Created to inform my patients and the general public about how I see chiropractic's role in health care, particularly spinal care and other neuromusculoskeletal conditions. I hope to educate and to be educated in the process.
Have you heard it said that breakfast is the most important meal of the day? Do you know why?
Wellness Tip:
The body is an exquisitely engineered machine - with muscles, nerves,
and hormones, all operating within a cycle. You sleep, you eat, you
play, you flex your muscles and you rest. After a full night's sleep of,
say, seven or eight hours, while your body has been resting and
regenerating, you have been fasting. No food or drink has been taken,
and your digestion has been at a low ebb. Once you are awake, your
entire body, including all life hormones, begins to percolate and react
to its environment, including your metabolism and your digestive system.
It is therefore imperative that you supply something for those
awakening digestive juices to "chew" on; not to mention revving up your
metabolism that has been asleep for several hours. A glass of water,
some fresh organic eggs, avocado and/or a piece of fruit is a great way
to start your day and break that fast.
Many people think that New Year's resolutions are a waste of time.
People who hold on to this perception, however, base their views on the
many failures they have either experienced personally or watched others
go through. Yes, too many people spend time coming up with resolutions
which are eventually forgotten or only partially implemented.
For these people, resolutions are indeed exercises in futility.
On the other hand, there are some people out there who not only come up
with great New Year's resolutions but they actually end up completing
and benefitting from them. Subscribing to New Year's resolutions, then,
is not the problem. Problems arise either because participants lack
the stick-to-itiveness/discipline to complete their goals or they simply
create or espouse poorly-constructed resolutions.
For the record, a good New Year's resolution is:
Practical
Realistic
Measurable
Based on sound (scientific) reasoning
Compatible with one's lifestyle, resources and abilities
Beyond choosing the right type of resolution, it's also about having
the right attitude, expectations and a workable plan. For example, do
you realize that your dietary habits will greatly affect how you feel
mentally/intellectually, what kinds of activities you can safely engage
in, and, more importantly, how long you may live.
With that in mind, here are 10 realistic and likely-to-be beneficial dietary New Year's resolutions:
1. Eat fewer processed foods.
Processed foods are heavily laced with all kinds of dangerous
chemicals--most of them of a preservative, appetite-enhancement or
appearance/taste amelioration type. Instead, go for natural foods;
examples are raw fruits and vegetables, meats cut at your local butcher
and nuts/grains obtained from local farms.
2. Eliminate or greatly reduce consumption of fast foods.
There are very few nutrients in fast foods--most probably because they
are often fried or processed. While you are on the road, these foods
may be convenient but a viable alternative is to bring your own snacks
and meals.
3. Be choosy as to how you quench your thirst.
Most beverages out there are bad for your health, especially alcoholic
beverages, carbonated drinks, and even otherwise-healthy drinks
injected with artificial sweeteners. Your best bet is to drink filtered
water (if drinking tap) or bottled water from a reputable dealer.
4. Stay well-read on the latest dietary development, trends and concerns.
The best decisions regarding your diet need to come from the
best-informed/updated sources--preferably those that base conclusions
and theories on studies, tests and the opinions of well-respected
experts.
5. Keep a close eye on condiment and seasoning consumption.
The fact is that people in developed countries overdo it when comes to
condiments and seasonings. This is especially true when it comes to
salt and refined sugar. To put it more bluntly: we eat too much salt
and refined sugar!
6. Stay away from carb-rich foods, especially if they threaten to burden you with more calories than your body needs.
As a general rule, baked goods (e.g., breads, cakes, muffins, cookies,
etc.) contain exorbitant amounts of fat and cholesterol. Another thing
to keep a close eye on is bleached flour.
7. Greatly increase your consumption of fiber.
This substance (naturally found in fruits and vegetables) can help
relieve constipation (which can contribute to many medical problems),
reduce chances of getting colon cancer, and help your body more
efficiently digest foods (thereby improving nutritional absorption).
8. Be exceedingly careful as to how you cook foods.
For example, avoid microwaving foods whenever possible. While the
jury is still out as to whether microwaved foods pose an immediate
danger, there are still too many questions regarding it's long term
safety. Also, avoid using Teflon-coated cooking surfaces, as well as
painted pots and pans (since some of them may contain lead paints).
