not designed to help someone decide weather or not to vaccinate their children. People should read and make their own opinions, rather than have it written into law that they must do this. It is true that some people have vaccine reactions (although a small sampling of the populace) and have neurological impairment or other problems as a result. Somehow, our society has made these risks acceptable even though much of our immunity to many diseases is natural (natural immunity still occurs believe it or not without vaccines) and natural immunity occurs by reacting to the infection.

What would happen if we decided tomorrow that vaccines are no longer mandatory? Would the masses avoid them in droves? My opinion is that it depends on what you believe. The only true way of finding out if vaccination is unnecessary is for the populace to avoid it. It would take many years to see if we need it or if the diseases we have tried to prevent come back or if our improvements in sanitation and living standards are really the reason we no longer see many of the diseases we vaccinate for.

What do you think? As always, I value your opinion.

Repeat athletic injuries - Should we change our way of competing or are we missing something.

2010-08-18T04:42:00.000-07:00

I was reading today an article in the NY Times concerning athletic injuries in aging athletes (http://www.nytimes.com/2010/08/17/health/nutrition/17best.html?8dpc). A thoughtful article, although I am surprised they did not ask the opinion of a non medical style provider. Is being an overachiever athletically a psychological problem?

I have been treating older athletes for years. It is always sad when an athlete has numerous injuries that are termed as overuse and then gives up the sport they love because the injuries continue to pile up. I too injured my back playing softball this season and I am likely not to return.

Many athletes we treat have chronic problems because they are misunderstood. Stress fractures, knee pain, hip pain, shoulder problems are often looked at as separate entities. The reality is that they are usually part of a gait related issue, causing the person to slam their foot into the ground. It is my experience that most health care providers are trained to look at the pain, name and diagnose the condition and then treat it or put the person on rest for a while then send them back into the wild. The problem is, without understanding the true cause, the next injury occurs, then the next and then the person eventually gives up after years of trying to fight through the eventual outcome of giving up.

A better idea is to understand the mechanism of the painful problem, name it functionally vs. using the typical dis ease monicre of itis, osis, tear, stress fracture and realize that functional problems require a functional solution which may include orthotics, gait retraining and other ideas. Most often, these people will likely return to activity and back to the sports they love with far fewer injuries. With the old way of thinking, they may require surgery, joint replacement and other interventions because the doctors were not trained to evaluate why the injuries occurred. Athletes of all ages deserve better. We should never treat or name anything we truly do not understand. Athletes should not suffer because their health care providers do not understand why they hurt. They joint replacement manufacturers will likely not enjoy this blog post however, if you are an aging athlete, for you it will.

What do you think. As always, I value your opinions.

Survey shows majority who utilize chiropractic care for their low back pain report "a great deal" of benefit.

2010-08-17T14:19:00.000-07:00

By Peter W. Crownfield, Executive Editor of Dynamic Chirorpactic

The past 12 months have been good - very good - for the chiropractic profession in terms of data supporting the efficacy of chiropractic care.
For starters, consider the Wellmark pilot study that suggests chiropractic reduces both costs and need for surgery;¹ the Milliman USA analysis that concludes, "[S]pinal patients who seek chiropractic coverage have materially lower health care costs than those who do not";² the Consumer Reports reader survey that found "hands-on" therapies, led by chiropractic care, were the top-rated treatments for back pain sufferers, with chiropractic receiving the highest satisfaction-with-care ratings (significantly higher than MDs);³ the "Mercer Report" that suggests chiropractic compares favorably to most therapies covered by health benefit plans and is "likely to achieve equal or better health outcomes";⁴ and the final report on the Medicare demonstration project, which notes that 87 percent of patients surveyed gave their DC a satisfaction score of 8 or higher and 56 percent gave a perfect 10.⁵
The latest thumbs-up comes courtesy of a survey analysis published in the June 2010 issue of the Journal of the American Board of Family Medicine.⁶ The analysis, based on data from the 2002 National Health Interview Survey, revealed that 60 percent of U.S. adults utilizing CAM therapies for back pain reported "a great deal" of benefit. Chiropractic was used most frequently (74 percent of respondents) and had the highest success rate (66 percent reporting significant benefit).
The analysis evaluated utilization of six CAM modalities: chiropractic, acupuncture, massage, relaxation techniques, herbal therapy, and yoga / tai chi / qigong. Sixty-nine percent used one therapy only, 21 percent used two, 8 percent used three, 1 percent used four and less than 1 percent used five or more therapies. Massage was a distant second in terms of patient use for back pain (22 percent of respondents reporting use) and perceived benefit (56 percent reporting "a great deal" of benefit for their back pain). The percentage of respondents perceiving similar benefit for the other CAM therapies was as follows: 56 percent for yoga / tai chi / qigong; 42 percent for acupuncture; 32 percent for herbal therapies; and 28 percent for relaxation techniques.
Two factors were independently associated with greater perceived benefit from CAM use for back pain: better self-reported health status and an indication that "conventional medical treatment would not help." The factor most associated with less benefit from CAM for back pain was "referral by a conventional practitioner." The authors of the survey analysis speculate that more or less perceived benefit may be attributable to several factors, including that an independent decision to utilize CAM (rather than being referred) may increase perceived benefit, while referred patients may have pain that is less responsive to treatment (contributing to less perceived benefit).
What is not discussed is whether data is available on the professional usage patterns for those who self-referred vs. those referred by a medical provider. If those who self-referred chose different providers than those referred by an MD, it could have impacted perceived benefit with care, particularly the reduced benefit perceived by those referred by an MD.
If there is a difference, and it can be shown that it did impact perceived benefit, it suggests that MDs need to have a better understanding of which CAM providers to refer to for back pain. Given that chiropractic continues to have the highest level of patient satisfaction, MDs who choose other CAM providers would want to ensure that they are not making that choice based on false assumptions. This difference also might ultimately lead to more specific referral criteria for MDs referring to CAM providers for back pain.
References

"Study Suggests Chiropractic Reduces Health Care Costs, Need for Surgery." Dynamic Chiropractic, Aug. 26, 2009.
"Cost-Effective Care: The Evidence Mounts." Dynamic Chiropractic, Sept. 9, 2009.
"Consumer Reports Survey Rates DCs Higher Than MDs." Dynamic Chiropractic, May 20, 2009.
"How Chiropractic Helps the Insurance Industry." Dynamic Chiropractic, Dec. 2, 2009.
"Medicare Patients Give Chiropractic High Marks." Dynamic Chiropractic, March 26, 2010.
Kanodia AK, Legedza ATR, Davis RB, et al. Perceived benefit of complementary and alternative medicine (CAM) for back pain: a national survey. J Am Board Fam Med 2010;23:354-62.

Source: dynamicchiropractic.com

Economy Led to Cuts in Use of Health Care - what do we make of this?

2010-08-17T10:17:00.000-07:00

I read an article today that stated that a study done by the National Bureau of Economic Research says that the recession reduced the utilization of health care services, across the board (http://www.nytimes.com/2010/08/17/health/policy/17health.html?_r=1). They compared our country to others with lower out of pocket costs and found that the higher out of pocket expenses contributed to the reduction of utilization.

Our office experienced this as well over the past 3-4 years. I am aware of a recovery taking place since May of 2009 when business in our office picked up. Part of it was pent up demand and the other part of it is likely people coming to terms that higher copayments are here to stay and they are probably used to it by now.

I am troubled by this data for a few reasons:
1. There were fewer doctor visits and therefore fewer procedures done, yet, the overall health of the nation has not been compromised. One would wonder that perhaps, many recommendations for tests and procedures may not be needed after all and are part of the problem. In other words, people can be left alone, with fewer interventions which does not appear to affect life expectancy. I hope the authors are looking at their data more closely now, and looking past the obvious. In other words, do we need to lean on the health care system as much as we are advised to do if there is no real benefit, or possible detrimental effect of procedures and tests that just are not necessary?

2. Higher co payments means insurance companies paid out less and consumers were expected to pay more. Since we also used our doctors less and had fewer procedures, why did rates increase an average of 20 percent this year for many of us, yet there is evidence that medical inflation this year has almost come to a halt? In other words, why the increase and who is benefiting (hint: its not the doctors and we personally were hit for another 18 percent on chiropractic fees by Aetna again)? In my opinion, health care reform did not go far enough and should have included a public option. This would have prevented these increases which make our country less competitive in the world economy because of the ridiculous cost of health insurance.

3. Over the last year, chiropractic utilization is up markedly. Perhaps, people are shifting their spending habits to a more cost effective and overall effective type of care. It costs less to get problems taken care of the right way, regardless of the visit costs. In other words, in our office treats a person with shoulder and neck pain. Doctor A before us evaluates the neck and shoulder, sends the patient for 2 months of rehab and orders an MRI, the problem returns two months later. The cost - Thousands of dollars for a non solution. The patient visits us Doctor B. We find out during the evaluation the person has right foot flare on the side of shoulder pain and his hip flexor is pulling the shoulder forward causing neck and shoulder pain. The problem resolves in 12 visits and the person purchases foot orthotics and is now aware of why the problem exists. The costs, slightly over $1000 but the person has to put our $40 per visit because of an outrageously high copayment which is not compatable with rehab. The person shoulders much of the costs but is pain free with money well spent and we got it right the first time. The lesson is that it is not the cost of the visit, or the amount of stuff that is done to someone. It is the quality of the health care experience that counts. Getting it right and improving the persons health for years to come is always better than having tests and procedures. Perhaps, this study also is a reflection of market forces which have been largely absent from our monopolized healthcare system.

What do you think? As always, I value your opinion.

Was Atkins right, new study shows low carb diets are better for you

2010-08-03T08:28:00.000-07:00

Todays NJ Star ledger had an article talking about the benefits of low carbohydrate diets vs. the calorie restriction traditional type (http://www.washingtonpost.com/wp-dyn/content/article/2010/08/02/AR2010080204125.html) . Truth be told, low carbohydrate diets lead to healthier people with higher levels of HDL's as the study shows. As with politics, companies who have diets also have pundits who will spin and twist diets benefits, without real world proof. I have always told patients that if you wish to lose weight quickly, cut your carbohydrate intake in half and you will likely drop some weight without working too hard at it. I have gone on many diets by doing just that: lowering my carbohydrate intake. The most offensive complex carbs (http://www.weightlossforall.com/complex-carbs.htm) are breads and pasta's because they are filling, satisfying however, easily converted to sugar by the body. Simple carbs include sugar itself (http://www.weightlossforall.com/simple-carbs.htm), soft drinks, fruits. Please check out these links because they will give you a better and more complete list of these products.

Atkins (http://www.weightlossforall.com/atkins%20low%20carb%20diet.htm) was persecuted for his beliefs in the low or no carb approach. Low carbs has been vindicated in this current study. I typically look at food as fuel since my job is quite physical. Carbohydrates such as cookies can be addictive and for many, their dietary downfall is through snacks which are carb heavy. I usually recommend increasing protein and decreasing carbs for a healthier diet. Carbs are often cheap fillers. If you go to any buffet, you will find food loaded with carbs at an affordable price. These places are a minefield for those who are not food savvy. You can, on the other hand do quite well at many of these by sticking with the salads, meats, cheeses and minimize the pastas, rices and other grains including the breads which cost less and people fill up on.

What do you think? As always, I value your opinion

Health care by numbers, putting healthy people at risk

2010-07-30T13:00:00.000-07:00

I was speaking to a patient today who was having some muscular problems and was concerned about. He had just had his creatine levels checked (http://ezinearticles.com/?Creatine-Levels&id=405381) and the level was high. Creatine levels that are high with cholesterol lowering drugs injestion is one of the reasons we need to be checked frequently when on these meds. I also suggested that some of his muscle stiffness and problems could be due to the drug. When I asked him why he was having the problem, he said that his heart had a problematic valve which has likely been there all his life. When I asked him about his cholesterol levels, it was well under 200 which really is not high.

The important question is this: Does the benefit outweigh the risk? The patient has a known problem that is probably developmental. Decreasing cholesterol levels that are near normal has no effect on heart function. Taking cholesterol meds 5 times per week puts him at risk for liver and muscular problems, as well as adding medical costs to monitor him. Since we are looking at a what if scenario which scares people because nobody wants a heart attack or a blockage to create a life threatening, what if we did nothing? What if he got hit by a car tomorrow?

I know that is ridiculous but giving a perfectly healthy person dangerous (http://www.thepeopleschemist.com/view_learning.php?learning_id=11) meds that potentially create problems he never would have had with constant monitoring makes little sense to me. It is not preventative care, and has a detrimental effect, rather than a benefit over the short term. True preventative care prevents known outcomes such as foot problems creating back problems for instance, since it is mechanical and easily identifiable. Shadow boxing with what if scenarios by physicians for dubious prevention of rare events is bad medicine. Taking potentially harmful cholesterol lowering drugs that are likely to have no benefit but cause problems you do not have is not preventative, its foolish and a bad way to spend our health care dollars. Statistics show that statin's have a very small effect on extending ones life (http://www.dailymail.co.uk/health/article-432395/Statins-truth.html), and their benefits are way overstated. The best doctors question everything, including some of the practices of their own profession. I have certainly done this as a chiropractor. If you are a person who is on statins and has naturally low levels of cholesterol, but were advised these meds are a good idea, think about this article, the resources in it and have a fair and honest discussion with your doctor. It is never about your doctors practice style, it is about your health and knowing the difference between prevention and an intervention that is good for your health vs. one that is not good for it.

What do you think, I value your opinion.

Can sitting shorten your life? A new study suggests it will.

2010-07-28T20:16:00.000-07:00

I read an article today regarding sitting and how it can shorten your life (http://www.usatoday.com/news/health/2010-07-27-sitting-death_N.htm) . In a 14 year study, they found that people who sit for longer periods of time (many of us do this at work for hours) are more likely to die from heart disease than those who get up and move around alot. Apparently, mixing alittle exercise with sitting did little to change the outcome. Apparently, there was a sedentary physiology that develops with those who sit alot. Please read the article. Very interesting.

What's a nice doctor like you doing in a plan like this. The story behind why after only four months in ASHN's management of Cigna, we are leaving their network.

