Archive by Author

Carpal Tunnel Syndrome – More Facts!

4 Jan

Carpal Tunnel Syndrome (CTS) is a condition where a nerve in the wrist gets pinched resulting in numbness, tingling and sometimes grip strength loss. One of the first symptoms of CTS involves waking up at night due to the numb, tingly sensations. This initially occurs once in a while but  eventually  becomes more frequent, leading to very un-restful, sleepless nights. Most people do not initially attribute this sleep interruption to CTS but rather report, “…it’s coming from sleeping on my arm or lying in a funny position.” Because restful sleep is a very important health issue, this early CTS symptom should prompt the person to investigate the problem, but usually they wait, sometimes for months or even years, making treatment more challenging.

Other symptoms may include waking up in the morning with wrist and/or hand pain, difficulty buttoning a shirt or threading a needle, radiating arm symptoms into the forearm, shoulder and/or neck, dropping silverware, pens, coffee cups, and, a specific pattern of numbness such as the index, middle, and part of the ring finger. The degree of functional loss varies from none to total disability, not being able to work or carry out many home activities. Some people notice the symptoms during the day while performing fast, repetitive movements such as playing piano, typing, using a computer mouse, crocheting/knitting, writing, assembly work, and more. Some of the most frustrating complaints from CTS patients are lost work time (due to both CTS symptoms and fatigue from not sleeping at night), a loss in earnings, lack of dexterity (buttons, tying shoes, turning a key in a door or car, fixing hair, applying make-up), daytime grogginess, and irritability that can impact their quality of life, including their relationships.

A question that often arises is, what is carpal tunnel syndrome? A simple answer is “tendonitis” or, inflammation of the tendons that connect the muscles on the palm side of the forearm (flexor muscles) to their respective tendons that attach in the hand and fingers. Digging a little deeper, there are nine of these tendons that travel through the tunnel, rubbing together as we move our fingers and all is usually well unless there is too much friction resulting in swelling in this confined space. In fact, CTS remains silent until the swelling starts pushing or compressing the median nerve at which point the numbness, tingling, pain, etc., are noticed.

So, the next question is, what can be done to stop the inflammation from compressing the nerve? A very common treatment approach is the use of a cock-up splint at night, which stops us from bending the wrist in our sleep. In a normal, non-CTS wrist, the pressure in the carpal tunnel increases 2-fold when we bend our wrist; however, if inflammation already exists inside the carpal tunnel, the pressure increases by many multiples. This is why sleep interruption is so common in CTS as we just can’t control our wrist position at night. Another common anti-inflammatory approach is cortisone shots into the carpal tunnel and/or taking an anti-inflammatory drug like ibuprofen. The chiropractic answer to anti-inflammation is ice (preferably ice massage over the palm side wrist) and anti-inflammatory nutrients such as ginger, tumeric, boswellia, and others. What gives chiropractic the “edge” over non-surgical medical care is the addition of joint and soft tissue manipulation of the hand, wrist, forearm, elbow and when needed, the shoulder and neck. The latter improves circulation, reduces fixation or adhesion between tissues and allows the tendons to slide with less friction resulting in better function as noted by longer ability to play piano, type, write, etc.

Another “key” item to CTS treatment is identifying and finding a solution to a poorly designed workstation so the wrist/hand does not have to work in an awkward manner. Here, the position of a computer screen, how a tool is held, and how long repetitive work is allowed are modified.

We realize you have a choice in who you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend or family member require care for CTS, we would be honored to render our services.

 

Tags:

You’re Not Dead Yet!!

4 Jan

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 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 then to teach others. We want you to know how much control you have over your quality and length of life.

This month, one of our readers, John (not his real name, he asked that not be printed) wrote in with: “I recently had a heart attack while having sex… [I] want to know when I can start enjoying sex again… and how will I know if I am in trouble short of serious chest pain…that was the first sign last time. My doctor doesn’t seem to want to address those questions with me.”

I’ll start my answer by referencing a favorite PBS show, Monty Python’s Holy Grail (look it up on YOUTube).  In one memorable (for me at least) scene, John Cleese carries out John Young (a dead body), when John Young utters the immortal words, “I’m not dead.”

I want to be very clear about this, John: If you’ve had a heart attack and you’re reading this, you’re not either! That means you can live life passionately.

Yes, check in with your doctor, but if it’s been 10 days since you were released from the hospital and you’re healthy enough to walk at a nice pace for a mile or so, and climb two flights of stairs (a la Jack Nicholson in “As Good As It Gets”), then you’re likely to be cleared for sex.