9. Avoid uncooked foods whenever possible.
When eating out, for example, choose meals that have been cooked, as
opposed to things like sandwiches, raw fruits/vegetables and
partially-raw meats (especially seafood). Some cultures have
traditionally favored raw seafood delicacies but the oceans today are
much more heavily polluted than they were in the past.
10. Reject so-called high-technology processed/created foods (until their safety has been definitively proven).
These include GMOs (genetically modified organisms), irradiated foods,
animals for human consumption injected with hormones and antibiotics,
lab-created foods (like sucralose or Splenda), etc. Instead, grow your
own fruits and vegetables (when possible) or buy organic products.
Conclusion
By all means, don't give up on New Year's resolutions just because they
have not worked well for you in the past. If you take the time to come
up with good resolutions, there is no reason why they may not
ultimately be beneficial. This is especially true when it comes to
dietary New Year's resolutions. If indeed we are what we eat, then we
need to make sure that we eat the right things--more importantly, we
need to develop the right attitude toward dietary habits.
The
first step is to avoid things and practices that have proven to be
troublesome for others or about which there are simply too many
questions/concerns. After that, it's a matter of sticking to
initiatives and endeavors more likely to do us good than harm.
Copyright, 2014. Fred Fletcher. All rights reserved.
On December 19,
the Center on 21st Century Security and Intelligence (21CSI) at the
Brookings Institution held a wide-ranging event on military health care reform.
The conversation included a diverse group of speakers from the
Department of Defense (DoD) to the think tank and management consultancy
worlds to the Congressional Budget Office.
Michael O’Hanlon of 21CSI hosted the event and was pleased to welcome
Assistant Secretary of Defense for Health Affairs Jonathan Woodson as
keynote speaker. Woodson described the value of the DoD health care
system—which cares for nearly 10 million beneficiaries, costs more than
$50 billion a year and has treated more than 50,000 war wounded in the
conflicts of the 21st century to date. It employs roughly 140,000
full-time personnel at more than 50 hospitals and some 600 medical or
dental clinics. It also involves a network of private providers who
treat DoD patients as well; that network includes some 400,000 providers
in round numbers.
Among Woodson’s most important points were that the value of military
medicine has to be determined across the broad missions that the
military health system is responsible for— readiness, health and
hospital care, public health, research and development and education and
training; and that global security and global health crises have
increased the demand for DoD's health expertise even as combat
operations are diminishing. Woodson pointed out that the DoD has made
important strides in military health care in recent years, including in
technologies such as advanced prosthetics, in battlefield survival rates
for casualties and also in responsibly holding down cost growth through
reforms in areas such as pharmaceutical prescriptions, payment reform
and the stand-up of a Defense Health Agency to better integrate care
across the military departments. He also spoke of progress in linking
the DoD health care system to the Veterans Affairs (VA) system (a
separate organization with a separate and even larger health care
budget), while acknowledging that a great deal of integration and
further improvement remains. He also noted, in response to a question,
that it is important to facilitate the access to health care services
for activated reservists, and DoD is working hard to make the associated
procedures simpler for reservists and families.
After his remarks, a panel made up of former DoD Comptroller Robert
Hale, Carla Tighe-Murray of the Congressional Budget Office, Alice
Rivlin of the Engelberg Center on Health Care Reform at Brookings, Henry
Aaron of the Economic Studies Program at Brookings and Jack Mayer,
Executive Vice President at Booz-Allen-Hamilton, convened to continue
and broaden the discussion, with O’Hanlon moderating. Among the key
points raised were the following:
Secretary Hale noted the success DoD has had in recent years in
reducing provider costs and having beneficiaries share a modestly
greater fraction of the military cost burden. Further efforts are
underway, motivated in part by the assessment of the Joint Chiefs of
Staff that in a budget-constrained environment, resources for training
and equipment could be compromised if compensation costs were allowed to
grow excessively. Hale made this argument while defending the premise
that military compensation should be adequate to meet recruiting and
retention needs, that those personnel less able to afford any premium
increases should be assisted, and that in general the goal of
compensation reform should be to limit future cost growth rather than to
make significant cuts. Secretary Hale also advocated closing or
streamlining some military treatment facilities that have inadequate
caseloads to justify their expense. He suggested a new way of budgeting –
return of health care funds to the military services along with
centralized execution financed with a working capital fund – that might
increase the incentives for the military services to streamline
facilities.