2010-07-20T14:29:00.000-07:00

Ah, what is an ethical doctor to do? Last January, we received a letter telling us that we can only continue our participation in Cigna Open Access Plus and the PPO if we become credentialed with a company called American Specialty Health Networks. We did not accept the Cigna HMO since ASHN took over their network around 1999, when their other vendor went out of business because or the perceived reputation that ASHN had. I was not thrilled, since two years previous, I had helped save Cigna's previous HMO network who was also hurting chiropractors financially by underfunding a capitated plan and not communicating with Cigna that a problem existed. Cigna historically likes to use vendors instead of administrating certain professions such as chiropractors directly. We did credential with ASHN for a short time about 11 years ago and quickly left when we saw what was required of doctors in the network (reams of paperwork and faxes). Over the last 10 years, Cigna had grandfathered us into their PPO without having to deal with ASHN which gave us the freedom to do what we thought was best for our patients. A few years ago,A Cigna representative convinced us to join their Open Access Plus networks as well which we joined under the condition that we did not have do deal with ASHN. Cigna's management under Open Access Plus and PPO plans was transparent and they allowed us to do what was necessary. We had many patients in the expanding Open Access Plus network and it worked well for the past few years.

Fast forward to 2010, we felt compelled to credential with ASHN, despite their reputation among my colleagues as being a paper and payment nightmare because Cigna now said that we can only continue our participation by joining the network. Some of my colleagues were exiting the network as I was credentialing however, I was willing to give it 6 months to try the network out.

They send us a large credentialing packet on CD with all the plans, their fee schedules and most of what I needed to decide if this could work, since we handle many managed care plans. The Cigna HMO fee schedule was quite low, if not below our cost of doing business however, the local rep assured us they would be fair but conservative. We were told that they would put us in a tier allowing us 5 office visits before any paperwork was necessary on their HMO patients. We were also told that Open access plus and the PPO, who had similar fee schedules in their packets to the ones under Cigna directly did not require any paperwork. In other words, things would not change other than who we bill through.

We officially joined as of 4/1/10 and had our first two HMO patients, and had programmed our computers to handle the fee schedules for their other plans as well under Cigna. There was little training for their paperwork and the first two were problematic because they gave us far fewer visits than we asked for. I finally spoke with the doctor in charge of the NJ reviews who stated that Cigna under ASHN's management is an acute only plan and does not cover any rehab. He agreed to cover the 12 visits one patient had and the 8 visits the other needed and explained that the paperwork should have been filled out for the 1st visit, even though we do not need to submit it until the 5th. We were told to fill it out after the 5th. After that conversation, all our Cigna HMO patients thereafter were required to sign an agreement saying they understand they can rehab, however, at their own cost.

We thought everything was fine until we did not receive any Cigna payments for their other plans for over two months. When we received them, the payments were far less than we expected and then when we inquired about the Open Access Plus claims being paid improperly, we were given a different fee schedule than the one in the packet, that was markedly lower in many ways. We also then found out that all their plans required certification, including non gaited plans (PPO and Open Access Plus) and we had been lied to or deliberately misinformed. This meant we now had to scramble to do precertification paperwork on a bunch of people, some who could not fill out questionaires since they were no longer under care. We submitted these care plans and they either denied increased treatment past 5 visits or gave us visits but reduced time frames that we billed within. We called and their staff said to file for extensions which were of course denied. I then requested that I speak with their medical reviewer who stated that during our last conversation in June, he believed that he was clear on the acute thing. I said I was and then he could not believe we were misinformed by their staff, offering little other than an apology and suggested more paperwork in the form of a continuing care paper form, to add to the other stuff we were already sending in, to get paid at less than were were paid before.

The final straw for us was a bounced check from ASHN, on services that we waited for payment for over two months.

As our patients know, I do my best for them. Back injuries, neck injuries, shoulder injuries and other problem we see patients for all require rehab to get the problem corrected. I believe it is wrong to tell someone that we will serve them half way for their co pay and then the rest is their problem. It just isn't right. It also is not right for an employer who to buys benefits that are advertised for up to 60 per year to have their employees find out it is limited it to 6 or 7. Bait and switch plans are not ethical.

Last night, after less than four months, I mailed and faxed in my resignation to ASHN. They are indeed a nightmare. They call themselves conservative. I call them intrusive and overbearing. I can now understand how they single handedly destroyed the economic viability for chiropractors who work in California, where they yield alot of influence.

For those of you who wish to continue under our care, we will continue to participate until the 60 days or so that are required have expired. After that, we will be out of network as a provider for Cigna. It is better that way and I believe our patients will find their out of network benefits are more beneficial without the interference of ASHN. For anyone else reading my blog, including other doctors in my profession, I am not suggesting any course of action, however, if your experience is similar to mine, you will have some thinking to do.

Was leaving the right thing to do? I believe it was. Working harder for less reimbursement and cheating patients out of their benefits was not what I signed up for. In my office, it is quality or nothing. In the case of the Cigna plans, I would rather be out of network where quality can exist. What do you think? I value your input.

What's a nice doctor like you doing in a plan like this. The story behind why after only four months in ASHN's management of Cigna, we are leaving their network.

2010-07-20T14:05:00.000-07:00

Ah, what is an ethical doctor to do? Last January, we received a letter telling us that we can only continue our participation in Cigna Open Access Plus and the PPO if we become credentialed with a company called American Specialty Health Networks. We did not accept the Cigna HMO since ASHN took over their network around 1999, when their other vendor went out of business. Cigna historically likes to use vendors instead of administrating particular professions directly. We did credential with ASHN for a short time about 11 years ago and quickly left when we saw what was required of doctors in the network (reams of paperwork and faxes). Over the last 10 years, Cigna had grandfathered us into their PPO without having to deal with ASHN which gave us the freedom to do what we thought was best for our patients. A few years ago, their representative convinced us to join their Open Access Plus networks as well. Cigna's management was transparent and they allowed us to do what was necessary. We had many patients in the expanding Open Access Plus network and it worked well.

Fast forward to 2010, we felt compelled to credential with ASHN, despite their reputation among my colleagues as being a paper and payment nightmare. Some of them were exiting the network as I was credentialing however, I was willing to give it 6 months.

They send us a large credentialing packet on CD with all the plans, their fee schedules and most of what I needed to decide if this could work, since we handle many managed care plans. The Cigna HMO fee schedule was quite low, if not below our cost of doing business however, the local rep assured us they would be fair. We were told that they would put us in a tier allowing us 5 office visits before any paperwork was necessary on their HMO patients. We were also told that Open access plus and the PPO, who had similar fee schedules in their packets to the ones under Cigna did not require any certifications. In other words, things would not change other than who we bill to.

We officially joined as of 4/1/10 and had our first two HMO patients, and had programmed our computers to handle the fee schedules for their other plans as well under Cigna. There was little training for their paperwork and the first two were problematic because they gave us far fewer visits than we asked for. I finally spoke with the doctor in charge of the NJ reviews who stated that Cigna under ASHN's management is an acute only plan and does not cover any rehab. He agreed to cover the 12 visits one patient had and the 8 visits the other needed and explained that the paperwork should have been filled out for the 1st visit, even though we do not need to submit it until the 5th. After that conversation, all our Cigna HMO patients thereafter were required to sign an agreement saying they understand they can rehab, however, at their own cost.

We thought everything was fine until we did not receive any Cigna payments for their other plans for over two months. When we received them, the payments were far less than we expected and then when we inquired about the Open Access Plus claims being paid improperly, we were given a different fee schedule than the one in the packet, that was markedly lower in many ways. We also found out that all their plans required certification, including non gaited plans (PPO and Open Access Plus) and we have been lied to or deliberately misinformed. This meant we now had to scramble to do precerts on a bunch of people, some who could not fill out questionaires since they were no longer under care. We submitted these care plans and many of them did not give us what we needed, or ended care prematurely either by visit or by date. We called and their staff said to file for extensions which were of course denied. I then requested that I speak with their medical reviewer who stated that during our last conversation in June, he believed that he was clear on the acute thing. I said he was and then he could not believe we were misinformed by their staff, and offered little other than an apology and suggested more paperwork in the form of a continuing care paper form, to add to the other stuff we were already sending in, to get paid at less than were were before.

The final straw for us was a bounced check from ASHN, on services that we waited for payment for over two months.

As our patients know, I do my best for them. Back injuries, neck injuries, shoulder injuries and other problem we see patients for all require rehab to get the problem corrected. I believe it is wrong to tell someone that we will serve them half way for their co pay and then the rest is their problem. It just isn't right.It also is not right for a company to buy benefits that are advertised for up to 60 per year and limit it to 6 or 7 and then tell the patient sorry, while I need to fan the flames of someone who was sold a bait and switch plan.

Last night, after less than four months, I mailed and faxed in my resignation to ASHN. They are indeed a nightmare. They call themselves conservative. I call them intrusive and overbearing. I can now understand how they single handedly destroyed the economic viability for chiropractors who work in California, where they yield alot of influence.

For those of you who wish to continue under our care, we will continue to participate until the 60 days or so that are required have expired. After that, we will be out of network as a provider for Cigna. It is better that way and I believe our patients will find their out of network benefits are more beneficial without the interference of ASHN.

Was leaving the right thing to do? I believe it was. Working harder for less reimbursement and cheating patients out of their benefits was not what I signed up for. What do you think? I value your input.

What's a nice doctor like you doing in a plan like this. The story behind why after only four months in ASHN's management of Cigna, we are leaving their network.

2010-07-20T14:03:00.000-07:00

Ah, what is an ethical doctor to do? Last January, we received a letter telling us that we can only continue our participation in Cigna Open Access Plus and the PPO if we become credentialed with a company called American Specialty Health Networks. We did not accept the Cigna HMO since ASHN took over their network around 1999, when their other vendor went out of business. Cigna historically likes to use vendors instead of administrating particular professions directly. We did credential with ASHN for a short time about 11 years ago and quickly left when we saw what was required of doctors in the network (reams of paperwork and faxes). Over the last 10 years, Cigna had grandfathered us into their PPO without having to deal with ASHN which gave us the freedom to do what we thought was best for our patients. A few years ago, their representative convinced us to join their Open Access Plus networks as well. Cigna's management was transparent and they allowed us to do what was necessary. We had many patients in the expanding Open Access Plus network and it worked well.

Fast forward to 2010, we felt compelled to credential with ASHN, despite their reputation among my colleagues as being a paper and payment nightmare. Some of them were exiting the network as I was credentialing however, I was willing to give it 6 months.

They send us a large credentialing packet on CD with all the plans, their fee schedules and most of what I needed to decide if this could work, since we handle many managed care plans. The Cigna HMO fee schedule was quite low, if not below our cost of doing business however, the local rep assured us they would be fair. We were told that they would put us in a tier allowing us 5 office visits before any paperwork was necessary on their HMO patients. We were also told that Open access plus and the PPO, who had similar fee schedules in their packets to the ones under Cigna did not require any certifications. In other words, things would not change other than who we bill to.

We officially joined as of 4/1/10 and had our first two HMO patients, and had programmed our computers to handle the fee schedules for their other plans as well under Cigna. There was little training for their paperwork and the first two were problematic because they gave us far fewer visits than we asked for. I finally spoke with the doctor in charge of the NJ reviews who stated that Cigna under ASHN's management is an acute only plan and does not cover any rehab. He agreed to cover the 12 visits one patient had and the 8 visits the other needed and explained that the paperwork should have been filled out for the 1st visit, even though we do not need to submit it until the 5th. After that conversation, all our Cigna HMO patients thereafter were required to sign an agreement saying they understand they can rehab, however, at their own cost.

We thought everything was fine until we did not receive any Cigna payments for their other plans for over two months. When we received them, the payments were far less than we expected and then when we inquired about the Open Access Plus claims being paid improperly, we were given a different fee schedule than the one in the packet, that was markedly lower in many ways. We also found out that all their plans required certification, including non gaited plans (PPO and Open Access Plus) and we have been lied to or deliberately misinformed. This meant we now had to scramble to do precerts on a bunch of people, some who could not fill out questionaires since they were no longer under care. We submitted these care plans and many of them did not give us what we needed, or ended care prematurely either by visit or by date. We called and their staff said to file for extensions which were of course denied. I then requested that I speak with their medical reviewer who stated that during our last conversation in June, he believed that he was clear on the acute thing. I said he was and then he could not believe we were misinformed by their staff, and offered little other than an apology and suggested more paperwork in the form of a continuing care paper form, to add to the other stuff we were already sending in, to get paid at less than were were before.

The final straw for us was a bounced check from ASHN, on services that we waited for payment for over two months.

As our patients know, I do my best for them. Back injuries, neck injuries, shoulder injuries and other problem we see patients for all require rehab to get the problem corrected. I believe it is wrong to tell someone that we will serve them half way for their co pay and then the rest is their problem. It just isn't right.It also is not right for a company to buy benefits that are advertised for up to 60 per year and limit it to 6 or 7 and then tell the patient sorry, while I need to fan the flames of someone who was sold a bait and switch plan.

Last night, after less than four months, I mailed and faxed in my resignation to ASHN. They are indeed a nightmare. They call themselves conservative. I call them intrusive and overbearing. I can now understand how they single handedly destroyed the economic viability for chiropractors who work in California, where they yield alot of influence.

For those of you who wish to continue under our care, we will continue to participate until the 60 days or so that are required have expired. After that, we will be out of network as a provider for Cigna. It is better that way and I believe our patients will find their out of network benefits are more beneficial without the interference of ASHN.

Sincerely,

William D Charschan DC,CCSP .

Right to die with dignity - NJ sees a new billboard campaign

2010-07-16T18:15:00.000-07:00

I read an article the other day about right to die groups and how they are getting out their message (http://www.nj.com/news/index.ssf/2010/07/national_campaign_guiding_ill.html). Apparently, there are many groups that are taking Dr. Kevorkians message and putting their own spin on people being able to be allowed to die if the conditions warrant it. In my opinion, many people die in hospitals, with tubes out their body in misery. There have been many instances where these same people have been given an overdose of a medication to put them out of their misery, however, this is considered illegal. I agree that is someone is terminal, and miserable, and has an extremely poor quality of life, they should have the option to end it. Many religions oppose this because the value of life is too great. In reality, many of these religions have been around for thousands of generations, long before we had the equipment to keep the near dead alive. Statistics show that we consume at least 1/3 of all our health care costs at the end of life, with the end being the same. When did it become ethical to torture the dying? We not only torture them, but we drain them and their family financially, emotionally, without having a rational alternative unless a living will is present. The outcome, statistics show is the same; death, which is a normal part of our lifecycle. We should educate ourselves about how to prepare and take a healthier view during the emotional end of a loved one, rather than try things that decrease the quality of life at the end and worsen the suffering.