Your doc is unfortunately typical. Most docs don’t talk about post-heart-attack sex with their patients. Only half of male and a third of female patients are ever told when to restart their love machine. Without that info, many patients are too timid to test the waters. So, I am glad you asked the question. Two long flights easily we say, and then get cleared by the doc.  I’ve been very disappointed that 87% or so of patients after heart attacks (both nationwide and in Cleveland and surroundings) do not avail themselves of either the usual cardiac rehab or any of the three Intensive Cardiac Rehab programs we offer [the ICR of Dean Ornish –paid for by Medicare, The Granddaddy of all programs–the Esselstyn Program (developed in Cleveland)—or the Lifestyle180 program].

You should take one of these programs (many are offered in other parts of the country) if you are at high risk of a heart attack, so you don’t have another one.

By the way, beta blocking drugs like metoprolol were commonly prescribed after heart attacks until two months ago for rhythm control if you had abnormal heart beats after your attack.  But, they caused patients to eat more, have insulin resistance and even have problems achieving an orgasm. New data supports rhythm control with rhythm specific drugs, which means you won’t need those beta blockers and can probably perform better (better orgasms for both males and females). If you are at high risk (50% of men over 65 are), and don’t go for Intensive Cardiac Rehab, and do have a heart attack, you’ll probably feel like a dolt – and you should. You can prevent all that pain, and suffering for you and your loved ones, and not have that heart attack in the first place. (The Essy program is only one day!)

Worse, worrying about sex after a heart attack can be harder on the heart than having sex. Sex reduces stress, and reducing stress and having a great partner with whom you enjoy life helps reduce heart-stopping belly fat. That’s one reason why sex twice a week cuts your risk of heart attack in half.

By the way, why would Medicare pay for it? Probably because it just might save your life, allow you much more fun (I’m not sure Medicare cares about your fun), and reduces your lifetime Medicare costs (Intensive Cardiac Rehab does in randomized controlled trials). So, don’t be an 87 percenter and remember, if you are reading this, you aren’t dead yet.   So John, and all you John wannabees, after that two flights of stairs test and after Intensive Cardiac Rehab has started, snuggle up with your honey and remember: you’re doing this for your health!

Thanks for reading.

Young Dr Mike

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.  It makes a great (even late) graduation gift.  Thanks for reading.

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.

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.

 

Tags:

Fibromyalgia and Foot Orthotics.

4 Jan

Fibromyalgia (FM) is a condition that (typically)  evolves slowly over time and often occurs for no apparent reason. The diagnosis is usually made by excluding other conditions leaving you with a diagnosis that in the absence of anything else, “….must be fibromyalgia.” Of course, the problem with that approach is that we all want to know, “…what caused this problem to start with?” In the end, we typically have to accept the fact that, “…it just did,” and move on to, “…now what are we going to do about it?”

A multi-disciplinary (involving several different types of doctors and approaches) treatment approach has been found to work well with Fibromyalgia patients. This approach may include medications from a primary care doctor who is aware and sensitive to this potentially disabling condition, massage therapy from a muscle relaxation point of view, clinical psychology when the stresses associated with FM become overwhelming and out of control, and chiropractic to quarterback joint mobility, diet management, exercise training, modality use, as well as offering foot orthotics. Coordinated care effort utilizing several disciplines is what is reported to be the most successful approach.

Because chiropractic embraces the concept of treating the whole person, this premise fits perfectly in the treatment plan for the FM patient since the entire body is considered, not just a specific area or system. In this approach, we assess posture, movement, alignment, and function and implement treatments to improve each of those areas.

During the postural assessment, because we are a 2-legged species, the feet must be carefully assessed for function and alignment. If you watch people walk, you will often see their ankles roll in with each step and for some, this can be quite dramatic where the ankle rolls in almost hitting the floor. What’s interesting is that most people don’t even know they are doing it! The truth is, most people with flat feet (technically called pes planus) and rolling-in ankles (or, ankle pronation) don’t have any foot pain or symptoms associated with the altered function. In fact, people with very high arches (pes cavus) usually have more foot pain than the flat footed person. If you look at shoes of those of us who pronate (which is about 80% of us), the wear pattern is usually quite excessive on the outer corner of the heel. Sound familiar? It is very common! So, why bother “fixing” ankle pronation if it doesn’t hurt? The answer is that biomechanical function is altered and it negatively affects the rest of the body quite significantly. Here’s what happens. When the ankle rolls in, the knee has to “knock” inwards, the hip has to impinge inwards, the pelvis on that side drops and the spine has to compensate for the pelvic drop and bend away from that side. Watch the shoulders and head sway back and forth as the pronated/flat footed person walks the next time you’re walking at the grocery store, mall, or airport.

