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Whiplash Facts.

30 Dec

“Whiplash” is considered a non-medical term that encompasses a range of injuries. These injuries typically affect the neck and are caused by a sudden movement of the neck associated with extension or forceful backward bending. The medical term “cervical acceleration-deceleration” (CAD) is considered to be a more accurate description of what happens during a car accident, and the term “whiplash associated disorders” (WAD) describes the injury’s residual signs and symptoms.

 

WAD or CAD is most commonly associated with motor vehicle collisions (MVCs), when a vehicle is struck from behind. Other less common causes include: dancing (especially “headbanging”), falls from stools or ladders, bicycle injuries, horse related injuries, and many others. In the UK in 2007, 430,000 people made an insurance claim for WAD, accounting for 14% of every driver’s premium. In the US, over 1 million WAD injuries occur annually due to car accidents alone with an estimated 3.8 cases per 1000 people per year. An estimated 6.2% of the US population has “late whiplash syndrome” or long-term problems associated with WAD.

Prior to the advent of the automobile, WAD was referred to as “railroad spine” (as it resulted from a train crash), first documented in 1919. WAD also occurred frequently in pilots landing on aircraft carriers due to the rapid deceleration that occurred as the planes landed and suddenly braked. When one thinks of “whiplash,” the visual of a high speed crash comes to mind. However, WAD can occur at speeds less than 15 mph due to less crash energy absorption by crushing metal. Since there is less car damage at lower speeds, that energy is transferred to the contents (the people) inside the car.

The neck consists of 7 vertebrae, the 6 disks, the 8 pairs of nerves, and the muscles, ligaments and other “soft-tissues.” There are 4 phases of injury (initial, retraction, extension and rebound), which all occur within 300 msec. Whereas, it takes about 800msec to voluntarily contract a muscle. Therefore, you can’t really “prepare” or fully brace for the impact. Most injuries occur at C5 and C6 in the lower part of the neck between 150 and 300 msec. of the cycle. Factors that influence injury include: the seat back angle, the seat back rebound, the headrest position, the direction the head is positioned at impact (worse if rotated), the occupants gender (females are at greater risk due to a more thin, less muscular neck), the size of each vehicle involved, and more. All these factors make it extremely challenging to accurately reconstruct a MVC on paper.

The most common symptoms associated with WAD include neck and upper back pain and headache, referred pain into the mid-back or down an arm and sometimes legs. The onset of symptoms can be immediate or delayed for days. Risk factors that worsen the prognosis of a case include: the presence of radiating pain from the neck to the arm and hand that follows a specific nerve, failure to respond to initial treatment, a delay in getting treated, and being placed in a cervical collar (especially if not allowing to be mobilized and exercised — i.e. chiropractic care). The key to the success of WAD treatment is to get treated immediately, don’t restrict yourself to a cervical collar, unless you have an unstable fracture, and do your exercises!

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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Cervical Traction – The Many Options and How To Use It!

30 Dec

The type of traction that this discussion will address will be limited to the kind that can be purchased and then used in the home, usually multiple times a day, giving it a clear advantage over in-office traction treatments which can only be applied a few times a week during office visits. In some cases however, it may be appropriate to use the in-office type for a few sessions to determine dosage and/or tolerance prior to administering a home unit, but this varies from case to case, and each type of traction unit is different. In the neck or cervical spine, there are many varieties including: sitting over-the-door types, cervical collar types, as well as supine (lying on the back) types. Each variety has its pros and cons and prices vary considerably from $10 to $600.

CONDITIONS: Probably the most common condition treated with cervical traction is “cervical radiculopathy,” or a pinched nerve. When a nerve root in the neck is pinched, pain, numbness, tingling, and/or muscle weakness occurs in the area the particular nerve innervates. For example, if a patient presents with pain and numbness radiating down the arm to the thumb and index finger and/or have weakness in bending their elbow and extending their wrist, then we know that the C6 nerve is pinched. When pulling or stretching the neck relieves the arm pain, traction is usually helpful. If pain worsens, the person is probably not ready for traction yet.