Without being morbid, I do believe in advanced directives, and I believe it is wrong to keep dying people alive artificially, to prolong their suffering. We surely do not usually do this with our pets who may die with more dignity when the terminally ill pet is put to sleep painlessly.

These groups have a valid point. We should have the option if we are terminal and have poor quality of life to end our own suffering. That is my opinion because it is humane. Regarding the use of billboards, this makes a big statement. Sometimes these types of statements are offensive however, often if you have not offended someone, you really did not get your point across effectively. BTW, the ensuing articles published by the newspaper on these signs is great marketing and PR.

What to you think? I always value your opinion.

Dr C

Dis ease - the idea of diseases as the cause of what ails us

2010-07-14T08:51:00.000-07:00

Wikipedia describes disease as follows:

A disease is an abnormal condition of the body of organism that is not comfortable for it. It is often construed to be a medical condition associated with specific symptoms andsigns.^[1]^[2]^[3] It may be caused by external factors, such as infectious disease, or it may be caused by internal disfunctions, such as autoimmune diseases.

In humans, "disease" is often used more broadly to refer to any condition that causes pain, dysfunction, distress, social problems, and/or death to the person afflicted, or similar problems for those in contact with the person. In this broader sense, it sometimes includes injuries, disabilities, disorders, syndromes, infections. Isolated symptoms, deviant behaviors, and atypical variations of structure and function, while in other contexts and for other purposes these may be considered distinguishable categories. A diseased body is quite often not only because of some dysfunction of a particular organ but can also be because of a state of mind of the affected person who is not at ease with a particular state of its body.

Our health care system is built upon the concept and the Merck Manual, a commonly used guide for diseases is used by doctors worldwide. Disease is regularly used in languages throughout the world and in many cultures, since this is the way we are used to describing a series of symptoms, sometimes with a known cause of pathogen, or sometimes it is just a series of symptoms, named after someone that they described as a new disease or ailment that afflicts us, as well as most living things. Disease has also been used by drug companies to sell product (eg: seasonal effective disorder, restless leg syndrome).

In the chiropractic world, using this definition, back problems can be classified as diseases too, however, this is because it is dis ease or as described above it is a medical condition of specific symptoms of signs. The problem I have with this is that often, using the term disease describes an affliction, without promoting understanding. Too often, diseases have been treated with medications to relieve the dis ease, without understanding why the problem exists. Knee problems are a perfect example of this. We diagnosed meniscus disease, kneecap tracking disease which in no way describes what the condition is or how it got there. We have trained people to treat these dis eases who could care less why it went bad. The reason it went bad is the problem. We teach them to throw therapies and solutions at the symptom which is knee pain which leads to tests and interventions, without the understanding of what we are treating. In the realm of musculoskeletal medicine, this is problematic, expensive, can be disabling (knee replacements gone bad with their thousands of dollars in implementation and rehab. What the dis ease moniker does not do is promote understanding. Lack of understanding currently leads to tests, questionable interventions and expensive solutions of limited benefit (knee replacements, which my mother had just undergone can last 10-15 years and then need to be redone). A better paradigm which is functionally based, rather than dis ease classified would lead to better prevention of many of the so called dis eases. Of course, there are many entities in our healthcare system who are profiting handsomely from the dis ease philosophy being used in the musculoskeletal system. It has lead to unbelievable high costs of treatment, mediocre rehab based on a paradigm that is not meant to promote understanding , unneeded testing and human misery. Managed care promised to hold the line on these costs but instead has tried to clear a profit without helping the paradigm change to a functionally correct one. As they have failed, like the government, they simply pass the bill on to us as higher insurance premiums which has lead to more people underinsured with higher out of pocket costs and a health care system very far from cost effective and effective when compared to the rest of the world.

My recommendation is that at least in the musculoskeletal realm, we move away from the dis ease idea and move toward one of function, which will yield to lower costs from better care and more effective treatment and better preventative care. Other diseases should come under the microscope too since we try to classify things we really do not understand into bite size pieces and then throw therapy regimens about the symptoms so the dis ease process is no longer noticed (not necessarily resolved).

Christian Medical Bill Sharing and other ideas for health coverage

2010-06-26T06:04:00.000-07:00

I came across this article on something called Christian Medical Bill Sharing (http://www.walletpop.com/blog/2010/06/24/christian-medical-bill-sharing-a-growin/). The catch to this that you need to be Christian, adhere to Christian values for coverage (they do not cover abortions, sexually transmitted diseases which are considered un Christian like behavior) however, the premiums are considerably lower than traditional insurance. Members like the plans because as long as they stay within the PPO network, they have a low co payment and it covers their needs. Of course, there are going to be critics of plans like these, however, as people look for more affordable types of coverage, or are displaced from their current employment or start their own businesses, the cost of insuring you and your family can be a deal breaker (Many average plans can cost 16 thousand dollars for an average plan and just ok coverage).

The big idea here is everyone shares everyone else's health care needs for the greater good, a very Christian ethic. Ethics seems to be a problem everywhere we look so an ethical type of healthcare plan with a strong belief system behind it that practices what it preaches is a good idea. They also work with people to help them maintain a healthier lifestyle, a paradigm that has been abused in todays society and health insurance plans. I can get into the healthier lifestyle area however, that is an entirely longer discussion since it encompasses what we eat, processed foods, the government helping corn growers with subsidies for corn syrup and other unhealthy foods rather than helping to keep the cost of good quality food affordable so even the poor can easily buy it and live healthier lifestyles.

I am currently shopping for new health insurance and quite honestly, the price increases over the past year have been incredible. Also incredible, is Aetna just decreased our reimbursements for chiropractic services again (something they have done every few years) by up to 18 percent, yet their rates are some of the highest I was quoted. Where is this money going if it does not go to providers who are already cash strapped by greedy insurance companies who have done this repeately over the years. Unlike this shared plan idea, insurance companies, and their focus on bottom line and CEO bonuses in the millions is very un Christian like especially when they deny medically necessary care by a reviewer you cannot communicate with other than appeal letters which often go nowhere, especially with self insured plans that are administrated by plans like Aetna.

Ethical shared health care - perhaps this is an idea we need to explore not just in the Christian communities but for other people like myself, a Jewish doc trying to help people live a better quality of life.

What do you think? I value your opinion

Salt and Heart Health - Know what you are eating and what is in your prepackaged food

2010-06-25T05:32:00.000-07:00

I read an article that was reprinted in the Star Ledger today from Bloomberg News (http://www.bloomberg.com/news/2010-06-24/potato-chips-help-drive-up-salt-intake-for-most-american-adults-cdc-says.html) regarding problems in the american diet. The Centers For Disease Control is sharing their concerns about food and the amount of sodium used in it. Many junk foods such as potato chips are laden with salt, way to much for our bodies needs. More salt means more electrolytes which means your body will retain water which means it can have an effect on blood pressure. Many of the pre packaged foods we eat are flavor deficient and salt is used to get them to have flavor. Many restaurants use salt, sometimes in abundance with soups and other dishes to give it flavor. Better restaurants find foods that mesh well together and therefore do not require too much salt.

Lets face it, many of use like salt however, often less can add more. Many times I have pushed away soup in a diner because of the salty taste. It really is overkill and our health may suffer long term for this. The answer is not your doctor or the blood pressure medication to control this. The answer is for the public to refuse to eat food that has exorbitant amounts of salt. You can check the packages and if the salt levels are way too high, dont buy that food. French fries if they are really good and flavorful need minimal salt (as opposed to what Mcdonalds sells)

The solution really is public awareness, changing tastes (corporations will make that the public will buy) and a willingness to change. This will be better for our health and should affect health care costs nationally if we make salt reduction a national priority.

What to you think. I value your opinion.

Pressure on doctor pushes up costs, or does it

2010-06-21T13:43:00.000-07:00

I was reading the opinion column in todays NJ Star Ledger regarding an article written by Stella Fitzgibbons MD, who is a hospital based board certified doctor in the Houston Area (http://articles.latimes.com/2010/jun/17/opinion/la-oe-fitzgibbons-health-costs-20100617). She talks about her experiences and who health cost containment is difficult leading to unnecessary testing. Apparently, many families pressure doctors to run many tests to rule out rare problems which the doctors experience had shown will respond well without the increase testing and intervention. She mentions other sources such as web sites and magazines which tell the patient to literally bully the doctor into doing certain procedures and tests.

From the health care providers perspective, what she has said is true from her unique perspective, however, people make many health decisions based on emotions and fear. Fear is a great motivator and our healthcare system has used and in some cases abused this to push patients into doing things they may never have done to themselves, sometimes with horrible and disfiguring effects. People have also been talked into taking harmful substances they would never have taken with horrible side effects because of the false hope they saw on television or the education their doctor received from the local drug rep convincing the doctor that this medication was indeed good for their patient.

When people come to the hospital with symptoms they do not understand, fear is ever present and rational thinking often is scarce, especially around caring family members who found their distressed family member. Our broken healthcare paradigm has literally brainwashed the american public to expect all these tests to leave no stone unturned even though a good exam and responsible recommendations are enough to stay within community standards of their medical specialty, which would protect them from malpractice lawsuits. .

There are not clear protocol recommendations for patients who enter the ER which eliminate the unnecessary use of diagnostic technologies giving families and the one who is ill a greater sense of confidence with the healthcare provider. The system is actually set up for people to want more because of the perception that more is better and the legal perception if liability if every last thing should be tested, even though in many cultures, it is not and people are in many instances are better off. A better system that would save costs, suffering and over testing would be one that would force the doctor to do certain protocols first. Then the patient has to wait a few days after following their home recommendations before further tests are done as they follow up with their own doctors. This would make sense and eliminate some unnecessary testing but not all. I doubt that would happen though because some lobbyist would likely call this rationing, some attorney would call it malpractice (which they cannot if the doctor follows community guidelines which is the way the average doctor in that specialty would behave) and would get the public in an uproar by using the appropriate buzz words.

Is it rational to steer patients down the most logical path based on the current science we have available? I believe it is and our healthcare systems can certainly help patients better with more rational and concise recommendations that take the patient and their families emotions out of the decisions.

In another case she mentions, she has a patient who just came into the IC unit after a huge stroke. She mentions that the family wants everything done to save the life of someone who is also in kidney failure and also has pneumonia. Again, failure of having concise protocols has the family making emotional demands that will prolong his suffering, are likely to fail on an individual with insufferable brain damage. The outcome with or without tubes and procedures is the same - the loss of a loved one. Our healthcare system needs to be able to council a family on the right thing to do which is prepare the patient and their family for the inevitable, rather than having these stressed and scared people make a decision they are likely unqualified to make in the situation that presents itself. The loss of a loved one is awful, and we do not want to let go. If the outcome is the same, and comfort rather than intervention is more humane, yields the same results and does not totally drain the persons bank account as well, shouldn't the best course of treatment be a protocol that leads the family down the right path, rather than giving them the right to push for intervention which clearly is wrong.
Some may say that this takes away freedom of choice and is rationing. I call it rational health care policy. As many studies are finding out, often less is more which is especially true in healthcare. Many developed countries do more with less and the care is often excellent. Their understanding on life, death and taking care of oneself is healthier as well (our country is #38 in the WHO for health care quality). Yes, we americans can learn from other countries healthcare systems and we should.

In life, we are born, we live our lives and at a certain time, our bodies will fail, while we used our lives to procreate and create our legacies. Disney called this the great circle of life. Disney had it right, perhaps our medical systems should learn from Disney. Its as simple as that!

What do you think. I value your opinions.

Shocked by $9M Horizon CEO salary? N.J. Chiropractors Association has own Horizon horror stories

2010-06-16T05:11:00.001-07:00

BY SIGMUND MILLER

COMMENTARY

The recent revelation that Horizon Blue Cross Blue Shield of New Jersey (Horizon) CEO William Marino's compensation package last year was nearly $9 million has come as no surprise to the tens of thousands of doctors and patients throughout New Jersey who have been cheated by the healthcare giant for many years; especially to the Association of New Jersey Chiropractors (ANJC), which represents over 1,600 chiropractors statewide.
As the outcry continues from the general public, legislators, and medical practitioners across the state for legislative hearings regarding Horizon's outlandish executive compensation packages, the ANJC, whose members have experienced first-hand the intransigence and audacity exhibited by Horizon, continues to pursue several strategies to rectify various injustices visited upon chiropractors in New Jersey and their patients by Horizon.
For example, on May 25, the United States District Court for the Northern District of Illinois upheld claims filed under the Employee Retirement Income Security Act of 1974 (ERISA) against 22 leading Blue Cross Blue Shield insurers across the country, including Horizon. The action was filed by a number of individual healthcare providers on behalf of a putative nationwide class of healthcare providers, and multiple state chiropractic associations on behalf of their members, including the ANJC, the Pennsylvania Chiropractic Association, the New York Chiropractic Council, the Florida Chiropractic Association, and the California Chiropractic Association.
The lawsuit challenges the BCBS defendants' abusive practices in using post-payment audits, improper repayment demands, and automatic recoupments, to pressure providers to repay substantial sums that have previously properly been paid on behalf of BCBS subscribers. In denying a series of motions to dismiss the case, the court validated the Plaintiffs' primary legal claim that even retroactive claim denials, including those made as a result of a post-payment audit, require proper appeal rights and other procedural protections under ERISA. The Court also upheld the rights of the state chiropractic associations, including ANJC, to pursue significant policy changes in these auditing and recoupment practices on behalf of their members.
Through the lawsuit, the ANJC hopes to level the playing field for chiropractors facing repayment demands from Horizon by requiring Horizon to fulfill its existing obligations under the law. "We are not challenging Horizon's right to audit claims to ensure payments are made appropriately," said John W. Leardi, Esq., of Buttaci & Leardi, LLC, Special Counsel to ANJC, and co-lead counsel in Pennsylvania Chiropractic Association et al. vs. Blue Cross Blue Shield Association et al., Case No. 1:09-cv-05619. "But too many chiropractors in this state have been unfairly subjected to inflated or otherwise illegitimate overpayment demands from Horizon and been forced to settle because of an inherently unfair process. What we want is a process that requires transparency and fairness; a process where a doctor is given a meaningful opportunity to understand and object to an overpayment demand before facing automatic recoupments from current claims."
The ANJC also continues to fight for fair reimbursement to its members by Horizon on the "front end." For years Horizon, unlike virtually every other private insurance carrier doing business in New Jersey, refused to pay chiropractors separately for patient exams and physical therapy modalities. Instead, Horizon "bundled" reimbursement for these services into payments for chiropractic adjustments. Last October, however, the Department of Banking and Insurance (DOBI) held that Horizon's chiropractic reimbursement policies violated the New Jersey Unfair Claims Settlement Practices Act and ordered Horizon to cease and desist from "bundling" payment for patient exams and physical therapy modalities into the reimbursement it pays for chiropractic adjustments. Nevertheless, it was not until April 15, 2010, that Horizon finally began processing and paying these claims separately in compliance the DOBI's order.
Certainly the DOBI order was a tremendous victory for chiropractors in New Jersey and, more importantly, their patients. And to Horizon's credit, they appear to have stopped bundling chiropractic services on all claims, including those submitted to self-funded plans, which fell outside of the DOBI order. But they have not addressed the thousands, if not millions, of chiropractic claims that were improperly denied in violation of the Unfair Claims Settlement Practices Act prior to October 7, 2009. And frankly we owe it to our members and their patients to explore all possible avenues of potentially recovering these amounts, which we believe are substantial.
The bottom line is that chiropractors and their patients in New Jersey have been subjected to unfair treatment by Horizon for years. So the recent news that last year, when health insurance premiums increased an average of 25% and the economy nearly ground to a standstill, top Horizon executives collected over $24 million in bonuses, came as no surprise to the ANJC, its members, and chiropractic patients throughout the state.

