"Doctors not honest." So what else is new and startling?

 By J.C. Smith Special to The Telegraph 

I read with amusement the recent Article: "Study: Doctors not always honest with patients" (by Lauran Neergaard of the Associated Press, Feb. 9); 

She refers to a survey conducted by a Harvard Medical School professor, Dr. Lisa Iezzoni. Issues revealed among the 1,800 doctors surveyed included that some physicians were prone to be less than totally honest with patients about treatment mistakes, overly optimistic about prognoses, using exaggerations to scare patients, and failure to communicate to patients their options to make fully informed decisions. 

According to this report, "1 in 10 surveyed say they'd told a patient something that wasn't true in the past year." 

As a 30-year chiropractic practitioner, I would like to add the most glaring untruth practiced by most, but not all, MDs is their well known defamation of chiropractors. It is common knowledge that medical bigotry is still paramount among most doctors and within medical schools. 

Although racism, sexism, anti-Semitism and homophobic prejudices have waned during the past few decades, the medical discrimination against chiropractic remains entrenched. 

This medical bigotry not only hurts the image of chiropractors, but it hurts patients and flies in the face of ethics and science. Modern research that began at 

Emory University in 1990 revealed the basis of spine surgery - the abnormal disc theory - to be invalid. Today spine researchers refer to disc abnormalities such as herniation and degeneration as "incidentalomas" because they are a part of the natural aging process like finding gray hair. 

In many cases, researchers found patients without pain to have abnormal discs while others patients with pain had none. Yet disc surgeries continue to increase in Georgia and the United States. 

On the other hand, as far back as 1994 an agency for the.U.S. Public Health Service did a two-year study on acute low back pain in adults that included more than 4,000 scientific articles and concluded that spinal manipulation was the preferred treatment in most cases. 

Other studies from Canada, the United Kingdom, New Zealand and the United States have confirmed that not only are spine surgeries unnecessary (with the exceptions of cancer, fracture,serious infections, or those rare cases that don't respond to conservative care), but epidural steroid injections and opioid narcotics are also ineffective, costly, dangerous and addictive. 

Recently, the North Carolina Blue Cross/Blue Shield insurance company changed its policy that now states it will no longer pay for spinal fusion if the sole criteria is herniated or degenerated discs. They also cited the same research that 

shows disc abnormalities are a common part of the aging process. Hopefully this will sweep through all the states to save people from these often debilitating and unnecessary surgeries. 

Ironically, after nearly a century of persecution and defamation,the chiropractic profession has not only survived the medical war, but now stands vindicated as the best choice for most back pain problems that are often caused by joint dysfunction, which explains why manipulation, decompression. massage and other hands-on therapies are so effective. 

Considering there are 137 joints in the spine, most spinal disorders begin with these primary spinal misalignments that secondarily cause disc and pinched nerve problems.

The sad fact is most doctors today are aware that the disc theory is outdated. They also know drugs, shots and disc surgeries are expensive. ineffective and unnecessary. More so, they also know chiropractic care is the preferred treatment for 85 percent of back pain cases, yet very few have the ethics to refer to chiropractors for fear of retribution from their own medical collegues. 

Although this Harvard survey admits 10 percent Of MDs lied to patients during the past year, I dare say 90 percent have lied to their patients about chiropractors. If you want to test your doctor's ethics, ask him or her about chiropractic care and if you are given the usual slander, run as fast as you can from that office. It is past time to confront this medical bigotry as the last bastion of prejudice that has harmed the well-being of patients as well as the reputations of chiropractors. 

JC. Smith, MA, DC practices in Warner Robins. 

The Facts About Fevers

SOURCE: To Your Health ~ January 2012

By Claudia Anrig, DC

Our body’s first line of defense when invaded by any microbe, virus or bacteria is cells called microphages; a strong, healthy immune system may be able to eliminate the problem with this first step alone.
If these fail to contain the microbe/”bug,” then the body creates other pryogens and proteins to try to assist. Once these have been created, the hypothalamus in the brain recognizes there is an invader and raises the body temperature to assist in killing it off.

This elevated temperature will generally be just a couple of degrees, but the hypothalamus determines, based on the number of pryogens and proteins, what will be necessary to eliminate the microbe/bug. If the hypothalamus creates additional biochemicals to try to protect the body, then the temperature rises accordingly.

Defining a Fever

For all children above the age of 3 months, a fever is actually a good thing. It’s a sign that their immune system is functioning properly. Although many parents will panic when their child has a temperature above 98.6° F (37° C), and this is understandable since many health care providers have called this a “low-grade fever,” the reality is that children’s temperature may naturally run a little higher than what many consider the norm.