Tighe-Murray explained that much of the growth in military
health care costs in recent times has been due, not to the wars in Iraq
and Afghanistan, but to expanded benefits, as well as a failure of DoD
premiums and co-payments to keep up with the general growth in health
care costs in the United States. This set of factors has translated into
more enrollees, more use of services and higher costs per doctor or
hospital visit than would have otherwise been the case. While Secretary
Hale had talked about options for DoD health care reform that would save
the Pentagon, and taxpayer, perhaps a couple billion dollars a year,
Tighe-Murray outlined options that might ultimately save nearly $10
billion annually.
Rivlin and Aaron placed DoD health care in broader context. They
recognized that the Department of Defense must provide certain kinds of
capabilities, including for battlefield expeditionary medical care,
that the private sector does not need to offer in similar ways. But
nonetheless, they talked of the pros and cons of more fundamental
possible DoD health care reform. For example, in less densely populated
parts of the country or for population groups such as retirees that had
other options, it might seek to encourage migration of more individuals
from the military health care system to the private sector and the
civilian system. This option may take on new feasibility in light of the
Affordable Care Act. Rivlin and Aaron were careful to emphasize,
however, that the DoD could still subsidize the health care costs of
its personnel, and perhaps particularly its lower-salaried personnel,
under such an approach. Acknowledging the complexities of the issue,
however, Aaron also pointed out that it was not clear that the DoD (or
the VA system) were necessarily any less efficient as health-care
providers than the private sector, at least in some areas of the
country.
Jack Mayer underscored the need to think comprehensively about
military health care as one element of compensation policy. With an
all-volunteer force, the goal of compensation policy is to be fair to
the men and women of the U.S. military, to be sure, but also to attract
and retain a sufficiently large and high-quality pool of talent. In this
regard, the country needs to be careful about providing benefits that
may have limited relevance to the recruiting and retention mission and
cost the country a good deal as well. Generous health care for
able-bodied military retirees and their families may be a case in
point—though Mayer also underscored the need for a consensual approach
that recognized the interests and equities of many stakeholders. As
such, his proposals for reforms focused more on rethinking benefits for
future recruits than on changing existing "contracts" with current
beneficiaries.
A number of the very useful and often spirited questions and comments
during the discussion period came from military personnel, their
families and some of their various organizations represented at the
event. For those wishing more information, CSPAN covered the discussion and will feature it on the cspan.org website, and Brookings will post a transcript as well.
To do ice massage therapy, a regular ice cube may be used, but it’s better to use a larger piece of ice. One easy way to do this is to freeze water in a paper or Styrofoam cup, then peel the top inch or two of the cup to expose the ice surface. Read more about how to use ice massage for back pain relief.
TUESDAY, Dec. 16, 2014 (HealthDay News) -- Chronic sleep loss is
rampant in America, and work commitment is a big reason why, new
research suggests.
"Work is the No. 1 sleep killer," said Dr. Mathias Basner, an
assistant professor of sleep and chronobiology in psychiatry at the
University of Pennsylvania Perelman School of Medicine.
A time-use survey of nearly 125,000 Americans, ages 15 years and
older, found that work is the main activity exchanged for sleep. Short
sleepers -- those who slept six hours or less -- worked 1.55 more hours
on weekdays and nearly two more hours on weekends and holidays than
those who slept longer, the researchers found.
Short sleepers were also more likely to have longer commutes or more
than one job. Adults with multiple jobs were 61 percent more likely to
sleep six hours or less on weekdays, the researchers said.
This finding "is telling us something about a trend that is a bit
worrisome," said Dr. Alon Avidan, director of the University of
California, Los Angeles Sleep Disorders Center.
Chronic sleep deprivation can lead to ill health, including blood
sugar problems and weight gain, said Avidan, who wasn't involved in the
study.
Changes in public policy are needed to remedy the problem, said
Basner. He suggested employers and schools consider later starts or
flexible hours.
Reducing commute times is another imperative, Basner said. With every
hour that work or schools started later in the morning, sleep time rose
by about 20 minutes, suggesting later starts or flexible start times
might be a solution.
Adults need about seven to nine hours of nightly sleep for best health,
productivity and daytime alertness, says the American Academy of Sleep
Medicine. But the study authors cited data from the U.S. Centers for
Disease Control and Prevention showing that 30 percent of employed
American adults typically sleep six hours or less in a 24-hour period.