PROTOCOL (DOSAGE): The key to a successful outcome using cervical traction is finding the right dosage. If you start with too much weight, it may leave you feeling sore, or worse, making you reluctant to try it a second time. Therefore, rather than relying on using a certain percentage of body weight, it’s safest to start with less weight and then gradually increase it, such as 5# (# = pounds or .45 kg) for 15-20 minutes. If that dose feels fine, try 7#/15-20 min., then 9#, 11#, 13#, etc., until you find it just isn’t quite as comfortable at the last weight. You have now found your current threshold and should drop down to the last most comfortable weight and use that for a few days and then MAYBE try increasing it again. Studies show a maximum stretch is usually achieved within 15-20 minutes, so extending the time longer may be less productive. Facing the over-the-door unit may be better tolerated than facing away. Try it both ways and you decide which feels best. The next most important issue is frequency.

How often to repeat the traction sessions depends on: 1. The condition’s severity and your response; 2. Your time availability. If there is a severe nerve pinch with muscle twitching, weakness and dense numbness/tingling, then the traction be repeated MANY times a day, gradually increasing the weight to find the optimum amount. We’ve had people repeat the traction 10x/day! With the option of wearing a cervical collar traction unit, you can actually travel and/or do certain activities during traction. We’ve had people travel to and from work while performing traction! Since each case is unique, we’ll discuss that individually. The bottom line, IT WORKS GREAT with proper chiropractic management and in many cases, surgery CAN be avoided!

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.

 

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Fibromyalgia and “SHINE.”

30 Dec

Fibromyalgia (FM) management can be as difficult as making a definitive diagnosis.  FM is characterized by generalized body aches and feeling exhausted, and yet, in spite of the exhaustion, the inability to sleep is a “classic” FM complaint. Some have referred to FM as “blowing a fuse” or as an “energy crisis,” as more energy is expended than what’s being made. FM sufferers, as well as the caregivers, know how physically and mentally difficult it is to manage this controversial condition. Many management strategies that have been published; SHINE is one approach. SHINE stands for Sleep, Hormones, Infections, Nutritional supplements, and Exercise. By focusing treatment strategies on these 5 areas, significant benefits can be achieved.

SLEEP: Some feel this is the most important problem to manage in order to gain control of FM. If we cannot reach “deep sleep,” (which is the sleep stage that is usually reached after about the 4th hour into sleep) then the body cannot fully rest. When discussing sleep problems with the FM patient, it is common to hear them say, “…I wake up every 1-2 hours and can’t get back to sleep for at least 15-30 minutes.” This results in NEVER getting to the deep sleep stage and eventually, because the body hasn’t fully relaxed often for years, everything starts hurting. This is the hallmark of FM. Some “tips” to help us get to sleep and stay sleeping include: keeping the bedroom cool (such as 65°), taking a hot bath before sleep to relax your tight muscles, spraying the pillow with lavender oil (helps promote sleep), taking 75-150mg of magnesium, avoiding caffeine (especially later in the day), the use of Valarian Root (a muscle relaxing herb) and/or melatonin (an amino acid that promotes sleep) can also help. The goal is to try to get 8-9 hours of sleep a night. Establish a routine in the evenings and go to bed at the same time or close to it.

HORMONES: These chemicals are produced by our endocrine glands (pituitary, thyroid, parathyroid, adrenals, ovaries/testes, and part of our pancreas. They are in balance with each other, and somehow, in FM they often fall out of balance. Have your health care provider perform tests (usually blood and/or urine) to determine your hormone levels and get them balanced!

INFECTION: The lack of sleep lowers our immune function, and infections can occur more readily. In addition to treatments, there are nutritionally based approaches to improve immune function, and if recurrent illnesses are part of your FM profile PLEASE consult with us regarding ways to boost your immune system!

