Archive by Author

Breast Cancer and Exercise.

29 Jan

The Most Important Principles For Staying Young: 

Breast Cancer and Exercise

 

Dr. Michael F. Roizen

Co-Author of 4 #1 NY Times Bestsellers including: YOU Staying Young.

The Owner’s Manual For Extending Your Warranty (Free Press)

Our basic premise is that your body is amazing:  You get a do over: it doesn’t take that long, and it isn’t that hard if you know what to do.  In these notes, we give you a short course in what to do so it becomes easy for you, and for you to teach others. We want you to know how much control you have over your quality and length of life.

This month, we wonder…

If Exercise Is So Good As A Preventive Strategy, Then Why Do So Many 

Great Women Athletes of the Recent Past Get Breast Cancer?

Arnold said it best: “I don’t know an athlete who hasn’t given up her body for her sport.” Yes, a little intense exercise prevents breast cancer, but too much promotes it. We’ll tell you the appropriate amount for best health and to best prevent breast cancer below (don’t peak). But first, why does intense exercise for prolonged periods cause breast cancer if a little intense or even moderate exercise prevents it?

The key is how many free radicals you produce (exercise produces them inside your cells; longer and more intense exercise produces more free radicals) and how many antioxidants you produce (it is the antioxidants you produce and have inside your cell when you exercise, not that you eat, that are key).

You see, the key to preventing abnormal DNA inside your cells is handcuffing the free radicals you produce as soon as you produce them with antioxidants inside you cell (before those radicals can do damage), and harmlessly escorting the cuffed (or bound to an anti) free radical out of your body. A little intense exercise actually helps your cells learn how to produce more antioxidants, that’s why a little regular, intense exercise is good.

But, too much intense exercise at once (think Olympic training regimen, or marathon) overwhelms most people’s inside the cell antioxidant producing capability. This promotes breast (and other) cancers, free radicals and wear and tear damage elsewhere.

As it turns out, you can run from breast cancer, if you do the right amount of exercise with the right intensity. Run, lift weights, do stretch bands, cycle, walk, swim – any regular, occasionally intense, exercise will slash your risk by up to 30%.  (Some studies show even active housework and gardening can make a difference.) A little vigorous exercise helps your cells learn how to produce antioxidants inside your cells, and you can benefit at any age.

So to answer the question, a little exercise really can fend off the biggies . . . like breast cancer. Bet on it!! Staying active reduces your odds of colon, pancreatic and prostate cancer (for men). Breast cancer rates are at least 33% lower in women who exercise regularly; in fact, two studies show just 20 minutes of daily walking cut them by 34 to 38%.

How does this work? Yes, moderate or intense physical activity helps you produce more antioxidants inside your cells to reduce DNA damage rates, but exercise also lowers specific hormone levels. Exercise also helps you decrease inflammation, which helps make it more likely you’ll live without disability from heart disease, stroke or memory loss. Physical activity also reduces body fat and triggers a chain reaction: Less fat, less estrogen, and less inflammation, and… less cancer risk.

So, what’s the best routine according to the data? #1) General physical activity every day (10,000 steps every day, no excuses). #2) Two days of strength training for just 15 to 30 minutes each of the two days.  It’s form (shoulders back and relaxed, core centered and strong, pelvis tucked in very slightly) and repetitions (3 sets of 12) that get results. #3) 20 minutes of cardio (raising your heart rate to at least 80% of your age-adjusted max) three times a week, with one minute as intense as your doc says you can go every 10 minutes. This triple combo will make you stronger, more relaxed and healthier in many ways, from dodging cancer and heart disease to keeping your mind sharp and your emotions calm.  Remember, there are other things to add, like daily cruciferous veggies, avoidance of getting too big a waist, and two baby aspirins with a half glass of water for maximum prevention of breast cancer (only if your doc agrees).

Thanks for reading.

Young Dr Mike

NOTE: You should NOT take this as medical advice. 

This article is of the opinion of its author.

Before you do anything, please consult with your doctor.

You can follow Dr Roizen  (and get updates on the latest and most important medical stories  of the week) on twitter @YoungDrMike. 

Feel free to continue to send questions to youdocs@gmail.com. You can follow Dr Roizen on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week).  The YOU docs have a new web site: YOUBeauty.com  and its companion BeautySage.com the only site we know of where you can find skin products proven to meet the claims (opened for business on June 1st, 2012), and a new book: YOU: The Owner’s Manual for Teens.