The study found that unemployed and retired people got more sleep
than job holders. Self-employed workers logged more shut-eye, too, and
were 17 percent less likely to be short sleepers. Basner thinks that's
due to their ability to be more flexible in their working hours.
The study is published in the December issue of Sleep.
The telephone survey -- sponsored by the U.S. Bureau of Labor
Statistics and conducted annually by the U.S. Census Bureau -- asked
respondents how they spent their time between 4 a.m. the previous day
and 4 a.m. on the interview day. The researchers looked at responses
from 2003 to 2011.
They combined responses into 40 activities that capture nearly all of
the 24-hour day. In the sleeping category were napping, waking up and
dreaming.
Work wasn't the only sleep thief. Grooming and watching nighttime television were also culprits, Basner said.
"What we are doing instead of sleep are other activities," he said. "That cuts down our ability to get seven hours of sleep."
Avidan saw two teens recently who had sleep issues. They were
evaluated for a sleep disorder known as narcolepsy, in which people fall
asleep while engaged in everyday activities. He found that simple sleep
deprivation was the problem.
Workers and students can take measures to increase sleep, Avidan and
Basner agreed. Cutting down on nighttime TV viewing is one way.
"Some people have elaborate hairstyles," Basner said. Simplifying
them can cut down on bathroom time in the morning and boost sleep, he
said.
Living closer to work can shorten commute time, Basner said. Aim for a
15- or 20-minute commute, said Avidan, although he acknowledged that
might not be realistic in some areas.
Asking for flexible hours might help, Avidan said. You could argue
that you will be more productive if you are well-rested, and research
would back you up, he said.
"We find people who are sleep deprived are more likely not only to
make errors objectively but subjectively," he said. "They are also going
to be more irritable."
SOURCES: Alon Avidan, M.D., M.P.H., professor,
neurology, and director, University of California, Los Angeles Sleep
Disorders Center; Mathias Basner, M.D., Ph.D., assistant professor,
sleep and chronobiology in psychiatry, University of Pennsylvania
Perelman School of Medicine, Philadelphia; Dec. 2014 Sleep
While the overall qualities of warmth and heat have long been associated with comfort and relaxation, heat therapy goes a step further and can provide both pain relief and healing benefits for many types of lower back pain. Read more about the benefits of heat therapy.
Childhood obesity may be prevented through reducing the amount of time kids spend using screen media
(dailyRx News) Trimming TV time may take childhood obesity down a notch. To help parents and inactive kids take a stand against childhood obesity, public health experts recommended cutting down screen media time among kids.
In a recent report, the Community Preventive Services Task Force (CPSTF) found that reducing the amount of TV and screen media helped lower kids' risk of being overweight and obese. Screen media time is time spent in front of a television, computer or cellphone screen.
Based on a past study, the task force confirmed that childhood obesity was tied to screen media exposure. In this new report, strong evidence supported that limiting screen time was effective in improving youth health and weight status, the task force authors wrote.
Barry Sears, MD, president of the Inflammation Research Foundation in Marblehead, MA, and creator of the Zone diet, told dailyRx News that simply reducing kids’ screen time alone would not be enough to stop childhood obesity. Parents can take other steps to keep their children healthy, he said.
“If the goal is to reduce childhood obesity, then there are more effective measures than simply reducing sedentary screen time," Dr. Sears said. "First and foremost is better meal planning that promotes [fullness] as opposed to hunger."
Dr. Sears continues, "The second is spending more interactive time with the child as opposed to using the computer or TV as a babysitter. Third is getting the child outside the house making it less likely to easily get to the kitchen."
The CPSTF — a group of public health experts formed by the US Department of Health and Human Services — reviewed 49 past studies that focused on the benefits of interventions only limiting screen time (screen-time-only interventions) and those both limiting screen time and adding other health components (screen-time-plus interventions).
Interventions were defined as ways to reduce inactive leisure screen time. They were also designed to help kids change their behavior to maintain low screen time. The CPSTF said this would help kids spend less time in front of the TV or computer in the long run.
The CPSTF noted that interventions could include classroom-based education, family- or friend-based social support, ways to track and monitor screen time, and coaching or counseling sessions.
The data showed that, for screen time watched, screen-time-only interventions reduced about 82 minutes of media per day. Screen-time-plus interventions reduced about 22 minutes per day.
Screen-time-plus interventions helped kids become more physically active. Kids who reduced their screen media time took and average of 130 more steps per day.