So, how does the use of foot orthotics help the FM patient? It has been reported that it takes up to seven times more energy to walk when the ankles pronate excessively. Chronic fatigue is a frequent complaint in the FM patient, and the less energy expended from walking, the more energy will be left over for other daily tasks. Also, the biomechanical stresses on the ankle, knee, hip, and spine will be smaller from wearing foot orthotics, correcting the excessive side-to-side strain on the various joints. The journal Clinical Rheumatology recently reported a significant benefit when foot orthotics were used in the treatment of FM. The bottom line is that this is a VERY SIMPLE FIX and when so much of FM is so difficult to treat, this a no brainer!

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

 

Tags:

Neck Pain and Our Pillow!

4 Jan

The relationship between neck pain and our pillow is more important than most of us realize! Though we all may have at one time or another slept on a variety of surfaces, and used any number of pillows (flat, medium, bulky) made of different materials (foam, feather, air, water, or memory foam), it’s usually not until neck pain and/or headaches start to become an issue that we start to think, “…how important is my pillow?” Thankfully, the question has been addressed in a randomized peer-reviewed study. So, what did they find out?

The goal of a pillow is to support the neck more so than the head. In a study headed by Dr. Liselott Persson, MD, of the department of neurosurgery at the University of Lund in Sweden, researchers tested whether specific neck pillows have any effect on neck pain, headache and sleep quality in people suffering with chronic (>3months), non-specific neck pain. They also researched whether there was an optimum or “best” type of pillow that was preferred by their 52 patient group. They used 4 different pillows, 1 “normal” pillow and 3 of which were specially designed, each having a different shape and consistency. Over a 4-10 week time frame, the pillows were randomly distributed to the neck pain group who then graded them according to comfort, the effects on neck pain, sleep quality and headache using a questionnaire, and also described the characteristics of an “ideal pillow.” Researchers and participants concluded the “ideal pillow” (for reducing neck pain and headaches and improving quality of sleep) includes a soft pillow with good support under the neck’s curve (lordosis).

 

There are many styles of contoured cervical or neck pillows that vary considerably. This study supports the use of a specially designed style over a normal pillow. So what are some of the things to look for? First, consider your neck’s length and girth.  When you look in a mirror, do you have a neck that is short vs. long or, narrow vs. wide? This will direct you to a pillow that has a larger “hump” for your neck to be cradled in if it’s a long neck and, the height of the hump – taller for the slender neck or, shorter for the wide neck. Some pillows have 2 options of “hump” sizes (located on the long edges of the pillow) – one short and flat and the other side taller and wider. Others recommend lying in the middle of the pillow if you’re a back sleeper vs. lying on the edge of pillow when sleeping on your sides. A measurement taken from the neck to the point of the shoulder determines if the pillow should be a small, medium, or large. Water filled and/or air filled pillows can be varied by the amount of water or air added. The bottom line of which is “best” is based on comfort and support. Regardless of which you choose, it can take several days to get used to the new pillow, so we recommend using the pillow for at least 1 week. By then, you’ll know if you chose the right style.

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.

 

Whiplash and Side Collisions.

4 Jan

Health Update: Whiplash

 

Whiplash is most commonly studied when it is a result of a rear collision where the occupant of the vehicle is injured  from a flexion (forwards) and extension (backwards) whip-like mechanism of injury, but what happens when a T-bone type of impact occurs?

The answer to this question is quite similar to many of the factors associated with any collision: the size of the bullet vs. target vehicle, the speed at which the collision occurs, the deployment or lack thereof of the airbag(s), the position of the neck at the time of impact, the “build” of the patient (skinny/tall vs. muscular), the road conditions, the “springiness” and angle of the seat back, and so forth. Unique to side impacts is the location of the strike to the target vehicle (front, middle, rear) and perhaps more importantly, the lack of space between the occupant and the point of the strike as there is a relatively shallow “crumple zone” between the occupant and the side of the vehicle.