Michael F. Roizen, M.D., is chief wellness officer and chair of the Wellness Institute at the Cleveland Clinic. His radio show streams live on http://www.healthradio.net  Saturdays from 5-7 p.m . E-mail him questions at YouDocs@gmail.com.   He is the co-author of 4 #1 NY Times Best Sellers including : YOU Staying Young and YOU: The Owner’s Manual. He is Chief Medical Consultant to the two year running Emmy award winning Dr Oz show– The Dr Oz show is #2 nationally in daytime TV.  See what all the fun is about, and what he, The Enforcer, is up to. Check local listings or log onto DoctorOz.com for channel and time. And for more health info, log onto youbeauty.com anytime.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fibromyalgia “101”

29 Jan

Fibromyalgia (FM) is a disorder that includes widespread musculoskeletal pain along with fatigue, sleep disturbance, memory changes, mood changes and more. Studies show that FM amplifies or increases painful sensations by changing the way the brain processes pain signals. FM is NOT a psychological disorder that only people with a troubled past or present acquire. Nor is it due to being inactive or lazy. If ANY doctor suggests that, PLEASE find a different doctor who understands the pathogenesis of FM. Unfortunately, this can be a challenge!

FM symptoms can begin after a physical trauma, surgery, an infection and/or after a significant stress experience. It can also just gradually appear over time without an obvious triggering event. Women are more vulnerable to acquire FM than men. Many FM patients have other conditions that may be associated with FM including (but not limited to) headache, TMJ, irritable bowel syndrome, anxiety, depression, thyroid/hormonal imbalances, endometriosis, and more.

Though the cause of FM may not be clearly identified, studies suggest there are a variety of factors that work together resulting in FM. Some of these include genetics, infections and physical and/or emotional trauma. Because FM tends to run in families, there may be certain genes or genetic mutations (changes that occur to genes) that make one more susceptible to developing FM. Infections appear to be a trigger for developing or aggravating FM. Post-traumatic stress disorder and less obvious physical or psychological trauma has been linked to the development of FM.  The amplified or heightened pain response has been termed, “central sensitization,” meaning, increased sensitivity to normal pain stimulation in the central nervous system (brain and spinal cord). Because of this heightened nervous system response, what normally isn’t processed as pain in the non-FM person, does reach and exceed the pain threshold in the FM patient (sort of like when amputation of a limb occurs and the brain still “thinks” there is a limb and “phantom pain” is felt). Studies show that repeated pain signals result in an abnormal increase in certain brain chemicals (called neurotransmitters). As a result, the brain’s pain receptors seem to develop a “memory” of the pain and become “sensitized” or they overreact to the pain signal input and pain is felt at an increased intensity. Certain risk factors come into play with developing FM, some of which include: your sex (female), family history (increased risk if other family members have FM), and rheumatic diseases such as rheumatoid arthritis and lupus.

Tests to establish the diagnosis of FM are few. In 1990, the American College of Rheumatology established 2 criteria for diagnosing FM. The first is widespread pain lasting at least 3 months, and the second is the presence of at least 11 out of 18 positive tender points. Since then, less emphasis has been placed on the exact number of tender points, while ruling out other possible underlying conditions that might be causing the pain is now utilized. There is no lab test to confirm a diagnosis of FM, but blood tests including a complete blood count, an ESR, and thyroid function tests are commonly done to rule out other conditions that have similar symptoms. Treatment is best approached by a “team effort” combining the skills from multiple disciplines including a primary care doctor who “believes in FM” and is willing to work with chiropractors, and others. Exercising, pacing yourself, accepting your limitations, yoga, psychological counseling, nutritional counseling, and having strong family/friend support are all important in the management of FM.

If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

 

Is It My Neck or Thoracic Outlet Syndrome?

29 Jan

Neck pain can arise from many different sources, and the patient’s clinical presentation can be quite similar making it a challenge to diagnose. One of those related, and sometimes co-existing conditions, is called thoracic outlet syndrome, or TOS. Let’s first discuss the anatomy of the neck and the thoracic outlet so we all have a good “picture” in mind of what we’re talking about.

TOS can arise from either blood vessel compression, nerve compression or both, making the ease of diagnosis difficult. Adding to the challenge, the “pinch” of the structure can occur at more than one place! The nerves and blood vessels can get pinched at the exiting holes in the spine (“neuroforamen”), by tight “scalene” muscles, under the collar bone (clavicle) and/or by a tight pectoralis minor muscle near the arm pit. Hence, the symptoms usually include pain and numbness in the shoulder, arm and hand (usually affecting the 4th & 5th fingers). It’s our job to run different tests to figure out where the primary pinch or pinches are located so we can treat the right area.