Concerning diet, screen-time-only interventions resulted in kids eating about 75 calories fewer per day on average. Screen-time-plus interventions resulted in kids eating about 118 calories fewer per day.
Reducing screen time among kids improved their health, the CPSTF said.
“Behavioral screen time interventions were found to be effective among children aged 13 years and younger,” the task force wrote.
The CPSTF noted, though, that only children ages 13 and younger were included in this review. They recommended that future reviews also study the effects of reducing screen time among middle and high school students, as well as adults.
This study has not yet been published but is available in The Guide to Community Preventive Services.
The authors disclosed no funding sources or conflicts of interest.
Joint dysfunction in the spine can produce pain, and mobilizing the
spine joints through manipulations (also called adjustments) can
decrease that pain.
The term "subluxation" is used by doctors of chiropractic to depict the
altered position of the vertebra and subsequent functional loss, which
determines the location for the spinal manipulation.
Fortunately, back muscle strains usually heal with time, with most
healing within a few days and almost all resolving within 3 to 4 weeks.
The large muscles in the low back have a good blood supply, which bring
the necessary nutrients and proteins for healing to take place.
Massage, which can help promote blood flow in the
lower back (to help with healing), loosen tight lower back muscles, and
release endorphins, the body’s natural pain killers.
If an episode of low back pain lasts for more than two weeks, the
muscles may start to weaken. Because using the lower back muscles is
painful, the natural tendency for most patients is to avoid using them.
However, lack of activity leads to disuse atrophy (muscle wasting) and
subsequent weakening, which in turn causes more low back pain because
the muscles are less able to help hold up the spine.
As a general rule, people who are active and well-conditioned are
much less likely to suffer from low back pain due to muscle strain, as
regular exercise stretches the muscles so they are less likely to
strain, tear or spasm.
There are three types of muscles that support the spine:
Extensors (back muscles and gluteal muscles)
Flexors (abdominal muscles and iliopsoas muscles)
Obliques or Rotators (side muscles)
While some of these muscles are used in everyday life, most do not
get adequate exercise from daily activities and tend to weaken with age
unless they are specifically exercised.
Finally, a regular, sustained program of hamstring stretching will
help reduce and prevent back muscle tightness and injury. The hamstring
muscle runs through the back of each thigh. Tightness in this muscle
limits motion in the pelvis which can strain the lower back. Regular
hamstring stretching can gradually lengthen these muscles and reduce the
stress felt in the lower back.
Traveling can be rough on the body. Whether you are traveling alone
on business or on your way to a sunny resort with your family, long
hours in a car or an airplane can leave you stressed, tired, stiff and
sore.
"Prolonged sitting can wreak havoc on your body," says Dr. Scott
Bautch, an ACA media spokesperson. "Even if you travel in the most
comfortable car or opt to fly first class, certain pressures and forces
from awkward positions can result in restricted blood flow. One of the
biggest insults to your system from prolonged sitting is the buildup of
pressure in the blood vessels in your lower legs. Contracting and
relaxing the muscles helps the blood flow properly."
Dr. Bautch and the ACA suggest the following tips and advice to fight the pains and strains of travel before they occur.
Warm Up, Cool Down
Treat travel as an athletic event. Warm up before settling into a car
or plane, and cool down once you reach your destination. Take a brisk
walk to stretch your hamstring and calf muscles.
In the Car:
Adjust the seat so you are as close to the steering wheel as
comfortably possible. Your knees should be slightly higher than your
hips. Place four fingers behind the back of your thigh closest to your
knee. If you cannot easily slide your fingers in and out of that space,
you need to re-adjust your seat.
Consider a back support. Using a support behind your back may reduce
the risk of low-back strain, pain or injury. The widest part of the
support should be between the bottom of your rib cage and your
waistline.
Exercise your legs while driving to reduce the risk of any swelling,
fatigue or discomfort. Open your toes as wide as you can, and count to
10. Count to five while you tighten your calf muscles, then your thigh
muscles, then your gluteal muscles. Roll your shoulders forward and
back, making sure to keep your hands on the steering wheel and your eyes
on the road.
To minimize arm and hand tension while driving, hold the steering
wheel at approximately 3 o'clock and 7 o'clock, periodically switching
to 10 o'clock and 5 o'clock.