Dr. Sigmund Miller is Executive Director of the Association of New Jersey Chiropractors.

Foods that build muscle and proper nutrition

2010-06-15T07:58:00.000-07:00

I was reading an article that was posted on AOL.com news (http://www.aolhealth.com/2010/05/07/8-foods-that-pack-on-muscle/) regarding foods that help build muscle. One of the biggest problems in our current diet is the lack of protein when compared to simple carbohydrates such as pasta's and breads. As I have gotten older, I have realized since my job as a chiropractor is quite physical, that without an abundance of protein in my diet, I tend to crash after the meal and feel tired and sleepy. This is typical if I have a lunch abundant in carbs and light on protein. Although I love food, during the work week, it is my fuel. I remember Michael Phelps talking about how his diet of in excess of 10000 calories a day was his fuel and at my own level, I need to use the proper fuel to make sure I have the energy to sustain my high level of function throughout the week while treating my patients. As the casual reader, your needs may differ but food is still fuel. It helps you maintain your edge during the week and in this competitive world, everyone needs to be at their peak while doing business. As the saying goes, you are what you eat. Read the article. It has some great advice. What are your thoughts?

AOL Reports Surgery for Back Pain Often Fails - Another perspective

2010-06-11T14:06:00.000-07:00

I just read an article on surgery for lower back pain (http://www.aolhealth.com/2010/06/08/surgery-for-backpain-often-fails/) published on aol. Since we treat many people for back pain, and handle many of the disasters that were mishandled, I believe a chiropractic point of view needs to be voiced.

When people are in severe pain and are scared and cannot sleep, they are willing to sometimes make decisions that are not in their best interest. Back surgery and injections to the spine to numb the area (done at great cost) are often the medical procedures recommended by surgeons because they are by nature, surgeons. You do not go to an orthopedic or a neurosurgeon to a conservative opinion, even though many are conservative in their recommendations.

The real problem in all this is that in our health care paradigm as it currently exists, we are obsessed with the site of pain being evaluated rather than evaluating the person, their body style and their gait, which are the most common reason for people having lower back pain and sciatica, as well as neck and shoulder problems and even headaches.

More and more primary care providers are sending their patients to chiropractors first. The reason is that their methods are safe, effective, have high levels of patient satisfaction and in most cases, their way of thinking leans toward the cause of pain rather than the symptoms that resulted from a mechanical malfunction.

If you have or had lower back pain and visited a doctor, did they ever look at your feet? Most people will say no which is why they never get relief. Foot problems are the most common source of lower back problems. What likely happened is that you either were sent for an MRI, x rays or some other diagnostic test, referred to a physical therapist or more commonly a chiropractor and they worked on your back with exercises, or any number of regimens.

The problem is that back pain is a gait issue (an issue with the way you walk). If your gait is irregular enough, you will get back pain, may have disc problems and are a likely candidate for sciatica or sacro iliac problems and will not be flexible. If you were unlucky enough to be sent directly to a surgeon because of your level of pain, you may make that rash decision for a surgery that is harmful rather than helpful because if does not correct the way you walk and instead, attempts to put stability in an area that is being torn apart by the way you walk.

In our office, we prevent many people from ever needing back surgery. The few who do are chosen well and generally do much better than they did prior. The secret to successful back surgery is picking the person properly.

Before even considering surgery for a shoulder, back, neck or hip, you are better off seeing someone like me who will look at you, find out why the problem is occuring and resolve the cause, rather than just the symptom of back pain. You are most likely to get better faster, have fewer problems in the future and enjoy a better quality of life. Trying to identify every pain as its own entity is medical wack a mole, with often less than satisfactory results. Chiropractic is a wiser decision. You can always have surgery....

Summer Back Pain Prevention With Better Footwear

2010-06-09T13:16:00.000-07:00

Sandals and flip flops are going to be huge this summer. The ugly secret though is that for most of our patients, the cheap flat sandals will cause your back to ache. Since your children are most likely built like you, they likely walk like you. Never buy sandals without arches. I will show you examples of what you should and should not buy. A good sandal is worth the extra cash if you have to do any extended walking. Your feet, knees, lower and upper back will thank you (trust me on this).

Reef Sandals (pictured above) are a great example of a terrific design, with a great arch and they look good too. Many local stores carry them and they are available on line. Notice these have terrific arches. Also to the right are Croc's which are a hot fashion item this year and they have good arches too.

Note below are examples of what not to buy. While these flip flops are inexpensive at Old Navy, they are not appropriate for anyone with foot problems that causes back pain. People without foot issues can wear these with minimal consequences. To the right are a typical womens sandal again without arches. These should be avoided by anyone with lower back problems.

There are many other companies that make well designed flip flops which are commonly sold at Nordstroms, Sports Authority, Dicks and have names such as NIke, Teva to name a couple. Since it is the end of the season around here, you may be able to score big during sales and stock up on great summer flip flops and other styles of shoes.

Lastly, dont forget to put your arches in your regular shoes and sneakers, especially when playing sports.

Hookworms, a cheap and effective way to treat auto immune disease - Now we are talking

2010-05-31T17:47:00.000-07:00

I recently came across an article about a man named Jasper Lawrence who has discovered a curative way to treat allergies, multiple sclerosis, Crohn's disease, ulcerative colitis or other autoimmune diseases. by using hook worms read the whole article at http://www.dailyfinance.com/story/hookworms-a-cheap-treatment-for-autoimmune-diseases/19486156/.

Apparently, hook worms occur in the ground naturally, especially when poor sanitation exists. They do not naturally occur in the United States because of our improved sanitation so he traveled abroad to inoculate himself because of severe allergies. He believed that hook worms naturally caused the immune system to be less reactionary, thereby controlling symptoms that are due to auto immune conditions. He also has shown that drug companies make products that do this but cost markedly more than hook worm inoculation and the hook worms are markedly safer. Apparently, as we evolved, we required hook worms in our system for our bodies to have a balanced immune system. Since our obsession with cleanliness and sanitation had gone to the extreme, we no longer contracted hook worms and therefore, we have seen an up tick of many autoimmune diseases processes which would have been kept in check with hook worms.

He has come under fire with the FDA but says the inoculation via skin contact with the live larvae who eventually live in our intestines are safe in low numbers and should be considered as a cost effective and natural/safe alternative to drug therapies.

Drug companies would have no incentive to develop such a treatment which could really cost at lease 90 percent less than the drug alternative. Personally, I believe that many problems we have in todays society have to do with similar processes that used to be in contact with us. Laetrile is one example of something we used to intake through seeds and pits which is no longer in our diets and evidence suggests it keeps cancer in check. Cancer rates in our society are skyrocketing and drug companies and hospitals like sloan kettering have no interest in low cost prevention/ alternatives because they are not good for their business model. Perhaps, we would be better off if truly non profit disease research would exist (it doesn't, even with the american cancer society) because we would find ways to keep people healthier and at lower cost, with better care. Technology is a double edged sword, and when private industry keeps the price high via patents and administration, of expensive technologies which have to pay themselves off, make a profit and pay their investors, perhaps we need to look outside the box of what we know to get the best answers.

What do you think. I value your opinion.

Chronic Pain and the Medical Merry Go Round. The problem with over specialization

2010-05-24T14:34:00.000-07:00

Today I saw a patient I have not seen in years. She was in terrible pain and could no longer work due to it. Her primary doctor had sent her to a number of specialists who drugged, poked, prodded, injected and pushed her off to other specialists, without actually helping her. Her arthritic knees and legs continued to worsen and be more painful and not at any time did they ever mention the idea of seeing her chiropractor again.

I was quite upset by what I saw because many of the increases we see each year from our health insurance carriers is because of never ending procedures and aimless care. I was able to help her today and she walked out of the office more easily and in less pain. The problem is that I am seeing this with increasing frequency. As your chiropractor, I see myself as part of a persons health care team, however, in many ways I am also primary care for the musculoskeletal system. I look at people, not just their symptoms. In this womans case, they looked at symptoms, and somehow forgot that everything is connected. I suspect this is because of our broken healthcare paradigm, which is proliferated at is source, the educational institutions that teach broken care full of big words, with little understanding behind them.

I firmly believe we need to make primary care to be more important that specialization, and we need to teach doctors about body systems. By looking at the knees, hips, arms and other painful areas, and ignoring their inter relationships, we are harming people and at worst, ripping off the public. The public deserves better.

If you know of someone who is experiencing this type of situation, and they have not looked outside the traditional medical system, perhaps they need to place their trust elsewhere. Doing the same thing and expecting a different result is the definition of insanity. I would be happy to help this person and steer them in the right direction.

The best doctors treat people, rather than the symptoms they'd shown up with.

What do you think? I value your opinions.

Why Do Medical Doctors Hate Chiropractors

2010-05-18T08:10:00.000-07:00

This article was forwarded to us from one of our patients. It was published by Bottom Line Personal and was part of their email feed. You can subscribe to this newsletter by emailing dailyhealthnews@edhn.bottomlinesecrets.com

Is Chiropractic Care a Visionary Form of Health-Care Reform?

If you’ve ever complained of a terrifically sore neck or lingering back pain, I’ll bet someone suggested that you see a chiropractor. I visit my chiropractor when my recurrent neck pain flares up (as in, when I spend too many hours in front of my computer for too many days in a row), and I know lots of other people who see chiropractors, too. Now research is affirming the efficacy of chiropractic care for a number of conditions, and this trend may be further stoked by changes brought about by health-care reform.
For many complaints, including such varied and seemingly unrelated ones as headaches and digestive distress as well as back and neck problems, chiropractic care can often provide safe, effective and fast-working treatment -- and (unusual for natural therapies) most insurance plans cover it. However, many mainstream medical doctors aren’t fans. Their reasons aren’t always clear but seem to lie somewhere on the spectrum between being worried that chiropractic care is not safe and feeling threatened that good chiropractors may take away many of their patients.
The Time is Right
In a glass-is-half-full kind of way, today’s troubled health-care environment actually presents an opportunity for chiropractors to gain some long overdue respect -- at least that’s a hope that’s currently afloat in the chiropractic community, I heard from Robert A. Hayden, DC, PhD, spokesperson for the American Chiropractic Association. A critical-care nurse for 20 years before becoming a chiropractor himself, Dr. Hayden explained that the nation’s ongoing and pressing concern about health-care costs and treatment efficacy is a good backdrop against which to understand the many ways chiropractic care can help patients.
Why are doctors skeptical? Dr. Hayden told me that one of his regular patients is an orthopedic surgeon -- but another orthopedist in his community won’t accept patient referrals from Dr. Hayden, and a nearby hospital won’t perform MRI scans for his patients. He believes this lack of acceptance is fueled by the very fact that chiropractic does not involve drugs and can be an effective alternative to hospitalization and surgery, which makes it attractive to both patients and the bean counters of health-care costs. The fact that Medicare now covers some chiropractic services enhances its credibility but also adds weight to worries that this natural, less invasive and less expensive alternative will divert health-care dollars away from medical doctors and hospitals.
What Will It Take?
Key to the growing acceptance of chiropractic care is evidence-based research demonstrating that it is safe, clinically effective and cost-efficient. In the latest such effort, funded by Mercer Health and Benefits in San Francisco, Dr. Niteesh Choudry and colleagues reviewed existing literature on the efficacy of chiropractic. Their conclusion is that it works as well as or better than conventional modalities, including exercise programs, drug regimens and surgical intervention, for treating many forms of low back and neck pain, two of the most common medical complaints. Numerous other studies also support the effectiveness of chiropractic treatment for spine and neck issues in particular. For instance, a 2002 study of patients with nonspecific neck pain found that pain was reduced and function improved for 68.3% after seven weeks of chiropractic care, while the success rate for those in the care of general practitioners was only 36%. The patients of chiropractors missed work less frequently and needed less pain medication.
Can It Cause Stroke?
One very specific concern voiced by many medical doctors is that chiropractic neck manipulation has the potential to cause stroke, or -- if done improperly -- even death. The basis for this is a fairly rare and often undiagnosed condition in which the vertebral arteries in the neck are weakened, possibly by high levels of homocysteine. The fear is that in a vulnerable patient, twisting or stretching those arteries during a chiropractic manipulation could cause them to rupture.
To investigate whether this is a real danger, researchers at the University of Calgary (Alberta, Canada) studied vertebral arteries from several recently deceased people and found that it would take nine times the force of a typical chiropractic adjustment to damage these arteries and mobilize plaque. In fact, according to Dr. Hayden, normal head and neck movement present a greater risk than chiropractic manipulation for the kind of weak arteries that are of concern. By that measure, it’s risky to have your hair washed in one of those beauty parlor sinks where you have to lean way back (there’s even a name for this one, "the beauty parlor stroke"), play sports or even to turn your head to complete a turn while driving.
The condition that puts people at risk for this problem is very rare, Dr. Hayden said, noting that the statistics don’t support the level of concern being expressed. He pointed out that chiropractic is so low-risk that practitioners’ malpractice insurance costs only about one-tenth what an MD has to pay -- around $1,300, on average, compared with $10,000 to $20,000 for general physicians.
The Trend Is Good...