The causes of TOS can be many, with one of the obvious being a fractured collar bone or clavicle. Another is from having an extra rib. As there is not a lot of room for an extra structure, this can be a point of compression for some (but doesn’t create TOS in everyone). An overly tight scalene muscle, scar tissue, an extra large muscle and so on can also result in pinching of the nerves and/or blood vessels.

Purses, backpacks, carrying golf clubs, a mailbag and the like can also cause a pinch. A seat belt injury in a car accident is yet another cause, either from the direct trauma, or later when scar tissue forms in the area.

Our posture alone (without trauma), such as a slouchy, slumped posture where the shoulders roll forwards can cause TOS and, large breasts and obesity also add to the list of risk factors. Women are affected 3x more than men. Certain jobs where reaching overhead or outwards such as waitresses, carpenters, electricians, increase TOS risk.

You can depend on us to identify, locate and treat the areas that need attending as chiropractic includes many effective TOS treatment methods. The surgical outcomes are less than impressive so do EVERYTHING else first (a good surgeon will tell you that).

We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

How Does Chiropractic Help Headaches?

15 Jan

Headaches are one of the most common reasons people seek chiropractic care. Many patients with headaches benefit significantly from adjustments made to the upper cervical region. So, the question is, how does adjusting the neck help headaches? To help answer this question, let’s look at a study that was recently published that examined this exact issue…

It’s been said that if one understands anatomy, determining WHERE the problem is located becomes easy. So, let’s take a look at the anatomy in the upper most part of the neck. In the study previously mentioned (http://www.ncbi.nlm.nih.gov/pubmed/21278628), the authors found an intimate relationship between the muscles that connect the upper 2 cervical vertebra (C1 and 2) together and their anatomical connection to the dura mater (the covering of the spinal cord). They identified this anatomical connection between the muscles that span between the back aspect of C1/2 and the dural connection as having a significant role in the development of headaches usually referred to as cervicogenic headaches.

There are several reasons why chiropractors adjust or manipulate the upper cervical vertebrae in patients with headaches. The obvious reason is simply because it helps to reduce the intensity, frequency and duration of headaches. The reason it works is this: If one or both of the upper 2 vertebrae (C1 and C2, also referred to as the atlas and axis, respectively) are either blocked or fixed and cannot properly move independently, then there is an abnormal change in the biomechanics in that region. Similarly, if one of the two vertebrae is rotated or shifted in reference to the other, a similar biomechanical “lesion” or problem occurs (often referred to as a “subluxation”). You can take all the ibuprofen, Aleve, Tylenol or other perhaps stronger, prescription medication for the headache, but it is not logical that the biomechanical problem at C1 and/or C2 is going to change by inducing a chemical change (i.e., taking a pill). All you’re doing is masking the symptoms for a while, at best.

Many people find that after a several chiropractic adjustments, their headaches are significantly improved. This is because restoring proper biomechanics to the C1/2 region reduces the abnormal forces on the vertebrae as well as any abnormal pull or traction of the posterior cervical muscles on the dural attachment. It has been reported that the function of this muscle/dura connection is to resist excessive movement of the dura towards the spinal cord when we look upwards and forwards. During neurosurgery, observation of mechanical stress on the dura was found to be associated in patients with headaches. In chronic headache sufferers, adjustments applied to this area results in significant improvement. There is no other treatment approach that matches the ability that adjustments or manipulation have in restoring the C1/2 biomechanical relationship thus, helping the headache sufferer. Another treatment option that has been shown to benefit the headache patient is injections to this same area. However, given the side effects of cortisone, botox, and other injectable chemicals, it’s clear that chiropractic should be utilized first. It’s the safest, most effective, and fastest way to restore function in the C1/2 area, thus relieving headaches.

We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for headaches, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Common Whiplash Myths – Part 2.

15 Jan

Last time, we began discussing common myths about whiplash injuries, and this month, we will continue on that course. Remember, the amount of injury that occurs in an acceleration/deceleration injury is dependant on many factors, some of which include gender (females>males), body type (tall slender = worse), the amount of vehicular damage (less is sometimes worse as the energy of the strike was not absorbed by crushing metal), head position at the time of impact (rotation is worse than looking straight ahead), and more. Therefore, each case MUST be looked at on its own merits, not just analyzed based on a formula or accident reconstruction.

MYTH #5: THERE MUST BE DIRECT CONTACT WITH THE NECK FOR INJURY TO OCCUR. Injury to the neck most commonly occurs due to the rapid, uncontrolled whipping action of the head, forcing the neck to move well beyond its normal range of motion in a forwards/backwards direction (if it’s a front or rear-end collision) or, at an angle if the head is rotated or when the strike occurs at an angle. When this occurs, the strong ligaments that hold the bones together stretch and tear in a mild, moderate, or severe degree, depending on the amount of force. Once stretched, increased motion between the affected vertebra results as ligaments, when stretched, don’t repair back to their original length and, just like a severe ankle sprain, future problems can result. This excess motion between vertebra can result in an accelerated type of arthritis and is often seen within five years following a cervical sprain or whiplash injury.