Do not grip the steering wheel. Instead, tighten and loosen your grip
to improve hand circulation and decrease muscle fatigue in the arms,
wrists and hands.
While always being careful to keep your eyes on the road, vary your
focal point while driving to reduce the risk of eye fatigue and tension
headaches.
Take rest breaks. Never underestimate the potential consequences of fatigue to yourself, your passengers and other drivers.
In an Airplane:
Stand up straight and feel the normal "S" curve of your spine. Then
use rolled-up pillows or blankets to maintain that curve when you sit in
your seat. Tuck a pillow behind your back and just above the beltline
and lay another pillow across the gap between your neck and the
headrest. If the seat is hollowed from wear, use folded blankets to
raise your buttocks a little.
Check all bags heavier than 5-10 percent of your body weight. Overhead
lifting of any significant amount of weight should be avoided to reduce
the risk of pain in the lower back or neck. While lifting your bags,
stand right in front of the overhead compartment so the spine is not
rotated. Do not lift your bags over your head, or turn or twist your
head and neck in the process.
When stowing belongings under the seat, do not force the object with
an awkward motion using your legs, feet or arms. This may cause muscle
strain or spasms in the upper thighs and lower back muscles. Instead,
sit in your seat first, and using your hands and feet, gently guide your
bags under the seat directly in front of you.
While seated, vary your position occasionally to improve circulation
and avoid leg cramps. Massage legs and calves. Bring your legs in, and
move your knees up and down. Prop your legs up on a book or a bag under
your seat.
Do not sit directly under the air controls. The draft can increase tension in your neck and shoulder muscles.
Safe Travel For Children:
Always use a car seat in a car when traveling with children below the age of 4 and weighing less than 40 pounds.
Ask the airline for their policy on child car seat safety. Car seats
for infants and toddlers provide added resistance to turbulent skies,
and are safer than the lap of a parent in the event of an unfortunate
accident.
Make sure the car seat is appropriate for the age and size of the
child. A newborn infant requires a different seat than a 3-year-old
toddler.
Car seats for infants should always face the rear. In this position,
the forces and impact of a crash will be spread more evenly along the
back and shoulders, providing more protection for the neck.
Car seats should always be placed in the back seat of the car-ideally
in the center. This is especially important in cars equipped with air
bags. If an air bag becomes deployed, the force could seriously injure
or kill a child or infant placed in the front seat.
Make sure the car seat is properly secured to the seat of the vehicle
and is placed at a 45-degree angle to support the head of the infant or
child.
Chiropractic Care Can Help...
"If you follow these simple tips, you can enjoy pain-free, safe
travel," says Dr. Bautch. "If you do experience pain and stress on your
back, doctors of chiropractic are trained and licensed to diagnose and
treat problems of the spine and nervous system."
The American Chiropractic Association (ACA) has launched a new YouTube channel for consumers, Get Healthy with Chiropractic, features videos about work ergonomics, the importance of conservative care, what to expect at one's first visit to a DC and patient testimonials. Go to
Seniors Still Given Potentially Dangerous Sedatives: Study
Drugs such as Xanax, Valium tied to confusion and falls, experts say
WEDNESDAY, Dec. 17, 2014 (HealthDay News) -- Doctors continue to
prescribe sedatives such as Xanax or Valium for seniors despite the
significant risks they pose, a new study contends.
The drugs in question are a class of medications called
benzodiazepines. This class includes drugs such as Xanax, Valium and
Ativan. As people get older, these drugs are known to put seniors at
risk for confusion and falls. Yet, the researchers found that older
folks are increasingly being prescribed these medications.
The analysis included national data from 2008. It showed that about 5
percent of Americans aged 18 to 80 (11.5 million people) were
prescribed these drugs. Just under 3 percent of people between the ages
of 18 and 35 were given these sedatives. But among those aged 65 to 80,
nearly 9 percent were on the drugs, according to the study.
Almost one-third of seniors given these sedatives stayed on them for
at least four months, the researchers found. Long-term use may make the
medications less effective. There's also a greater risk of dependence on
the drugs with long-term use, according to the study authors.
"These prescribing patterns likely put a large number of older adults
at unnecessary risk of falls, motor vehicle accidents and confusion,"
study senior author Dr. Mark Olfson, a professor of psychiatry at
Columbia University Medical Center and a research psychiatrist at the
New York State Psychiatric Institute, said in a university news release.