Meanwhile though, patients are voting with their feet -- so maybe doctors should try to learn more about chiropractic care rather than stand in the way of progress. The number of chiropractic patients in this country doubled in the two decades from 1982 to 2002, and an estimated 10% of Americans have seen a chiropractor in the past year.
As for me, well, when my neck hurts, I visit my chiropractor... and I feel better. If you’re interested in exploring this form of alternative medical care, you can go to http://www.acatoday.org/search/memsearch.cfm to find an experienced, licensed practitioner in your area.

Source(s):
Robert A. Hayden, DC, PhD, founder and director of Iris City Chiropractic Center, PC, Griffin, Georgia, and spokesperson for the American Chiropractic Association.

You can subscribe to this newsletter by emailing dailyhealthnews@edhn.bottomlinesecrets.com

Personal Gene Tests? Good or bad idea?

2010-05-12T05:19:00.000-07:00

Do you think we should be able to purchase a personal gene test over the counter to find out if we have genes for high blood pressure, Alzheimers disease, high cholesterol, cancer and a host of other potential diseases that may or may not occur? Not long ago, genes were patentable until the patent office was challenged on the patenting of genes such as BRAC 1 and 2 known for breast and ovarian cancers. People spent close to 3000 dollars to do this test that should cost less but due to the patent, there was a monopoly. I guess the monopoly is broken but if we now can do it yourself gene testing, does it show things we can do things about, things we cant and can our privacy be breached by life insurers who make this part of their screen along with the typical blood tests that are done? I am also concerned because it may make certain people do things they may never consider doing including self mutilation in the name of prevention (women have had breasts and ovaries removed with the discovery of BRAC 1 and 2 for example) even if the problem has never appeared.

People are not always rational and giving them information like this can cause them to worry about problems they may have even though they may never develop the problem. A television series called Flash Forward entertains this idea by having a global blackout where everyone either sees their future or does not. Those who did not are assumed to have died and others see things happen they could never imagine. As the date approaches or passes, they of course learn the future is pliable and can change or be modified. The same idea goes to genetic testing where the gene says this is likely to happen but may of course not if we change the way we live in some cases or things may never happen; we really do not truly know. To act on something we believe is likely but do not know is taking a risk that can either pay off handsomely or create a problem that never existed after all (kind of reminds me of our current health care interventions and the mess they have created) On the other hand, some genes such as obesity can be attacked early in life by lifestyle changes and knowing allows us to be proactive. Many other gene variants are known however, we have no way of fixing them. Some research has been done with the idea of using viruses to deliver repaired genetic code to the cells, thus altering our future.

I guess gene testing is a start. I would recommend that anyone who decides to do it should have it repeated. Imagine if you did the test, believed everything in it only to find out your test was confused with another persons test and you had your breasts removed preventatively with your ovaries. Part of the argument against the death penalty is that we killed innocent people who were sentenced by a jury, only to find out after that they never did it with genetic testing.

What are your thoughts? I value your comments.

Antacids a cause of bone fractures and infections, Vitamin D and Osteoporosis and more

2010-05-11T09:43:00.000-07:00

I was reading in the Star Ledger about certain acid reducing medications and their relationship to ones health (http://azstarnet.com/news/science/health-med-fit/article_247ef04b-9813-5d77-bbc8-fbeb497a226f.html). For quite some time, if we have acid reflux, or heart burn or any other stomach complaint, antacid meds such as nexium have been given to relieve the complaint. Commonly, most regular doctors are quite comfortable with the idea that if we have acid reflux or any other type of symptom representing overproduction of acid which have been thought in the past to cause ulcers and other gastro intestinal distress, these substances buffered the acid and reduced the amount we produced. The symptoms may have been relieved, however, was it really the right thing to do? As we age, we normally produce less acid. This makes it more difficult to digest food, break down minerals such as calcium before it enters the intestines and even allows for increased likelihood of having infections in the stomach such as H Pylori which was treated with, you guessed it, nexium. Years later, we have studies showing people with reduced calcium in their bones and more gastro intestinal infections as they get older. This is what I call learning the hard way. There are of course other treatments such as having a teaspoon of vinegar which has been known to calm the stomach. Vinegar? Sure vinegar because it has acetic acid and that helps digest food in older people. As I have said, we need a paradigm shift, away from symptoms and more toward understanding what we are treating. How can we treat something we do not understand and call it the science of health care?

The other article was on Vitamin D and osteoporosis (http://www.omaha.com/article/20100511/LIVING01/100519970). For quite some time, vitamin D has been included in milk which has calcium because it helps assimilate calcium into the body. Milk producers proudly state their milk has vitamin D added. Vitamin D also is produced in the body naturally however, many seniors have skin sensitivity due to medications and some have fair skin which is a concern because of melanoma. Because of this, many seniors stay out of direct sunlight which can cause a deficit of vitamin D. The article suggests that many hip fractures and other fractures in the elderly may be avoided with vitamin D supplementation. I agree. I also believe it is more preventative than dexa scanners and using the results to talk people into taking drugs like boneva.

In healthcare, we are all consumers and in our office, educated consumers (as the Syms commercial says) is our best customer. What do you think?

Surgery for Flat Feet - Good Idea?.... Not

2010-05-08T12:54:00.000-07:00

I was reading an article in the NY Times about actor Gbenga Akinnagbe who decided to have surgery to correct flat feet (read the entire article at http://www.nytimes.com/2010/05/04/health/04case.html?ref=health). Out of desperation, he decided to undergo a surgical procedure to correct a severe problem in his feet to relieve knee and back pain. Apparently he had tried foot orthotics and other therapies with no real improvement and decided to do this instead. He had his left foot done first and is waiting to do his right one next.

After being in health care for 23 years, I have seen many people resort to many crazy things such as this with varying results. Almost daily, I am visited by frustrated athletes and regular folks who are in chronic pain in their joints and their doctors just don't understand. Orthotics are casted poorly and are ineffective, they are aggravated rather than helped by therapies and few people they visit understand why they are hurting, even though they pedal cures that "may helP.W" Recently, I was visited by a woman who hurt her back initially a few months ago, was then told to have an MRI to rule out a disc problem, was then told she had uterine fibroids and needed a hysterectomy and then when she began having knee pain, the orthopedic told her to have knee surgery first. This patient is a classic case who is drawn into the system and told to do painful and disfiguring things to herself in the name of health. I sat with her for 20 minutes and explained her symptoms made sense, to get a second opinion on the hysterectomy and to avoid the orthopedic doctor for her knee. I just completed her third visit today and she will be planting flowers tomorrow for mothers day instead if being miserable and in pain. She is literally reclaiming her life from the medical experts after a couple of visits and now understands why she was in pain. She cancelled her hysterectomy as well, opting for something more sensible . Informed consumers of health care are not our systems best customers since they will opt out of a bad situation once they finally understand it.

I bring this up because mismanagement of the musculoskeletal system is rampant in our health care system and people who lose hope or are scared are its best customers. Is it any wonder health care costs are out of control?

Regarding the actor in the article, I have never had to resort to recommending a surgery for anyone who has e severe foot overpronation which by the way is an inherited trait. Some of our severe overpronators run marathons. I believe this gentleman has likely never visited the right doctor who understands his problem and can intelligently treat it conservatively. Foot overpronation and the pain it can produce is nicely controlled with foot orthotics, myofascial release and repatterning or movement and the myofascial surrouding the core and the lower kinetic chain. Chiropractic adjustments to the spine and the extremities will help improve movement and reduce pain further while improving outcomes non surgically. In the case of clubbed feet, surgery is necessary and this is typically corrected in early childhood. In the case of this gentleman, it is too bad we never met. The solution is easier than he was lead to believe and much less painful and disabling too.

What do you think? I value your opinion.

Preserving your knees and hips - avoiding the joint replacement syndrome

2010-04-27T08:13:00.000-07:00

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

Control Your Weight
Go Low Impact
Avoid Injury
Get Fit
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?

2010-04-21T12:08:00.000-07:00

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

2010-04-12T11:45:00.000-07:00

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

2010-04-07T15:18:00.000-07:00

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.

2010-04-06T08:05:00.000-07:00

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?

2010-04-03T14:42:00.000-07:00

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?

2010-04-02T08:08:00.000-07:00

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

2010-04-01T15:20:00.000-07:00

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.

Israeli invention allows paraplegic's to walk - check it out

2010-03-30T08:41:00.000-07:00

I recently came across this device now being tested that allows paraplegic people to walk and mount stairs upright. Previously, these types of people were bound to a wheelchair for mobility. I think this is ingenious. What do you think?

Is Junk Food Is as Addictive as Heroin or Cigarettes?

2010-03-30T08:39:00.000-07:00

A recent study suggests junk food is addictive (http://www.dailyfinance.com/story/study-says-junk-food-is-as-addictive-as-heroin-or-cigarettes/19417741/). If anyone has ever had a potato chip or an oreo cookie, it is hard to just have one. Many of these foods are geared toward our cravings for carbs and also salt and starches. These foods are high in calories and are believed to be part of our countries obesity problem. Now, some government entities because of this are believing that a sin type of tax should be placed on them. The article asks if these foods should be regulated like a drug. Read the article and I welcome your comments.

In my opinion, we need to begin at the family level to reeducate families as to what types of foods are good. We need to make better quality food cheaper rather than cheaper foods such as starches (pasta). Instead of paying farmers to grow corn (corn sweetners, ethanol), we should supplement them to grow food and make better foods cheaper. I believe this would be a better way of handling the poor food consumption problem. Perhaps, over time, we will see our diets change for the better

Top Foods That Fight Cancer

2010-03-26T17:59:00.000-07:00

I just came across this article that was published in Dynamic Chiropractic. Check it out. It is worth the read.

Top Foods That Fight Cancer

By James P. Meschino, DC, MS

In case you haven't seen the book Foods That Fight Cancer: Preventing Cancer Through Diet, I strongly suggest you pick up a copy and recommend it to your colleagues, friends, clients, patients, students, associates and family members.

The book is authored by two leading cancer researchers, Drs. Richard Beliveau and Denis Gringas. Dr. Beliveau holds the Chair in the Prevention and Treatment of Cancer at the University of Quebec in Montreal, and Dr. Gringas is a researcher in the Molecular Medicine Laboratory of UQAM-Sainte-Justine Hospital (Centre de Cancerologie Charles-Bruneau) and the University of Quebec at Montreal.

As stated in their book, "Nature supplies us with an abundance of foods rich in molecules with powerful anti-cancer properties, capable of engaging with the disease (cancer) without causing any harmful side effects. In many respects, these foods possess therapeutic properties on par with those of synthetic drugs". In a very precise but understandable manner, the two researchers outline the many biological targets affected by bioactive nutrients in foods that can help prevent cancer and be used in the adjunctive management of cancer. More specifically, they highlight the research showing how specific food-borne bioactive molecules can do the following

Decrease free-radical damage to DNA, which is known to produce cancerous mutations;
Strengthen immune system function, as various immune cells are known to destroy cancer cells (e.g., macrophages and killer-T cells);
Inhibit angiogenesis of developing tumors;
Block key signal transduction pathways required for cancer cell replication;
Stimulate pathways that induce programmed cell death (apoptosis) of existing and emerging cancer cells;
Enhance detoxification, helping to neutralize and eliminate carcinogens in the body;
Promote cellular differentiation, which decreases the risk of healthy cells from becoming cancer cells;
Block the formation of dangerous nitrosamines in the body;
Block the synthesis of dangerous forms of estrogen and testosterone, which are associated with reproductive organ cancers;
Slow the rate of cell replication, which is a key factor in reducing the frequency of genetic mutations that may occur;
Blocking receptor sites on cells to prevent over-stimulation of hormones and growth factors, which, in turn, slows down the rate of cell division;
Reduce the synthesis of inflammatory prostaglandin (series-2), which is also linked to increased cancer risk.

Foods That Fight Cancer

In addition to reviewing the worldwide evidence on this subject, the Nutrinome Project, conducted in their own lab, has shown that raw extracts from certain fruits and vegetables inhibit the growth of certain cancer cells to varying degrees. Using medulloblastoma cancer cells (a very aggressive brain tumor), they showed that extracts of certain fruits and vegetables could inhibit the growth of these cancer cells in the following order, from most effective to least effective: garlic, beet, kale, red cabbage, onion, turnip, cranberry, carrot, potato, squash, cabbage, and tomato.

Since then, these researchers have gone further to show that blending some of these fruits and vegetables together into a cocktail and feeding it to immune-deficient mice (nude mice), who were injected with human lung cancer cells under their skin, resulted in better health outcomes than occurred in nude mice who were injected with lung cancer cells, but did not receive the fruit and vegetable cocktail. (A more in-depth description of these experiments and pictures of the mice can be found in the book Anti-Cancer: A New Way of Life, by David Servan-Schreiber, MD, PhD.) The specific brewed cocktail given to these mice closely matched what would be attainable for humans to mirror and included:

Cabbage
Blueberries
Brussels sprouts
Broccoli
Garlic
Scallions
Turmeric
Black pepper
Cranberries
Grapefruit
Green tea

The implication is that individuals who have cancer may wish to use a daily cocktail of this nature in conjunction with their standard medical treatment, as a means to enhance certain biological mechanisms that may help their body fight the disease.

Anti-Cancer Foods for Daily Use

For the rest of us, Drs. Beliveau and Gringas suggest there is a daily preventive threshold level of cancer-fighting foods that each of us should strive to attain. Their suggestions for the prevention of cancer include consumption of the following items each day:

Brussels sprouts - ½ cup
Broccoli, cauliflower, cabbage - ½ cup
Garlic - 2 cloves
Onions, shallots - ½ cup
Spinach, watercress - ½ cup
Soy (edamame, dry roasted beans) - ½ cup
Freshly ground flaxseeds - 1 tablespoon
Tomato paste - 1 tablespoon
Turmeric - 1 teaspoon
Black pepper - ½ teaspoon
Blueberries, raspberries, blackberries - ½ cup
Dried cranberries - ½ cup
Grapes - ½ cup
Dark chocolate (70 percent cacao) - 40 g
Citrus juice - ½ cup
Green tea - three 250 ml servings
Red wine - 1 glass (5 ounces)

What About Supplements?