A true low-grade fever is anything between 100° F and 102.2° F (37.8° C and 39° C). This level of fever is beneficial; with most microbes/”bugs” that a child will be exposed to, this fever will assist the body in repelling the invader.

A moderate-grade fever is typically between 102.2° F and 104.5° F (39° C and 40° C). This temperature is still considered beneficial; if a child’s body has reached this temperature, it’s what’s needed to kill whatever bacteria or virus their body is attempting to fight.

A high fever is a fever greater than 104.5° F (40° C). This fever may cause the child some discomfort and result in a bit of crankiness. Generally indicative of a bacterial infection, this fever means that the body is fighting something a little more serious than the common cold. While it will not cause brain damage or any other harm to a child, it is wise to seek assistance from their medical provider.

A serious fever is one that is at or above 108° F (42° C); this fever can be harmful.

Can a Fever Be Dangerous?

Fevers that are caused by the body’s immune system are not dangerous, and the hypothalamus will control the body temperature and not allow it to get so high as to cause harm. While it can be frightening to have a child running a moderate to high fever, it is simply their body doing what it was designed to do.

The only body temperature that can actually cause brain damage, despite what many parents believe, is 108° F (42° C), and this body temperature cannot typically be achieved on its own, but requires extreme external environmental temperatures – for instance, if a child is left in a closed car in hot weather.

What About Fever Reducers?

Since it is a very rare fever that can actually cause any kind of harm to a child, the best response is to let it run its course; most fevers will resolve themselves in 24 to 72 hours.
Parents should be aware that fevers will naturally spike a little in the late afternoon and evening, so a slight increase in temperature during these times is not a cause for alarm. A wait-and-watch approach should be recommended, rather than turning to over-the-counter chemicals.

The American Academy of Pediatrics (AAP) does not recommend fever-reducing drugs: “Fever is not an illness, rather, it is a symptom of sickness and is usually a positive sign that the body is fighting infection.” Even in cases of high temperatures, the AAP says, “Fevers generally do not need to be treated with medication unless your child is uncomfortable or has a history of febrile convulsions. The fever may be important in helping your child fight the infection.”

The Best Response

The best response to a fever below 104.5° F (40° C) for children over the age of 3 years is lots of rest and clear fluids. Since fevers may cause the child to sweat, parents need to be aware that they will lose sodium and water, which must be replaced with proper fluids. (This does not include Gatorade or other sugary sports drinks.) Parents should contact the child’s health care provider right away if any of the following occur:

• A child younger than 3 months is running any grade of fever.
• A child between 3 months and 3 years has a temperature above 102.2° F (39° C) and appears ill (it should be noted that even teething may cause a slight increase in temperature).
• A child of any age has a temperature over 104.5° F (40° C).

Additionally, since dehydration is a potential side effect of fever, encourage parents to watch their child for the following: dry mouth, lack of urine or wet diapers for 6-8 hours (or only a small amount of really dark urine), dry skin, lethargy, irritability, fatigue, or with an older child, dizziness. These signs of dehydration may be a concern and the child should be seen by a health care professional, especially if they are unable to keep down clear fluids.

It is important to note that in children under the age of 5 years, a fever can also lead to a seizure, known as a febrile seizure. However, while this can be frightening, it will typically have no lasting effects.

“Fever Phobia”

In 1980, Dr. Barton Schmitt published a now-classic article in which he coined the phrase “fever phobia.” Many parents believed that untreated fevers could actually rise to critical levels and that even low-grade fevers could have serious neurological effects. This is just not true.

In 2001, Dr. Michael Crocetti, an assistant professor at Johns Hopkins, was the lead author of a study called “Fever Phobia Revisited: Have Parental Misconceptions About Fever Changed in 20 Years?” He found that 20 years later, not much had changed and that despite education, parents still believe that fevers are dangerous. Keep in mind that although they do increase the need for fluids, fevers in and of themselves are not harmful.

A fever is a natural part of a child’s immune response. When it is functioning at its absolute best, a child’s body will fight off most foreign invaders so swiftly that they will have no outward effect at all. However, when necessary, a child’s immune system will raise their temperature to create a hostile environment for that invader. It’s how a properly functioning body functions.

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Claudia Anrig, DC, practices in Fresno, Calif., and is on the board of directors of the International Chiropractic Pediatric Association, an organization that can answer your questions regarding the value of chiropractic care during and after pregnancy.