NUTRITIONAL SUPPLEMENTS: This topic is related to the last as there are MANY supplement recommendations that have been found to boost immune function, increase energy, enhance sleep quality, and more. This is an area of FM management that is largely overlooked by traditional medical management approaches. Remember, a “team” of providers offers the FM sufferer the best way to manage this challenging to treat condition. Look for health care providers who are willing to work together as a team on your behalf.

EXERCISE: This is a MUST! For example, in a 2010 Oregon Health & Sciences University study, women with FM who practiced yoga for 8 weeks had a 24% pain reduction, 30% fatigue reduction, and 42% depression reduction.

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

 

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New Research Shows How Sugary Drinks Are Probably Harming Children As Young As 2 To 5 Years Old…

24 Dec

“What we do for ourselves dies with us. What we do for others and the world remains and is immortal.”  ~ Albert Pine

Earlier this year, New York City Mayor Michael Bloomberg proposed a ban that would stop restaurants, delis, movie theaters, food carts, and stadiums from selling certain sugary drinks in containers larger than 16 ounces as a way to help combat obesity in the city. As you can imagine, there was enormous public and political backlash.

Eventually, an appeals court ruled against the proposed ban just before it could go into effect, citing that it was an overreach of executive power. While it may not be Mayor Bloomberg’s place to tell you or your children not to drink sugary drinks, research has tightly linked sugar-sweet beverage consumption to weight gain among older children.  But what about younger children?

New research published in Pediatrics, the official journal of the American Academy of Pediatrics, studied 9,600 children from birth to age five.  The researchers found correlations between sugary drink consumption by children as young as two years old and weight gain in later years. The drinks examined in the study were sodas, sports drinks, and any other sugar-added beverages or juice drinks that were not 100 percent juice.

Because of the study’s size and length of follow-up, many experts believe the information to be very valuable.

According to Dr. Dyan Hes, Medical Director of Gramercy Pediatrics in Manhattan, who has been lobbying for public policies like soda taxes that would make these drinks less attractive to families, “It’s a fantastic study because we need more evidence… We know that sugar-sweetened beverages are the greatest contributor to increased obesity in young children because they’re cheap. It shows that by giving your children sugar-sweetened beverages by age two, you’ve already set up habits that are very hard to break.”

Here’s what is really important about this study: The study did not find that two year olds who drank at least one sugar-sweetened drink to be any heavier than other two year olds.  But, drinking just one sugary drink per day did set those toddlers up for weight gain in the near future.  In fact, the children who drank at least one sugary drink per day were already heavier by the age of five.

According to Scientific America: In fact, they were 1.43 times more likely to be obese than preschoolers who consumed sugary drinks less than daily, even after accounting for other factors that could influence weight gain.  Mark DeBoer, Assistant Professor of Pediatrics at the University of Virginia, says the findings support the hypothesis that regular consumption of sugar-sweetened beverages has a cumulative effect over time. “We were struck by this data that even at a very young age, the sugar-sweetened beverages contribute to weight gain… and we wanted to put this information out for pediatricians and for families to help them make healthier choices for their children.”

Why Do Sugary Drinks Cause

So Much Weight Gain?

The answer to that question is most likely two-fold.  First, is simple caloric intake.

Sugary drinks are full of “empty calories.”  In other words, they contain very little (if any) nutritional value but are high in calories.  These calories, because they are liquid, do not make you feel full. So someone drinking all these empty calories will still need to eat solid food to feel full, increasing the total amount of calories consumed in a day. The second reason is how your body chemically reacts to sugar.  These types of drinks are usually loaded with fructose. Fructose can be harmful to your body by setting up the conditions for not only obesity, but also diabetes.

This “junk sugar” unstabilizes blood sugar levels and makes your pancreas work overtime.  Your pancreas is the organ responsible for secreting the hormone insulin so the sugar in your blood stream can be absorbed by cells.  After years of sugar consumption, the pancreas may “wear out” and an individual could become a type 2 diabetic.