Drs. Beliveau, Gringas and Servan-Schreiber all suggest there is no evidence to support the use of dietary supplements to prevent cancer, or to be used in the adjunctive nutritional management of cancer. On this point, I disagree wholeheartedly with these experts, in that numerous studies have appeared in peer-reviewed medical and scientific journals in recent years showing important anti-cancer properties provided by various nutritional supplements. This includes studies demonstrating their ability to help prevent cancer, reduce cancer incidence, and be used in conjunction with medical practices as an adjunctive measure to enhance the efficacy of some forms of chemotherapy and/or slow the progression of cancer and/or decrease the recurrence of cancer.

As a practitioner who is affiliated with a leading cancer treatment facility in Toronto, our patients are provided with the best that medicine, diet and supplementation have to offer, based on the total pool of peer-reviewed scientific evidence. I have published numerous review papers on subjects pertaining to the use of nutritional supplements and cancer. I am also a lecturer on this subject in the Cancer Fellowship Program for medical doctors through the American Academy of Anti-Aging Medicine

Click here for more information about James P. Meschino, DC, MS.

Too Much Medical Care? A doctor speaks out about his own profession and my thoughts

2010-03-26T11:40:00.000-07:00

In todays star ledger, in the opinion column, there was an article written by H Gilbert Welch, an internist in the Department of Veterans Affairs titled Are we getting too much medical care (This has been printed by numerous newspapers because it says many of the things I have been talking about for quite some time http://www.projo.com/opinion/contributors/content/CT_welch_03-19-10_7EHQ2QT_v14.3f8b13f.html).

In todays health care environment, we have used fear quite effectively in getting people to undergo many tests and screenings of dubious value and placing them on substances all paid for by a system that is slowly going broke by this. The worst part of it all, is that people are not necessarily leading better lives because of these interventions and periodically have procedures done at great cost that left them worse off with no benefit, all paid for by us. I question all the people on cholesterol meds who would likely feel better and have fewer problems in their muscles and bodies without them. I question all the people taking Dexxa scans and being put on bone forming meds which have their own side effects which is done because there is a remote possibility that they will have problems when they are in their 80's from compression fractures maybe.

Of course, in the article it also raises the point of when to use technologies. At the end of life, we still die yet many of us die in the ICU rather than in the comfort of our homes and at great cost as well. As your parting gift, we drain your bank account for you and you die miserably. Is this an intelligent and even humane paradigm (pardon my sarcasm).

Maybe, we need the wellness model after all, where people are taught how to stay healthy vs. obsess about weather we are going to be sick or not.

What do you think? I welcome your thoughts and comments.

New Car Design Will Make You Healthier

2010-03-23T04:46:00.000-07:00

Today, I came across an article about a human powered car that will run at highway speeds and is a great solution with the sedentary lifestyle ( http://autos.aol.com/article/human-car/). Needless to say, I was quite impressed by the thought process (out of the box which is how I think about problems) and for the casual commuter, who wants a street legal vehicle that will also give them the exercise they crave as well. They call it the HumanCar "FM-4," for "Fully Manual-4 people. BTW, the vehicle will also function as a hybrid and they claim can get the equivalent of 100 mpg. Check out the article on the link above. You can actually purchase one of these through http://humancar.com/. This guy deserves to get rich from an idea like this. Of course, this is not for everyone but for all those who get up at 6am to go to the gym before they work out, your ship has come in. Just drive this to work on nice days.

Genetic Testing Gone Mainstream - the Age of Genomics

2010-03-20T13:47:00.000-07:00

A just read an article in the NY times on Genomics or genetic testing. A few company's are trying to get this to go main stream (http://www.nytimes.com/2010/03/20/business/20consumergene.html) with some difficulties due to the public embracing the concept slowly. The big question is can genetic testing really predict who will develop certain diseases and who will not? In my line of business, it is not difficult to evaluate who may develop problems and painful conditions due to their body mechanics because genetic traits show up as our structure and ultimately determine how we stand, walk and function. Predicting this from the DNA sequence is much less reliable, yet, these companies would like us to believe that if we know our genetic breakdown and have it discovered, we can act on problems that may not have occurred yet. I can use the analogy of a company that was recently busted for trying to convince consumers that if they buy their identity protection service (http://www.lifelock.com/), that they will ensure that nobody can steal their identity and they will be protected. They were recently shown to do little or nothing and using fear to motivate people to use the service (http://www.theinternetpatrol.com/lifelock-lawsuit-over-settles-deceptive-advertising-claims-with-feds-for-12million/), they were doing little that most people could do themselves to protect their identities which is why you needed the insurance.

With genetics, even if you spent thousands to decode your genome (genetic map), we simply do not know enough about genetics to say that if someone has a certain genetic makeup, they will develop diseases. A number of years ago, we paid for BRAC1 and BRAC2 testing (http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA) which are known as cancer genes. The thought is that if you had these genes, you are most likely to get breast or ovarian cancers will enter the minds of many women who are diagnosed. Some women are so afraid of the cancer after being diagnosed, they have their breasts removed preventative, even though nothing is wrong simply based on fear. The question we should all ask ourselves is that if we find out we have a gene and it is suspected to be potentially harmful, will it be and if so, what will trigger the problem? The problem is that we do not understand genes or these processes well enough to use this information constructively and our fears will create many unneeded treatments and procedures that can be worse than the gene itself?

What do you think? I invite your opinions. Check us out at www.backfixer1.com

Garlic soup - Chasing away colds, cancer and vampires too

2010-03-20T06:43:00.000-07:00

A garlic-rich diet appears to protect against various cancers, including breast, prostate and colon cancer, according to the NY Times (http://well.blogs.nytimes.com/2007/10/15/unlocking-the-benefits-of-garlic/). It is also an effective antibiotic and recently, since many of our patients have had colds, I thought that this may be a timely post. The site Garlic-Central.com sites the following:

Always consult your doctor regarding any health or medical matter
The medicinal properties and benefits of garlic are strongest when it is raw and crushed or very finely chopped
Don't overdo it - too much can irritate the digestive tract
Raw, crushed garlic is an anti-fungal, however it can produce skin blistering
Raw, crushed garlic is a powerful antibiotic (1)
Cooked prepared garlic is less powerful but still reputedly of benefit to the cardiovascular system
Garlic cloves cooked whole have very little medicinal value however their milder taste makes them more acceptable to some people
There have been claims that garlic can help with cholesterol management however the research is inconclusive
If buying garlic pills, check the ingredients
Garlic should be seen a part of a healthy diet and lifestyle, not an alternative to one
Be aware of the possible problems with garlic

An easy way to do this is with garlic soup. I pulled this recipe off the NY Times (http://events.nytimes.com/recipes/7022/1999/09/01/Garlic-Soup/recipe.html).

RECIPE

Garlic Soup

Adapted from Jean-Georges Vongerichten

TOTAL TIME: 30 minutes

INGREDIENTS

3 tablespoons extra virgin olive oil
4 whole garlic bulbs, separated into cloves, peeled and thinly sliced
2 teaspoons fresh thyme leaves
6 cups chicken stock, preferably homemade
Salt and freshly ground black pepper
2 large eggs
1 tablespoon white wine vinegar

PREPARATION

1.: In a large saucepan over medium heat, heat the olive oil and add garlic and thyme. Saute until garlic is soft and translucent, about 6 minutes.
2.: Add chicken stock, and bring to a boil over high heat. Reduce the heat to medium, and simmer until the liquid is reduced by half and the garlic is very tender, about 15 minutes.
3.: Season to taste with salt and pepper. In a small bowl, combine eggs and vinegar, and beat with a fork until well blended. Whisk into soup, and stir until soup has thickened. Serve hot.

YIELD: 4 servings

Be aware that if you decide to make this, or eat raw garlic , it may have some other side effects such as you will be offensive to vampires (one less thing to worry about) and your significant other will be much less likely to kiss you and/or be near you.

Core Strength and the way you function

2010-03-16T10:21:00.000-07:00

A friend just told me about a great article written about the core and his experience going through the strengthening process. Read it at the Wall Street Journal http://online.wsj.com/article/SB10001424052748704588404575123510044247310.html?mod=googlenews_wsj.

My opinion of core strengthening is that a solid well functioning core is essential to activity, especially athletic activity. Though the literature information currently available is limited as far as what good core activity can accomplish, many disciplines such as trainers, pilates and even Wii Fit (something I use for this) improve core strength and stability and as a result, I feel and function better. When I took hitting lessons a few years ago (I never was a good hitter in softball), at first i learned the movements, practiced but the Wii fit pulled it together using the virtual trainer and I had my best hitting season last year (although many guys are much better than I am) with balls that now go into the outfield. Now if I can get better at running bases, I will have it made.

The problem with core training is that it is not enough. If you are built asymmetrically, the myofascia in your abdomen and lower back muscles has likely tightened in response to this and torqued your core, which makes you lose leverage. Loading this up will cause you to recruit in your legs and shoulder muscles causing shoulder and neck tightness as well as tight hamstrings and calves. This will eventually cause pain. There are many people who attempt to counteract this with foam rollers however, this is just dealing with the symptom. Even worse, many trainers attempt to modify what you do so you can do it, even though they are reinforcing the torqued core and making your problems more chronic.

This is precisely where our office comes in. The best ways to address this is by either using myofascial release or graston techniques and by active evaluation. Once core stability is achieved, you can train it and if you use a personal trainer, they will no longer have to modify your activities and it will enable you to reach your goals. Running or training through it really is not an option. Check us out at www.backfixer1.com. Now as the spring arrives, we can be your secret training weapon and make your training more efficient.

Dr C.

Too many medical tests, too little doctor time and what is the poor patient to think or do?

2010-03-13T06:01:00.000-08:00

The Star Leger reported in its article reprinted from the Associated Press from Lindsay Tanner (http://news.yahoo.com/s/ap/20100312/ap_on_he_me/us_med_unnecessary_tests) that we are over tested, over doctored and the rationale for what we do is truly broken. More and more are being written about how the current model, especially the cancer screening models are coming under fire for over promising and under delivering when it comes to life expectancy. Statistics do not lie although because health reform will likely affect our current ways of doing things, there will be winners, losers and hopefully in the end the patient benefits. Some of our patients have heard me say that right now, our cancer detection methods are like whack a mole because we have people and do tests that may detect a problem and then do more tests or interventions (hit it) to try and see if they get it or if it moves (either are wrong in our assumption - found a breast lump for instance that is normal but had a biopsy to determine this for example) with the implied idea that if it is cancer and it is not too aggressive, we can poison you with chemo and radiate you until the cancer cries uncle (hopefully). I hope you get the analogy which I use because until we actually understand what cancer really is (see my prev post for some possible ideas on this), these tests and their interventions may be harmful or helpful and may disfigure you for life. Cancer is just one example but it all starts with the primary care model and how we use it.

Primary care heavy states (fewer specialists) statistically show lower costs, fewer specialist referrals with therefore fewer interventions and overall, the same or better outcomes. One HMO in Illinois uses a chiropractic primary care model which has shown to cost the system up to 50% less overall with high satisfaction from the public (yes, primary care can be drug and vaccination free). The chiropractors understand the musculoskeletal system better which comprises of many of the complaints and I have always said that one of the primary reasons our health care system is a monopoly is that we have the disease based model feeding the disease based model where in other countries, acupuncturists, natropaths and other styles of primary care do primary care well and cost effectively. In our current model, most regular family practitioners do not know musculoskeletal very well and so they sent it out. From a chiropractors perspective, we can very well save the system millions by being the primary specialists in this realm and since many symptom complexes that are diagnosed with a disease differential diagnosis are actually musculoskeletally based, these patients often endure thousands of dollars of unnecessary tests and end up on drugs that may relieve their problems but do not solve them. Conversely, chiropractors and other non disease based model practitioners are more capable to rule our musculosleketal and enlist disease based model practitioners like our family doctors and internists who can likely manage or co manage these patients. The co management idea is likely one we will probably see more of in the future.

The incentives are perverse. Why does a primary care doctor get penalized financially for spending time (a complaint of geritricians who need to spend time with their elderly patients). If we paid them for their time and allowed them the opportunity to get paid well for it, there would likely be fewer tests. We also should have some tort reform to limit payouts for pain and suffering but also, if we had fewer specialist referrals and fewer procedures, the patient would benefit and it would overall cost less. On the other side, if we made fewer referrals to fewer specialists, are all those disease specialists necessary and what will happen to our hospitals if fewer people were admitted because the new model just did not do this as much? Surely, super high paid specialists and facilities would suffer but as our needs change, so must the systems that feed off of it. If we had less testing, many of these companies who do these including the many MRI centers would now be forced to consolidate. As you can see, real reform is not rationing, but better doctoring which includes primary care doctors who are compensated for patient time and care and other types of primary care that work together to help patients and their needs. The losers unfortunately would be those that benefit from the over testing and the unnecessary testing which is fear mongering at its worst. The problem is why our health care system is the 6 largest force in our economy. Does anyone in congress have the political nerve to put a dent in this overpriced and under achieving system?

The insurance companies are not the innocent victims of this because in our office, they ration care by using outside companies that pervert the word medical necessity for chronic patients with chronic problems. In their world, if someone has used our services alot over the past couple of years as we problem solved their situation and improved their quality of life, they abuse us and the patient by asking for their notes, wanting appeals and concentrating on cost, rather than the patients wellbeing. Quite honestly, we are not the cost drivers in the system and are just a blip on the screen of a much bigger healthcare ocean. Since our office handles many difficult chronic pain cases, we are often subjected this this more commonly. The insurance models are why specialists are paid more and generalists are paid less. Like the government, when they have poorly managed their pool, the pass the cost on to us giving us less but charging us more each year. Somehow, they still manage to make billions and reward their management. Shouldn't we just pay the doctor better instead since they spend 30% on saying no. This is why I believe we need a public option because they do indeed ration our care making sure to turn a profit and as capitolism goes, make money for their investors (http://www.creators.com/liberal/froma-harrop/coming-between-you-and-your-doctor.html). Why is insurance company rationing ok and government rationing bad? If it is ok for them to say yes or no to cancer treatments or other treatments supported by research, they are not the boogey man but if the government does it and it does cost us less without the profit motive being the real reason, ultimately, we will have a cleaner and better health care system that makes more sense. I actually believe that if government without a profit motive did our cancer research, we would likely find the common link faster because finding the reason behind the problem is indeed the solution we need and is like minting money, since true prevention does not seek a cure and the game of whack a mole is not the game of prevention which is the key.