Related posts:

1. Early Life Infections and the Immune System
2. Spinal Cord Processes Information Just as Areas of Brain Do, Research Finds
3. Government Support and the Research Challenges of Chiropractic Pediatrics

New Study Reveals That Back Surgery Fails 74% of the Time

Editorial Commentary:

Researchers reviewed records from 1,450 patients in the Ohio Bureau of Workers’ Compensation database who had diagnoses of disc degeneration, disc herniation or radiculopathy, a nerve condition that causes tingling and weakness of the limbs. Half of the patients had surgery to fuse two or more vertebrae in hopes of curing low back pain. The other half had no surgery, even though they had comparable diagnoses.

After two years, just 26 percent of those who had surgery had actually returned to work. That’s compared to 67 percent of patients who didn’t have surgery. In what might be the most troubling study finding, researchers determined that there was a 41 percent increase in the use of painkillers, specifically opiates, in those who had surgery.

“The study [1] provides clear evidence that for many patients, fusion surgeries designed to alleviate pain from degenerating discs don’t work”, says the study’s lead author Dr. Trang Nguyen, a researcher at the University of Cincinnati College of Medicine. [2]

Just a month after back surgery, Nancy Scatena was once again in excruciating pain. The medications her doctor prescribed barely took the edge off the unrelenting back aches and searing jolts down her left leg. “The pain just kept intensifying,” says the 52-year-old Scottsdale, Ariz., woman who suffers from spinal stenosis, a narrowing of the chanel through which spinal nerves pass. “I was suicidal.”

Finally, Scatena made an appointment with another surgeon, one whom friends had called a “miracle worker.” The new doctor assured her that this second operation would fix everything, and in the pain-free weeks following an operation to fuse two of her vertebrae it seemed that he was right. But then the pain came roaring back.

Experts estimate that nearly 600,000 Americans opt for back operations each year. But for many like Scatena, surgery is just an empty promise, say pain management experts and some surgeons.

This new study in the journal Spine [1] shows that in many cases surgery can even backfire, leaving patients in more pain.

The study provides clear evidence that for many patients, fusion surgeries designed to alleviate pain from degenerating discs don’t work, says the study’s lead author Dr. Trang Nguyen, a researcher at the University of Cincinnati College of Medicine. [3]


27 Million Adults With Back Problems

A recent report by the Agency for Healthcare Research and Quality, a federal organization, found that in 2007, twenty-seven million adults reported back problems, with $30.3 billion spent on treatments to ease the pain. While some of that money is spent on physical therapy, pain management, chiropractor visits, and other non invasive therapies, a big chunk pays for spine surgeries.

Complicated spine surgeries that involve fusing two or more vertebrae are on the rise. In just 15 years, there was an eight-fold jump in this type of operation, according to a study published in Spine in July. That has some surgeons and public health experts concerned. [4]

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You may also want to review the recently published European Guidelines for the Management of Acute and Chronic Nonspecific Low Back Pain, which specifically states: 

"Surgery for non-specific CLBP cannot be recommended unless 2 years of all other recommended conservative treatments — including multidisciplinary approaches with combined programs of cognitive intervention and exercises — have failed".

This study re-confirms the findings of the UK BEAM Trial, published in the British Medical Journal in 2004. [5] Those authors stated:

"Manipulation, with or without exercise, improved symptoms more than best care (medical care) alone after three and 12 months.   However, analysis of the cost utility of different strategies shows that manipulation alone probably gives better value for money than manipulation followed by exercise" (page 1381). 

You may also want to read these 3 recent Editorials:

Why Do Spinal Surgery Rates Continue To Rise? 
Chiro.Org Blog ~ April 10th, 2010

New Study Finds Chiropractic Care Superior to Family Physician-directed Usual Care
Chiro.Org Blog ~ October 7th, 2010

If Not Chiropractic Care, Then What’s Your Alternative?
Chiro.Org Blog ~ September 25th, 2010

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REFERENCES:

1.   Long-term Outcomes of Lumbar Fusion Among Workers' Compensation Subjects: An Historical Cohort Study
SPINE (Phila Pa 1976) 2011 (Feb 15);   36 (4):   320–331

2.   Study Says Back Surgery Often Makes Things Worse
The Daily Hit ~ Oct 14, 2010

3.   Back Surgery May Backfire On Patients In Pain
MSNBC.com ~ Oct 14, 2010

4.   Why Do Spinal Surgery Rates Continue To Rise?
Chiro.Org Blog Editorial ~ April 10th, 2010

5.   Findings from the: “United Kingdom Back Pain Exercise and Manipulation (UK BEAM) Randomised Trial”
British Medical Journal 2004 (Dec 11); 329 (7479) 

Send all comments or additions to:    Frankp@chiro.org

Body clock 'alters' immune system

By James GallagherHealth and science reporter, BBC News

The time of the day could be an important factor in the risk of getting an infection, according to researchers in the US.They showed how a protein in the immune system was affected by changes in the chemistry of the body through the day.