Many type 2 diabetics start taking insulin injections when the better solution for many may to manage their blood sugar levels may simply be proper diet and exercise.  However, the best solution is to prevent the condition altogether by limiting consumption of bad sugar, such as sugary drinks (along with a proper diet and regular, moderate exercise).

Here Is Something Disturbing…

A UCLA study published in the Journal of Physiology is the first to show how a steady diet high in fructose can damage your memory and learning.

Researchers investigated the effects of high-fructose syrup. It’s similar to high-fructose corn syrup, a cheap sweetener six times sweeter than cane sugar which is used in most soft drinks, processed foods, condiments, and even many baby foods.

They fed rats a fructose solution instead of clean drinking water for six weeks. Then, they tested their ability to remember the way out of a maze.

The results were quite shocking.  The rats fed fructose syrup struggled to negotiate the maze, demonstrating significant impairment in their cognitive abilities.  They were slower and their brains showed a decline in synaptic activity.  Their brain cells had trouble signaling each other, disrupting the rats’ ability to think clearly and recall the route they’d learned six weeks earlier.

Additionally, the fructose-fed rats showed signs of resistance to insulin, a hormone that controls your blood sugar and synaptic function in your brain.

Researchers concluded that a high-fructose diet negatively affects the way the brain functions. According to Dr. Fernando Gomez-Pinilla, a Professor of Neurosurgery at the David Geffen School of Medicine at UCLA and a Professor of Integrative Biology and Physiology in the UCLA College of Letters and Science, “Our findings illustrate that what you eat affects how you think… Eating a high-fructose diet over the long-term alters your brain’s ability to learn and remember information.”

Don’t forget, if you ever have any questions or concerns about your health, talk to us. Contact us with your questions. We’re here to help and don’t enjoy anything more than participating in providing you natural pain relief.

 

Building a Bigger Brain.

24 Dec

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 both the  quality and length of your life.

What do your favorite wool sweater, your retirement savings account, and your brain have in common? They’re all better off if they don’t shrink! But the brains of the 79 million Americans (and millions more Canadians) are at risk of not only shrinking but not growing right from the start!

“All work and no play makes Jack a dull boy.” That proverb has been around since at least 1695, and it was a creepily obsessive phrase in the 1980 movie The Shining (and look what happened there!). Yet, this very simple and profound observation has somehow gotten lost in our modern scramble to make kids smarter. Recess, that time honored tradition that lets kids work off their restless energy and teaches them everything from being part of a team to negotiating conflicts with classmates, has virtually disappeared from many school districts. (In some school districts instituting recess is a challenge. In Chicago, for example, nearly 100 elementary and middle schools have no playgrounds.)

But people who make such policies are finally beginning to realize that it’s a huge mistake to eliminate  playtime. The benefits of recess include: stimulation of creativity and imagination, improved physical health and control of obesity, building friendships, and an improvement in classroom attention and learning. Kids who have an hour of play first thing in the day learn better. Social-emotional learning should be woven into academic learning because it enhances a child’s ability to learn and to thrive.

So if your child goes to an elementary school that does not have recess, or you have school administrators who do not think recess is important, then speak up and step in.  If you have no outdoor space for recess, then help school teachers find creative ways to make the gym or a classroom work. If you have to take the issue up at parent-teacher meetings or the PTA, then do it. Your child’s health, happiness, and school success depend on it.

On to another topic…

Intestinal bacteria are big news: Breast milk contains 700 varieties (that’s good because it seems to build an infant’s immune system and digestive health). We now know these bacteria break down and generate amino acids and neurotransmitters that affect mood (these are true gut reactions); and it seems disruption of a healthy balance of gut bacteria may cause (or be the result of) type 2 diabetes. But perhaps the most astounding news is that a fecal transplant (putting someone else’s, um, healthy mix of gut bacteria into the GI tract of a person suffering with Crohn’s disease or a C. difficile infection) can banish chronic diarrhea PDQ. But it sounds so… what’s the scientific word? Icky.