My future vision of healthcare should be true prevention based, without the marketing (drug ads on television for every symptom you have), with a healthier public (healthy food promotion without subsidizing farmers to grow certain things and not grow others but raising demand for fresher and better foods and subsidizing this way). Changing the publics ideas about things like our current model will take years but if we start now, it will assure us of living better, longer and the end of life needs to be embraced as part of the (disney said it best) great circle of life. We are born, we live out our lives and then eventually we go. The quality of life is paramount (not the quantity, the quality) and it is not necessary to be on drugs like lipitor if it helps you live an additional year with tons of problems the drug creates since it is not really preventative). When we are in school, we will screen not only for scoliosis but for postural problems and body asymmetry which will help children grow into adults with fewer problems in the musculoskeletal system. Perhaps our video games will be built in the future on an exercise bike so we can sit and play only as long as we pedal assuring better fitness. At the beginning of life, we will make wiser decisions on when we use technology to prolong a life that has little change, and at the end of life we will accept the inevitable, and rather than throw technology at it, have a more humane end point. Doctors will be allowed to be doctors and there will be fewer lawsuits because fewer drugs will be needed and fewer procedures will injure fewer patients. We will leave with the same body parts we came into the world with because most knee and hip replacements can be prevented if in school, we found the problems early and something as simple as an orthotic could have changed our future.

Wow, this is alot to think about, isn't it. I welcome your comments. Check out our web site at backfixer1.com and join our twitter feed. Thanks for reading.

Stop hurting from carpal tunnel syndrome Non surgically - a better option

2010-03-10T08:23:00.000-08:00

One of the most expensive and poorly treated conditions of the computer era is carpal tunnel syndrome. It has frequently been poorly diagnosed and the treatment of this common conditions costs business and industry thousands of dollars in lost work time and disability. It is most common among people who type on computer keyboards or who perform other repetive tasks with their hands, arms, shoulders and neck. Current treatment methods often fail to bring long term results and sometimes results in worsening disability. Common treatments used for the condition are wrist splints, massage, injections into the area of pain and discomfort, medications, nutritional supplements, physical therapy, exercises including stretching and finally when all else fails, surgery. Recently, these arm conditions have more appropriately been reclassified as Cumulative Trauma Disorders (CTD's).

Typical Symptoms

The typical CTD sufferer may note the following:

Arm/Hand/wrist pain.
Arm/Hand Numbness.
Raising the arm makes the hand go numb(Nerve root adhesion).
Numbness in the first finger and thumb(true carpal Tunnel).
Numbness in entire hand or finger tips(Nerve root adhesion).
Wrist pain/thumb pain.
Shoulder Pain.
Neck Pain
Stiffness in the hand or forearm.

Appropriate diagnosis

Commonly, to diagnose the condition, patients have been subjected to Nerve Conduction tests and simple orthopedic tests which make the hand go numb. CTD’s actually are comprised of quite a number of different conditions which must be diagnosed properly to be treated successfully. The truth is, more often than not, the condition does not involve the Carpal Tunnel.
Dr.’s Leahy and Mock1 in their article from Chiropractic Sports Medicine published in 1995 theorized the condition results from muscular adhesions in the forearm and other structures along the path of the nerve roots, as they pass down from the neck to their respective nerves. In proving their theories, these chiropractic physicians treated thousands of patients in Colorado showing a 96% success rate with the average case lasting six visits. He also extrapolated the formula which explains why people develop this problem and how to prevent it. Dr. Leahy has recently passed on his knowledge to other doctors willing to learn this new technology. Myofascial Release loosens the area and the doctor mobilizes the joint involved through joint manipulation. Another method that has also gained momentum and is very effective is Graston Technique which uses tools to actually resolve the adhesions. Both methods have their strengths however, it is ultimately the chiropractors diagnostic skills rather than just the technique that will ultimately help you resolve the problem. Since many upper body conditions such as carpal tunnel, are created in the lower body when the core muscles are functioning poorly, you want a doctor who looks at you, not just the symptoms you showed up with.
To appropriately diagnose this condition, a doctor must examine the entire arm, check for adhesions (tissues stuck to eachother which interfere with normal nerve function) and systematically work them away by hand. The doctor should also check your feet, pelvis and other contributing factors since problems in the pelvis will pull the shoulders forward and cause the arms to tighten. Over the past few years, a new breed of doctors such as our office now does active evaluation and treatment, which further improves our results because when we treat an area, we can immediately test it for improved function and change what we are doing on the fly which is far more efficient and cost effective. When this is done properly, the problem often resolves quickly and with appropriate periodic exercises, usually does not return.

Appropriate Treatments Myofascial Release Technique’s, Graston Technique, Exercises

One must define what is appropriate in the treatment of CTD. A good definition is “Any treatment method which is cost effective, yields reliable results in the majority of the population and is scientifically valid.” Current treatment methods do not meet this criteria. The typical CTD case costs an average of $15,000 including the surgery. Many other therapeutic approaches, including wrist manipulation show promise in the treatment of the condition although dysfunctional muscles and soft tissues will not allow for proper wrist joint function since there is often limited flexibility of the areas where the adhesions exist.
Myofascial Release Technique’s and Graston Technique meets the criteria for “Appropriate Treatment.” These are cost effective methods which often results in quick resolution of the condition and its symptoms. Many of the more difficult cases, including those that failed with surgery have succeeded. Many Cts's respond favorably to treatment within six visits or less. Many other common arm complaints such as tendonitis (tennis elbow, golfers elbow) and shoulder complaints are present when a patient has the CTD syndrome. Myofascial Release treatment and Graston Technique can resolve these problems as well. There is a cascade of event s(called the kenetic chain) which includes neck motion, shoulder motion, elbow motion and wrist motion, as well as foot, knee and hip. Any dysfunction along this kenetic chain can result in common overuse syndromes of the arm, shoulder and wrist. A thorough practitioner will often check the relationship of these structures when a CTD is present.
The treatment consists of the doctor checking for adhesions and working them away by hand as he/she finds them on each session and then challenging the results using active evaluation techniques. The treatment is usually not painful and the area being treated may experience soreness for a day or two following the treatment. An experienced practitioner can very quickly resolve many of these conditions and will give you appropriate exercise designed to prevent a reoccurrence.
For further information, you can visit our web site at backfixer1.com

1. Improved Treatments for Carpal Tunnel and related Syndrome's. Chiropractic Sports Medicine
Vol9 #1 1995 Pgs. 6-9, Williams and Wilkins.

The spring cleanup ritual has arrived

2010-03-08T06:58:00.000-08:00

Ok, the snow is going around and now what? Did you see all that muck underneath the melted snow including the itchy balls (hundreds of them), dead leaves and other stuff. It is now time for the annual spring cleanup for all you home owners. That means bagging, blowing, lifting, dragging and getting rid of the stuff so you can get your lawn and house looking nice for the summer months to come.

Have you asked yourself if your body is ready for the task? In many spring cleanup's many of our patients find out that no, it is not. They may have strained themselves removing snow and doing other things and they may also be out of condition for a task they do only periodically.

This means it is time for putting chiropractic back on your radar. Lately, we have seen quite a number of people who tightened up during snow removal who just thought it would go away. This usually means their back is in spasm but they are tolerating it because it they can still function with it in its current condition. When the pelvic body mechanics are compromised, your body loses leverage and power. Stretching does little improve this phenomenon because of shortened myofascial and loading it up with spring cleaning will surely increase the likelihood of an acute exacerbation that could take weeks to treat.

Our recommendation is to get back into the chiropractic habit now, before doing spring cleaning. I realize we are all busy but you need to take care of yourself first. One or two visits can pay off big when hitting a ball, raking, bagging and lifting. Now is the time to do it. Make this your priority. Your body and your spouse will thank you.

Prostate cancer tests could be of questionable value - my thoughts

2010-03-04T18:57:00.000-08:00

I am a firm believer in prevention and preventative care and have always preached that finding problems early, especially in the musculoskeletal system and someones structure can help them live a better functional and less pain filled life. Much of the research bears this out. Lately, some of the holy grail tests to catch and treat cancers have been under attack using statistics as the attack tool. Today, the Star Ledger reported that regular prostate screenings and PSA tests in younger populations was not only not preventative but also lead to procedures with harmful side effects with minimal benefit to the patient (http://www.nj.com/business/index.ssf/2010/03/prostate_cancer_tests_could_be.html). A few months ago, routine mammograms and Pap smears were also attacked by the American Cancer Society for similar reasons.

Many people will be up in arms about this especially women who have been trained and accustomed to the preventative rituals that modern medicine promised them would increase the likelihood they would live longer.

Could it be the medical preventative paradigm is crumbling before our eyes? It may appear that way but many people will swear that those screenings and preventative surgeries saved their lives. In many cases, perhaps they did. In other cases, people endured horrible procedures with horrible end results.

In my opinion, cancer is something that we have yet to understand which is likely why screening procedures are not as helpful as we would like. Some cancers such as breast can be very fast growing and screenings cannot save the life it claims it can. I believe that we need to understand what cancer really is before you propose to cut out what you do not really fully comprehend. For now, removal and treatment of cancerous tissues is the way it is done. In some circles, it is believed that cancer has a common thread - Candida albicans which is present when cancer is. One doctor, an oncologist from Italy went against the grain and claimed that Candida gets into the cells, and causes them to look and act differently even though candida can be treated with bicarbonate and he claims he has repeatedly reduced tumors safely using it and was chastised by his profession for his approach. What a cost effective way to treat cancer (if it works). Another school of thought is that cancers have increased in our society because of certain foods we no longer have in our diet. That nutrient is laetrille (http://video.google.com/videoplay?docid=4312930190281243507) which is no longer a staple in our diets and whose reputation had been hurt by organizations that were drug based. You can find this in apple pits, apricot pits and has evidence that it works. I have personally stopped throwing away apple cores and eating them instead as well as papaya seeds. What could it hurt, but the question is could it prevent and keep your body cancer free (http://cancertutor.com/Cancer/Laetrile.html)?

The big question I always ask myself is what would the big institutions and high cost cancer centers have to lose if it were found out that this is the common link to cancer. My guess is hundreds of millions of dollars and they have a financial stake in seeing that the problem is complicated and the cost is high. Perhaps, a cure or a low cost dietary preventative change is not in their long term financial interest, eh?

Maybe this is one instance when government would be a good place for research for a cure should be done, rather than in for profit drug based entities whose sole purpose for the research is to turn a profit on their investment. This is food for thought (literally) but I believe if it really were that simple, health care costs would drop unbelieveably and there would be fallout as large institutions went under since we no longer needed their services.

I also guess that if the problem is indeed dietary and not a disease in the way we think it is, although diseases can be caused by a lack of nutrition (eg: scurvy), could this change be shown to lower cancer rates in a 10 year period markedly? Maybe our government should begin a campaign to explore such a program, instead of scaring the public with the heavy handed politics of swine flue epidemics that never really materialize but affect certain people with inoculations and their side effects (http://diseases-viruses.suite101.com/article.cfm/side_effects_of_swine_flu_vaccine).

Times are changing and maybe our research of cancer, our understanding of it and our treatment of it needs to change as well to make screening for it safer and truly preventative. It would also give attorneys less work to do.

WNYC does program on chiropractic - check this out

2010-03-04T07:41:00.000-08:00

Here is the link to this program that is available on the net. While this is quite general, it gives people a basis of what the average chiropractor will handle.

http://www.wnyc.org/shows/lopate/episodes/2010/02/19/segments/150389

In our office, we also handle the following:

Upper Back Pain	Sciatica Pain	Knee Pain
Lower Back Pain	Shin Pain	Ankle Pain
Wrist Pain	Elbow Pain	Foot Pain
Shoulder Pain	Rotator Cuff Pain	Plantar Fasciitis
Achilles Tendon Pain	Fibromyalgia	Myofascial
Neck Pain	Migraine Headaches	Tension Headaches
Hip Pain	Rib Problems	Trauma
Tennis injuries	Golf Injuries	Baseball Injuries
Basketball Injuries	Running Injuries	Weight-Lifting
Temporal Mandibular Joint Syndrome (TMJ)	Numbness in Hands and Feet	Carpal Tunnel Syndrome
Golfer’s Elbow	Tendonosis, Tendonitis	Tennis Elbow

Knee Pain, change your destiny by understanding it better than your doctor does.

2010-03-03T08:31:00.000-08:00

In our office we treat quite a number of knee problems. Most people with knee pain have not had a true trauma to the knee but had symptoms when they were children that may have been ignored or poorly managed. Most people do not know that foot problems create knee problems. They do not also understand that the knee is merely a conduit or pulley that allows us to walk. The kneecap is the pivot point that the muscles use to transmit force from your feet to your core. If this mechanism is not firing or coordinated properly, the result is knee pain, meniscus tears, clicking or grinding at the kneecap as well as shin pain and even lower back pain. We inherit our body style and if we have low or flat feet which tend to transmit these forces less efficiently in combination with feet that turn or toe out (overpronated), you have the recipe of knee pain, shin pain, plantar fascitis, kneecap tracking problems and back problems.

In our health care system, most people visit their primary care doctor who will usually have you visit an orthopedic doctor (surgeon). Their primary interest is knowing who is a surgical candidate and who is not. There interest is not getting your out of pain. I often see patients with chronic knee pain visiting physical therapy where heat, muscle stim, some light massage to the knee and then they are asked to lift weights with the knee. Many people do not get improvement this way and often, they exacerbate simply because they have problems tolerating gravity with their current structural integrity and are then being asked to tolerate more weight.

You can make better choices because knowledge is power. The better physician will look at what is surrounding the knee such as your core muscles (lower back, hip flexors, gluts, abs) and see what they are doing first. In our office, anyone with knee pain will have their pelvis and their feet checked first. The reason is (we get almost all our patients with knee pain free of it by getting to the source) that if you are asymmetrically built (remember this is an inherited trait and typically appears around the age of 3 and by the age of 6 it is well set), your body will respond to these forces and the myofascia in your core will tighten in response and literally glue it into improper motion. This will cause you to recruit other muscles because of a lack of leverage and torque the hips. Since we stabilize and fire from the core first, one of the places you recruit into is the legs which causes tight legs. Many people attempt to self manage this with exercise, yoga, foam rollers and pilates which all appear on the surface to help, however there is one large problem... You cannot train a torqued core which will create chronic neck and back as well as knee pain. These methods all have some benefit however, you need to have a stable core to train, which takes stress off the knees and improves mechanical firing patterns which will keep you looser without doing all these maintenence methods. This is why visiting the orthopedic and then having therapies thrown at the problem is a lesson in futility for the long term, even though it may offer short term relief.