The findings, published in the journal Immunity, showed the time of an infection changed its severity.

An expert said drugs were likely to take advantage of the body clock in the near future.

Plants, animals and even bacteria go through a daily 24-hour routine, known as a circadian rhythm. Jet lag is what happens when the body gets out of sync with its surroundings after crossing time zones.

It has been known that there are variations in the immune system throughout the day. Researchers are now drilling down into what causes the details.

The immune system needs to detect an infection before it can begin to fight it off. Researchers at Yale University School of Medicine were investigating one of the proteins involved in the detection process - Toll-like receptor nine (TLR9), which can spot DNA from bacteria and viruses.

In experiments on mice, the scientists showed that the amount of TLR9 produced and the way it functioned was controlled by the body clock and varied through the day.

Immunising mice at the peak of TLR9 activity improved the immune response, the researchers said.

They said humans with sepsis, blood poisoning, were known to be at a greater risk of death between 02:00 and 06:00.

Time link

When testing mice, the severity of sepsis depended on the time of day infection started and coincided with changes in TLR9 activity.

Prof Erol Fikrig, who conducted the study at Yale University, said they had found a "direct molecular link between circadian rhythms and the immune system", which could have "important implications for the prevention and treatment of disease".

He added: "It does appear that disruptions of the circadian clock influence our susceptibility to pathogens."

Dr Akhilesh Reddy, who is researching circadian rhythms at the University of Cambridge, said it was "known long ago" that timing had an impact on the immune system, but this was "one of the first forays" into the reasons why.

The implications for healthcare could mean that drugs need to be given at certain times of day in order to make them more effective, or drugs could be made which actually target the body clock to put the immune system into its most active phase.

Dr Reddy said drug companies were "all switching onto this" and were "now screening drugs at different times of the day".

He could see the body clock impacting medicine "within 10 years".

Medical Funnies

Is Mercedes Benz, Jaguar, Maserati, etc. the "alternative" to GM?

Truth is Chiropractic is the #2 form of healthcare on the planet.  We are not alternative although that name gets used to insult and demean us.

Fortunately, our patients know better.

Our patient generally come from the swollen ranks of the failures of medicine.  People that took the drugs, went to the physio, had the surgery and STILL they got no relief.  With chiropractic they got the relief they needed.

Have a chuckle at this, it's not anti-chiropractic, but keep everything in perspective.  What chiropractic does it does the best.

How can I prevent neck strain while sleeping?

Without even realizing it, you may be putting stress and strain on your neck muscles at night. But there are steps you can take to prevent neck pain, even as you sleep.

If your neck could talk, what position would it tell you it wanted to be in while you slept? It would say please keep me in gentle flexion (chin towards chest) in a neutral position.  When I roll on my side, keep my head straight, don't make me bend my neck.  Definitely don't let my head drop down to the mattress.

If you don’t use a pillow, use one: You need one to give your neck muscles support. Specifically, use a pillow that supports your neck. 

“Memory foam” that molds to the curve of your head and neck is one of the worst choices. It lets the weight of your head press the foam down, bending your neck sideways and putting a strain on your muscles.

Avoid pillows that are too high or stiff. These will keep your neck flexed overnight and can cause morning pain and stiffness.

The double-humped, wave-like pillow works just as well for side-sleepers as back-sleepers.  I've used one for years. remember that no pillow is designed for more than 6 months use.  Replace your pillows at least twice a year.

DO NOT sleep on your stomach, you probably wouldn’t want to hear your neck’s views about that. Since it’s unwise to sleep with your face buried in a pillow, given the need to breathe, you’ve got to twist your head. If you’ve been a lifelong stomach sleeper, it might be tough to switch sleeping positions now. Still, start the night sleeping in a well-supported back or side position.  I've found the change can be made in less than 2 weeks and will give you back a life time of healthy sleeping.

If it seems like an extravagance to buy a specially shaped pillow, consider these two points. First, a good night’s sleep is really important for your health. Second, we spend a third of our lives sleeping. Why skimp on how you live a third of your life?  Your bed is important too.