Well, now there’s an artificial mixture of gut bacteria that’s called, we kid you not, RePOOPulate.  In tests, people with “untreatable” C. difficile infections (that’s the bacteria that can thrive in the gut after treatment with antibiotics) saw their diarrhea clear up in three days after RePOOPulate-ing. Six months later, they were still free of the sinister bug. This not-quite-as-personal bacterial transplant successfully rebalanced their gut with a healthy bacterial mix.

If you have chronic intestinal problems, get onboard with a probiotic regimen (we recommend Culturelle and Sustinex) and make sure you eat plenty of apples. They’re loaded with pectin (it’s what’s called a prebiotic); it helps balance gut bacteria in favor of the good guys. Asparagus, chicory root, garlic, onions, and oats are other prebiotics. And if that doesn’t help, talk to your doc about repopulating your intestines with friendly bacteria.

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.

 

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Carpal Tunnel Syndrome – 13 Fun Facts!

24 Dec

Carpal Tunnel Syndrome (CTS) results in numbness, tingling, and sometimes weak grip strength due pinching of the median nerve as it travels through the carpal tunnel at the wrist. There are many conditions that are similar to CTS, many of which we have discussed in the past. The following is a list of “13 fun facts” aimed at helping to properly identify CTS, knowing what to do about it, and at helping to make an informed decision as to whom to seek help for it.

CTS is most common in women, age >50, who work in a repetitive, rapid moving manually demanding occupation (typing/computer work, line assembly work, waiting tables, and more).

CTS is complicated by the presence of obesity, diabetes, hypothyroid, pregnancy, taking birth control pills, and other conditions that cause inflammation (rheumatoid arthritis and others).

CTS may develop on the dominant side, the non-dominant side or both– each case is individual.

CTS symptoms may FIRST present as morning or night time numbness that can wake the sufferer up once or many times during the night.

CTS sufferers USUALLY wait for weeks, months or even years before seeking help for it, which is a risk factor for a delayed recovery – GET HELP ASAP!!!

CTS can often be managed without surgery– especially IF you have it treated sooner rather than later.

CTS surgery may be necessary if non-surgical care fails. This may be due to the nerve being damaged beyond a certain point (an EMG/NCV or, electromyography/nerve conduction velocity helps determine this along with an accurate history and examination).

CTS non-surgical care includes: chiropractic manipulation of the wrist, elbow, shoulder and/or neck– depending on the case. All health care providers usually include a night wrist splint, anti-inflammatory measures, ergonomic modifications of work stations, and stretching exercises.

CTS non-surgical success favors chiropractic because of the inclusion of the manual therapies. When only exercise, night splinting, and NSAIDS are used, the success rate drops off dramatically.

Reduced thyroid function makes CTS worse because of the unique type of swelling associated with hypothyroidism called “myxedema.” Because of the confined space available in the carpal tunnel, a small amount of swelling can result in nerve compression and the classic numbness/tingling symptoms in the middle three fingers on the palm-side of the hand.

CTS is worse at night because it is impossible to control the position of the wrist while we sleep. As a result, we tend to curl the wrist and hand under our chin, and when the wrist bends forwards or backwards, the pressure inside the carpal tunnel increases significantly due to the change in tunnel size. This is why wearing a wrist splint at night REALLY HELPS as it keeps the wrist from bending, keeping the tunnel as wide as possible, thus lowering the pressure within it.

CTS patients respond well in some cases to vitamin B6. This is due to the healing effects of B6 (peridoxine) on neuropathy and/or it’s anti-inflammatory qualities. Other anti-inflammatory nutrients include ginger, turmeric, boswellia, bioflavinoids, white willow bark, quercetin, and others.

CTS patients do not always improve after surgery. This can be due to the fact that the median nerve is frequently “pinched” in more than one area such as the neck, thoracic outlet (shoulder), pronator tunnel (elbow) as well as at the wrist. When more than one compression is present, this is referred to as “double” or “multiple crush syndrome.”

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.

 

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