"As life expectancy increases and the population ages, an increasing
number of older adult Americans will face these risks from long-term
benzodiazepine use unless steps are taken to promote safer alternative
treatments," Olfson said.
The researchers hope the study is a wake-up call for health care
professionals. They suggested that health care professionals could teach
older adults who have trouble sleeping or experience anxiety about
non-drug options for their problems.
"Examples include increasing light-to-moderate exercise, promoting
supportive relationships, ensuring adequate exposure to natural light,
avoiding stimulants such as caffeine late in the day, avoiding naps,
establishing a regular, relaxing bedtime routine, and accepting that
quality of sleep naturally tends to decline as we age."
The study was published online Dec. 17 in the journal JAMA Psychiatry.
“Almost everyone can benefit from chiropractic,” says Dr. Nancy J. Trimboli, owner of Trimboli Chiropractic with offices in Munster and Cedar Lake, about managing pain. “Every person on the planet has had a fall, has done sports, and has been involved in a vehicle crash of some type, however minor. These bumps and bruises of life cause spinal misalignments which irritate or interrupt normal joint function and nerve function. If left uncorrected, this will definitely lead to problems. Chiropractors correct those misalignments, allowing the body to heal and function normally. It’s a simple concept yet the ramifications are huge.”
According to Trimboli, chiropractic care has shown through individual patient cases and published research to be not only highly effective for long term back—and other--pain resolution, but to be highly cost effective.
“We have helped countless numbers of people over the years avoid surgery,” she says. “Back surgery obviously should be a last resort. You should do every treatment possible prior to surgery. That should include Chiropractic, massage therapy, physical therapy, acupuncture, even yoga and other exercise. There are specific reasons to have back surgery and pain is not on that list. This is because you most certainly will have pain after back surgery from the surgery itself.”
But that doesn’t mean surgery isn’t totally off the table in certain cases.
“If someone has a progressive muscle weakness or loss of sensation that does not improve with conservative care, they may need a surgical intervention,” says Trimboli. “Also, you need to remember that most people have multiple issues creating their discomfort. Sciatic type pain can be caused from the nerve as it exits the spine, or from disc issue, from a pelvic misalignment, from a muscle spasm, or adhesions on the nerve itself. Chiropractic can address all of these issues, where surgery may only address one of them.”
This approach to pain management has long been a goal for Trimboli who knew from a young age she wanted to work the in medical field. Despite achieving high grades, after completing her undergraduate studies in pre-med, Trimboli decided attending med school was not for her. When a friend’s mother suggested she talk to a chiropractor, it didn’t take long for Trimboli to realize that was the field for her.
“Even when I was 18 I knew there had to be a different way,” she says. “I wanted to study a style of healing that was different than drugs and surgery.”
Choosing chiropractic school, Trimboli spent the first three years taking the same courses and using the same books as medical students. It was then that chiropractic and medical studies began to differ. That divergence formed the foundation for her work. Her mission, she says, is giving to people, young and old, the power and knowledge of chiropractic, so that they may get their greatest enjoyment out of life.
“We offer low force chiropractic adjustments for infants, children and adults,” says Trimboli noting that means there is ‘no popping’ when adjustments are made. “To help us in our work, we have 15 massage therapists on staff that do therapeutic massage, myofascial release, lymphatic drainage, and cranial sacral therapy. Our trainers teach our patients effective at-home exercises to stretch and strengthen spinal muscles. Modalities, such as cold laser therapy, help patients to feel better more quickly and heal more completely.”
It’s also important for people to work at keeping their spines remain flexible and functional including doing specific stretches at home on a routine basis to alleviate or prevent pain.
“Exercise by doing something you enjoy,” says Trimboli. “Challenge your balance and strengthen your core with a yoga, tai chi or Pilates class. Ask for help when lifting things or doing heavy work that you don’t often do. Watch your diet and avoid foods that inflame the spinal joints, which for everyone is sugar.”
It's fun to get into the
holiday spirit and participate in all of the festive activities that
abound this time of year, but the added demands of the season can also
stress the capacities of our bodies. Remember to take the time to care
for yourself, too. Try these tips for handling the holidays in a
healthy, happy way.
Eating healthy can be a year-round challenge, but it's
especially difficult during the holidays with office parties and
family get-togethers complete with cookies and holiday treats. You
can enjoy the festive desserts -- just don't overload on them.