How do we fix and manage this better

We should screen all children for asymmetry and those who have flat feet should be educated in the importance of shoe inserts or orthotics. This will improve the way they walk. A chiropractor who understands the myofascial system (some have special training in the diagnosis and treatment of this, especially those who are involved in sports medicine) can be a terrific asset in your quest for cost effective management for yourself and your family members.

Before you embark on trying to do exercise, a visit to the chiropractor to correct any joint and myofascial problems in the core can lead to a much more successful training experience. Those who train with a torqued core will get foot, calf, hip and shoulder pain and will find that without the exercise, they continue to tighten. You can break this cycle by getting the core right.

Once the core is functioning properly, in our office, we look at the calves, shins, posterior knee since adhesions in these areas brought on by years of poor body mechanics will also adversely affect the firing pattern of the leg. We then test and retest because firing patterns can be physically challenged and poor patterns are really obvious to both the doctor and the patient. Chiropractors are also trained and skilled in manipulation of the spine and extremities which is essential for the best outcomes. This is why we are in demand at major sporting events.

Finally, foot orthotics whether they are custom or off the shelf will improve your gait and should be part of the management of these types of problems.

In Summation

You will notice that knee management is secondary, not primary. This is because the knee is a conduit and develops problems because of the foot and the core, and usually not because of the knee itself. Sports simply increase the forces on the region if structurally it is unsound. Proper management in most knee problems even if an injury occurred should include strengthening and improving core stability, shoe inserts and checking stability of the kinetic chain (the series of joints comprising the ankle, knee and hip). Once you can tolerate increased forces via testing and have improved stability, you should quickly rehab over a period of 2-6 weeks.

This is quite different from what most people are advised to do however, this makes mechanical sense. I often tell patients who have growing children to think outside the box when the pediatrician describes leg pain with terms like growing pains and osgood schlatters (a really bad case of shin splints). These children need a good biomechanical workup and the chiropractor can often be a better place to start. If you did not improve or if the doctor suspects there is knee damage which may not be amenable to rehab, the doctor will send you out for testing (MRI) and then make a surgical referral to an orthopedist.

If you have knee pain and have tried the other options I have outlined here, you are likely frustrated by the lack of results. Here is an approach that is effective, tried and true and methods like active evaluation (challenging areas that are not working properly to find the source of the problem treat, test and retest) which is the future of musculoskeletal medicine. My hope is that the information in this blog post will help you make better decisions regarding your knees and other problems in the musculoskeletal system.

Proof chiropractic works, chiropractic and the Olympics, Workers compensation and more

2010-03-02T08:10:00.000-08:00

One of my colleagues sent me this video of our gang comedies (the little rascals for all you baby boomers) that shows one of the kids giving an adjustment fixing another kids neck. Years ago, as a kid I saw this one and the clip is quite funny. Check it out at http://www.youtube.com/watch?v=eB7PL6m8CFg.

Many of you saw the olympic's and you may not realize that the United States had two chiropractors delivering care to athletes, with one being Blaze Toto from East Brunswick. We attended National college together and being from neighboring towns, cross paths regularly at sports council meetings. Chiropractors had been involved officially in the Olympics since 1980's because the athletes wanted them present. There are many people out there who still do not trust chiropractors to evaluate certain musculoskeletal problems however those who are really good are in demand and athletes know that it is the most effective way to take care of an injury. At the olympic's it is a kind of health care nirvana because everyone is an equal part of the team. Chiropractors, physical therapists and orthopedic doctors work hand in hand with trainers and other medical professionals. Food for thought considering in the real world, competition and posturing is often considered before the ultimately, the patient is sent to those who are most cost effective. In NJ, this is most true in our workers compensation system that badly needs change and full inclusion of chiropractors since they have been shown to save money... lots of it and get people back to work faster.

Federal panel says 73 million in the us have high blood pressure - my thoughts

2010-02-23T06:09:00.000-08:00

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.

Adult Track and Field in Toms River NJ 2-21-10 - Check it out

2010-02-21T16:35:00.000-08:00

I had the pleasure of being the medical staff of a USATF NJ track and field meet at the Toms River bubble. I helped quite a few athletes today, some of which are world class. Where do world class athletes go after they did the olymipcs? They are often found doing events just like these in NJ and other states. I worked with athletes from as far away as Maryland and from the tri state area. Above is a photo as a 200 yard sprint began. Here is a long jump that was done at todays meet as well. Many runners often do not know why they have tightness or pain. My job is to help them feel better and to also give them guidance as to where they can go to get help and to help them perform better while at the event by working on them, taping their feet (many runners have body style issues) and occasionally I am called into emergency service like I was today for someone who got injured performing the high jump. This was a wonderful event to be a part of.

Avandia Diabetes Drug, another one bites the dust

2010-02-20T09:27:00.000-08:00

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.

Steroids for asthma and better alternatives through chiropractic

2010-02-19T13:50:00.000-08:00

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."

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.

Health Care Reform, what is wrong with this picture

2010-02-16T14:06:00.000-08:00

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.

Snow and how to move it safely.

2010-02-09T07:50:00.000-08:00

The Ultimate Cold Fighting Regimen

2010-02-07T08:50:00.000-08:00

Jerry Rice and Chiropractic - A Top NFL Receiver Credits Much of His Success to Chiropractic Care

2010-02-03T05:01:00.000-08:00

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-/

Track and Field event today in Lakewood NJ

2010-01-31T14:07:00.000-08:00

Today I attended a track and field event in Lakewood NJ. As many of you know, I am the medical director for USATF NJ and I am responsible for chiropractic coverage for their sponsored events. This event today featured athletes 18 and under. I was mentoring a chiropractor from southern NJ, Fred Mayer DC who had never attended one of these events before. Together, we saw a number of competitors who needed help and he learned about the different types of events and what to look for when runners are having problems. I will be attending additional events toward the end of February, 2010

Patients in Medicare Demonstration Project Give Chiropractors High Marks

2010-01-28T08:12:00.000-08:00

For those who are in Medicare or are about to be enrolled, this is a great thing. The history of chiropractic inclusion in Medicare is that the limited benefit was negotiated in the 1970's before chiropractic had the widespread acceptance it has now as the top complementary health care profession in the country, if not the world. It is safe, effective and cost effective and studies support these statements. Unfortunately, in Medicare, chiropractic is only covered for manipulation and nothing else. Seniors are required to pay for their own evaluations, x rays and therapies done even though these procedures are paid for when they visit other providers. Many seniors value chiropractic as the best way to limit their exposure to harmful medications and stay out of pain and active.

Two years ago, after much chiropractic lobbying, Medicare was forced to create a chiropractic demonstration project in a few markets. The purpose of this was to see if chiropractic would add to the cost, lower the cost or be budget neutral. The good news is that chiropractic in most areas was chosen instead of other interventions without higher costs and the better news was the level of satisfaction most seniors reported.

What this all means - The American Chiropractic Assn. now has an opportunity to change the Medicare problem forever which means if you are enrolled in Medicare, you will be covered for everything just as you are when you visit other doctors and it will end the discrimination against chiropractic patients under Medicare. This is in the public's best interests and they should have the right to choose chiropractic as their intervention for their health care issues.

If you have seen the nonsense that went on as health care debated, you should realize that full inclusion for chiropractic is an uphill battle. Last night pres Obama scolded congress for not doing their job and he is right. They are not there to get elected. They are there to pass laws to help you and I. Hopefully, chiropractic will be finally fully covered.

Here is the ACA press release for your reading

Patients in Medicare Demonstration Project Give Chiropractors High Marks

According to long-awaited results from a congressionally mandated pilot project testing the feasibility of expanding chiropractic services in the Medicare program, patients have a high rate of satisfaction with the care they receive from doctors of chiropractic.

When asked to rate their satisfaction on a 10-point scale, 87 percent of patients in the study gave their doctor of chiropractic a level of 8 or higher. What’s more, 56 percent of those patients rated their chiropractor with a perfect 10.

Contributing to that satisfaction was the attention given to patients’ needs and the accessibility of chiropractic care. Patients reported that doctors of chiropractic listened to them carefully and spent sufficient time with them. Some 95 percent said they had to wait no longer than one week for appointments.

“Doctors of chiropractic everywhere should feel pride in these patient satisfaction results and in being part of a profession that still sees the great need for spending time with patients and truly listening to them,” said Dr. Rick McMichael, president of the American Chiropractic Association (ACA). “It’s clear that patients deeply value the time their chiropractic providers spend with them and the expert care that DCs offer.”

The pilot, known as a “demonstration project” in Congress, was conducted from April 2005 to March 2007 throughout the states of Maine and New Mexico, and also in Scott County, Iowa, 26 counties comprising the Chicago metropolitan area, and 17 counties in central Virginia.

Current chiropractic coverage under Medicare is limited to spinal manipulation. Under the demonstration project, however, chiropractic care was expanded to include diagnostic and other services, such as X-rays, examinations, physical therapy and rehabilitation services.

The final report to Congress also includes information on the costs of expanding chiropractic services in the demonstration sites. The report indicates that in all but one of the demonstration sites, patients’ health care costs were not significantly changed by expanding coverage of chiropractic services. In contrast, a cost increase was found in the Chicago metropolitan area. Further research into the reasons why the results in Chicago differ from the rest of the demonstration project sites is needed to better understand these findings.

“We already know that Medicare costs in general tend to be higher in Chicago than other similar areas of the country. We must find the underlying cause of the cost difference found in the chiropractic demonstration project and determine whether it had anything at all to do with the expansion of chiropractic services,” Dr. McMichael noted.

To further analyze the results of the demonstration project, ACA is creating a taskforce of Medicare experts and researchers who will review the report and develop a response for the

Centers of Medicare and Medicaid Services.

To view the report online, visit www.acatoday.org/pdf/demo_report.pdf.

Signing of the Chiropractic Practice Act for New Jersey

2010-01-18T12:52:00.000-08:00

I just received word that we should have our scope of practice signed into law by Gov Corzine today. It has been a long road to get to this point. Stay tuned for more stuff.

Diary of a NJ Chiropractor

I'm taking bigger steps, my wife says

The genetics of back pain - is back pain genetic or does a genetic trait cause back problems in families?

Lower Back Pain Study Shows Chiropractic is Most Effective Treatment Long Term

The US healthcare monopolies, and how cost shifting costs us

Better options for tendon problems - Hint; the tendon is a symptom, not the problem

New article in NY Times talks about new theories about side stiches

The Equation Of Running And Winning Free Of Pain

Should children run marathons - something every runner should consider reading

Jack La Lane was a chiropractor. I didn't know that and more...

USA Track and Field NJ y Open & Masters Indoor Track & Field Championships

How to stay running injury free this spring

Fewer scans recommended for lower back pain says a recent NY Times article

Defying Medical Convention - Dr. Charschan's New Book arriving soon

The cost of managing chronic pain, are there better options?

Big breakfasts don't help you lose weight, study says.

More problems with muscles and cholesterol meds such as Lipitor. Are they really necessary

Fighting colds naturally - Dr. Charschan's cold survival kit

Doubts about foot orthotics - Do they really help?

The $99 health plan brought to you by Sams Club - What does this really offer?

Safe Methods For Snow Removal

Another study shows chiropractic is much less expensive and more effective for lower back problems

Dead Butt Syndromes and other fairy tales affecting those who run

Study Favors Chiropractic over Surgical Discectomy for Sciatica

Macro vs.Micro - Getting to the source of your problems

Running Shoes - Do they fit right and how to know?

Cortisone - Does this cure make problems worse?

High level activity in older adults is very beneficial - I see this with many of our patients

New Obamacare benefits begin today - These are good changes - check them out

Osteoporosis drugs causing fractures - another promise that does not add up

USATF evaluates if stretching prevents running injuries - Science says it doesn't, their study agrees and more

Doctors are seeking new ways to prevent muscle loss - buyer beware..

Parents in NJ are finding reasons to forgo vaccinations. Food for thought

Repeat athletic injuries - Should we change our way of competing or are we missing something.

Survey shows majority who utilize chiropractic care for their low back pain report "a great deal" of benefit.

Economy Led to Cuts in Use of Health Care - what do we make of this?

Was Atkins right, new study shows low carb diets are better for you

Health care by numbers, putting healthy people at risk

Can sitting shorten your life? A new study suggests it will.

What's a nice doctor like you doing in a plan like this. The story behind why after only four months in ASHN's management of Cigna, we are leaving their network.

What's a nice doctor like you doing in a plan like this. The story behind why after only four months in ASHN's management of Cigna, we are leaving their network.

What's a nice doctor like you doing in a plan like this. The story behind why after only four months in ASHN's management of Cigna, we are leaving their network.

Right to die with dignity - NJ sees a new billboard campaign

Dis ease - the idea of diseases as the cause of what ails us

Christian Medical Bill Sharing and other ideas for health coverage

Salt and Heart Health - Know what you are eating and what is in your prepackaged food

Pressure on doctor pushes up costs, or does it

Shocked by $9M Horizon CEO salary? N.J. Chiropractors Association has own Horizon horror stories

BY SIGMUND MILLER

COMMENTARY

Foods that build muscle and proper nutrition

AOL Reports Surgery for Back Pain Often Fails - Another perspective

Summer Back Pain Prevention With Better Footwear

Hookworms, a cheap and effective way to treat auto immune disease - Now we are talking

Chronic Pain and the Medical Merry Go Round. The problem with over specialization

Why Do Medical Doctors Hate Chiropractors

Personal Gene Tests? Good or bad idea?

Antacids a cause of bone fractures and infections, Vitamin D and Osteoporosis and more

Surgery for Flat Feet - Good Idea?.... Not

Preserving your knees and hips - avoiding the joint replacement syndrome

Is salt and sugar really making our society ill?

Expanding Chiropractic Services Under Medicare - The Effective Truth

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

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

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

Is toughing out a sports injury a good idea?

Chocolate and Your Heart - Some delicious news

Israeli invention allows paraplegic's to walk - check it out

Is Junk Food Is as Addictive as Heroin or Cigarettes?

Top Foods That Fight Cancer

Top Foods That Fight Cancer

Too Much Medical Care? A doctor speaks out about his own profession and my thoughts

New Car Design Will Make You Healthier

Genetic Testing Gone Mainstream - the Age of Genomics

Garlic soup - Chasing away colds, cancer and vampires too

RECIPE

Garlic Soup

Adapted from Jean-Georges Vongerichten

INGREDIENTS

PREPARATION