MYTH #6:  SEAT BELTS PREVENT WHIPLASH INJURIES. It’s safe to say that wearing seat belts saves lives and, it’s the law! So, WEAR YOUR SEAT BELTS! They protect us from hitting the windshield or worse, being ejected from the vehicle. But, as far as preventing whiplash, in some cases (low speed impacts where most of the force is transferred to the car’s occupants), the opposite may actually be true. (This is not an excuse to not wear a seatbelt!) The reason seat belts can add to the injury mechanism is because when the chest or trunk is held tightly against the car seat, the head moves through a greater arc of motion than it would if the trunk were not pinned against the seat, forcing the chin further to the chest and/or the back of the head further back. The best way to minimize the whiplash injury is to have a well-designed seat belt system where the height of the chest harness can be adjusted to the height of the driver so that the chest restraint doesn’t come across the upper chest or neck. Move the side adjustment so the chest belt crosses between the breasts (this also reduces injury risk to the breasts) and attaches at or near the height of the shoulder (not too high). Another preventer of whiplash is positioning the head restraint high enough (above the ears typically) and close to the head (no more than ½ to 1 inch) so the head rest stops the backwards whipping action. Also, keep the seat back more vertical than reclined so the body doesn’t “ramp” up the seat back forcing the head over the top of the head restraint.

We realize you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for whiplash, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

Common Whiplash Myths.

15 Jan

Whiplash is most commonly associated with the rapid, uncontrolled movement of the head as it whips back and forth during a motor vehicle collision. Though different types of injuries are associated with rear vs. front vs. side collisions, the net result is similar: the neck hurts! This month, we will look at several “myths” or untruths associated with the cause of whiplash or WAD, whiplash associated disorders.

MYTH #1: MEN ARE MORE VULNERABLE TO INJURY BECAUSE OF THEIR GREATER NECK MUSCLE MASS: FACT: This is exactly the opposite! Women are more vulnerable because they have LESS muscle mass, and hence, less tissue stopping the neck from going through a greater range of motion during the “crack the whip” process. Woman with long, slender necks are especially more vulnerable. They also take longer to recover and are more likely to suffer permanent residual problems long after their case settles.

MYTH #2: YOU CAN’T HAVE A CONCUSSION UNLESS YOU HIT YOUR HEAD: This seems logical as most concussions occur from direct head trauma. However, during the whiplash process the brain, which is suspended by ligament-like structures inside the skull, bathed in a liquid, can literally smash into the inside wall of the skull resulting in concussion just from the whipping action, without hitting anything. Permanent residuals such as memory problems, articulating thoughts, staying on task, and more can result. This is often called “post-concussive syndrome” or “mild traumatic brain injury.”

MYTH #3: NEGATIVE X-RAYS MEANS NO INJURY: Often, in the ER after a motor vehicle collision, x-rays are taken and read by the radiologist as “…essentially normal.” This can be confused as meaning, “…then there was no injury.” X-rays only show the bones in the neck and head region, not the muscles, tendons, ligaments or nerves. MRI (magnetic resonant imaging) shows more of these “soft tissues,” not just bone. But, due to the high costs of MRI, x-rays are performed first, and only later, if symptoms warrant it, is an MRI ordered. Soft tissue injury to the ligaments (the tissues that strongly hold bone to bone) can be assessed when we take flexion / extension (or bending forwards & backwards) x-rays, but many times these are not ordered in the ER.

MYTH #4: REST AND TIME ALONE WILL HEAL WHIPLASH: Though time for healing plays a role in recovery following all injuries, many patients find this approach fails and their pain persists. In fact, studies suggest that mobilization and manipulation performed as soon as possible after a whiplash injury yields significantly better outcomes than wearing a cervical collar and not moving the neck. Whiplash injuries, when not properly treated, often results in permanent loss of motion, pain, headache, and more. The days of rest and time only should be replaced by the sports medicine model of hot/cold packs, modalities such as interferential, pulsed magnetic stimulation, light or laser therapy, manipulation, massage, traction and guided exercise. Not, “…wait and watch.”

Tune in next month for addition myths about whiplash as there are MANY! Rest assured that prompt chiropractic care is the best approach for treatment of the whiplash injured patient.

We realize you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for whiplash, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

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