Probably one of the best examples of how side impacts from different angles can be appreciated is to think about what happens to a person when they ride the “Bumper Cars” at the local fair. Though many fairs have now banned that “ride,” you may recall participating or watching those kids who were “having fun.” When a bumper car is struck in a classic “T-Bone” manner in the front end, the target car is spun around and the occupant hangs on for dear life. Similarly, a side strike from to the rear of the bumper car spins the back end around. When the occupant is aware of the impending crash, they grip the wheel, tuck their head by shrugging their shoulders and make their body rigid and typically, do not get “whipped around” as much as those that don’t anticipate the impact. Because the bumper cars don’t dent or crush (that is, there is no plastic deformity where damage occurs, only elastic deformity where there is no damage or, no energy absorption by crushing of the car), ALL of the crash energy is transferred to the occupant or the contents. If a person has a purse lying on the floor of the bumper car, it can go flying out and spill all over. Similarly, the person who is unaware of the impending collision will “go flying,” giving great satisfaction to the driver of the bullet bumper car.

When considering factors such as plastic vs. elastic deformity, side air bags, and the shallow crumple zone on the sides of motor vehicles, some manufactures stand out in their ability to protect the occupants in side impact collisions. Generally, those vehicles with a stiff side and roof structure have been found to be the best in protecting the occupant from injury by maintaining the survival space and dissipating the energy, or force, of the impact away from the occupant. Manufactures that stand out include Volvo, Mercedes, and Subaru. They have had the best design for decades and remain at the forefront for occupant protection in side impact collisions. The combination of energy absorbing side structure design and the side airbag has proven to be one of the most important factors in improving the crashworthiness in side impact collisions. Side air bags became popular in the 1990s. In 2012, more than 95% of all passenger cars sold in the US are equipped with side impact airbags as standard equipment.

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.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR WHIPLASH!

FOR A FREE NO-OBLIGATION CONSULTATION CALL (717) 697 1888

Are You A Good Enough Person To Do This?

2 Jan

Here is proof that there are still amazing people in the world.  Are you one of them?

Every day, it feels like all the news covers is the dark, horrible side of humanity.

Sure, people do bad things,  even evil things.  But, there is another side to this story.  There’s a clear argument that can be made that many more people are good than bad.  For every one bad person in the news (or going viral on the internet) there are hundreds, thousands, or millions who did not do anything wrong.  In fact, many, if not most, probably did quite a bit of good.

So, why don’t we hear about all this good?  Quite frankly, it’s because bad stuff sells.  It sells much more than good news.  People love drama.  It’s no coincidence Honey Boo Boo, The Kardashians, and The Jersey Shore were/are monstrously successful shows.

That’s why I bet you have probably heard of those shows but have not heard about this…

Rabbi Noah Muroff lives in New Haven, Connecticut and bought a desk off Craig’s List for $200.  So far, that’s nothing shocking… but it gets better…

When he got the desk home, he couldn’t get it into his office in one piece.  So, Rabbi Noah took the desk apart and pulled out the drawers.

Behind one of the drawers, he found a plastic bag.  At first glance, Muroff saw what he thought to be a $100 bill.

When he opened the bag, he discovered there were quite a few $100 bills.  In fact, there was $98,000 in cash.  That’s ninety-eight THOUSAND dollars in CASH.

WOW!  So let me ask you a question… What is the first thing you would do with that money after you stopped jumping around cheering? Pay off some bills?  Buy a car?  Go on vacation?  Give some to charity?

Muroff did none of that.  Instead, he did the right thing.  He called the person he just bought the desk from and told them what he had found.

As it turned out, the desk’s previous owner had hidden her inheritance money in the desk and had forgotten all about it.

Muroff returned the money.  All of it.  He is quoted as simply saying, “The most important thing in life is to be honest.”

That’s it.  There was no police chase.  No drugs or violence.  No one yelling and screaming.  Just an ethical and moral person choosing to do the right thing and not making a big deal about it or even looking for public approval or praise.

The comments posted on this story were varied.  Some praised him and said they would do the same thing.  Others said he was a fool and they would have spent the money.  Some said it is all just a matter of the amount and that we all have a price.  If that was $10 million… or $1 billion… that he would have kept it.

So, the question for you is, what would YOU do?  Let’s say it was $10 million and no one else knew.  It was your secret.  Do ethics and morality really have a price?

Do YOU have a price?

We love helping our patients and their friends and relatives through their tough times and 

getting them feeling better!  We are here to help you stay feeling better and looking younger!

Don’t be a stranger.  You really can afford Chiropractic care! Don’t wait until you can no longer move!

← Older Entries
Newer Entries →