Manage
your stress better so it doesn't affect your holiday fun. Try
thinking positively, using aromatherapy, drinking tea or getting a
massage.
Treat travel as an athletic event. Warm up before
settling into a car or plane, and cool down once you reach your
destination. While seated, vary your position occasionally to
improve circulation and avoid leg cramps.
With all of the
parties, the shopping, the decorating and the baking, sleep often takes a
backseat during the holidays, but sleep is critical to good health
and functioning. Exercise regularly, limit your intake of caffeine
and keep your bedroom at a cool, comfortable temperature to help
your body get the rest that it needs.
If you're going to be standing in line this season, check out some additional tips to avoid aches and pains.
MUSIC IS COMMONLY HEARD IN THE LOBBIES AND WAITING ROOMS
of doctors’ offices. Current literature reports how music facilitates
stress reduction in patients while they sit in emergency and surgery
waiting rooms.1,2,3
Because music is so diverse, it is imp ortant to consider specific forms
to evaluate the impact on patient perception. For instance, the
classical genre can be very relaxing. In 1998, research from the
Department of Management Science, Science University of Tokyo looked at
the influence of music on the body by comparing the difference of
influence on heart rate variability and comfort when subjects listen to
music and are exposed to noise. Researchers used rock, classical music
and noise. The following conclusions were made:4 1) Hearing classical
music results in a small variance of Mayer wave-related sinus arrhythmia
(MWSA) component and respiratory sinus arrhythmia (RSA) component
compared with a body at rest. This is because the sympathetic nerve is
suppressed by the sound of classical music. With rock music and noise,
however, the MWSA component increases and the RSA component decreases.
2) From a psychological evaluation, classical music tends to cause
comfort, while rock music and noise tend to cause discomfort. 3) A
correlation exists between the balance of the MWSA component and the RSA
component and the psychological evaluation. As the comfort increases,
the variance of MWSA decreases; as discomfort increases, the variance of
MWSA increases.
Music for Pain Relief
A 2006 systematic review of the literature5 found that when patients are
able to select their own music, there is no decline in pain intensity.
However, significant pain relief was noted in four studies that reported
the proportion of subjects with at least 50 percent pain relief;
subjects exposed to music had a 70 percent higher likelihood of having
pain relief than unexposed subjects. Moreover, researchers found
post-surgical patients who were exposed to music required between 15
percent and 18 percent less opioids than patients who were not exposed.
Researchers at the Institute of Music and Neurologic Function, a
non-profit research center founded in 1995 in New York City, study
music’s extraordinary power to awaken, stimulate and heal as they work
with severely disabled patients at the Beth Abraham long-term
residential care facility. Concetta Tomaino, DA, a board-certified music
therapist and the institute’s director, has seen music decrease
agitation and stimulate memory in patients with dementia, help stroke
patients recover the power of speech, strengthen muscle groups and
increase range of motion in patients beyond the help of traditional
rehabilitation.
Cancer Patients
It is clear that music makes an impact in the healing process. In
addition to reducing heart rate (or increasing the heart rate depending
on the genre), music may be applied to assist with some common side
effects that cancer patients experience with chemotherapy. Maria
Montserrat Gimeno investigated the effects of music and imagery versus
imagery-only interventions on inducing relaxation and reducing nausea
and emesis in cancer patients undergoing chemotherapy treatment.6 She
found a significant decrease in the frequency of nausea and emesis over
time, that is, across the six weeks of treatment. Because vomiting is
more of a parasympathetic function than sympathetic, it is fair to say
that music may offer positive effects in either activating or blocking
the sympathetic or parasympathetic pathway depending on the desired
applications and outcomes.
Music and Chiropractic
In 2000 in the Journal of Manipulative & Physiological Therapeutics,
researcher Budgell7 states that it is the collective experience of the
chiropractic profession that aberrant stimulation at a particular level
of the spine may elicit a segmentally organized response, which may
manifest itself in dysfunction within organs receiving autonomic
innervation at that level. He discusses how this belief about the
potential for somatic stimulation of spinal structures to affect
visceral function has been at odds with classical views. However, after a
major recent review of the literature on the influences of somatic
stimulation on autonomic function and from recent original physiologic
studies concerning somatoautonomic and spinovisceral reflexes, Budgell
found that current neuroscience research supports a neurophysiologic
rationale for the concept that aberrant stimulation of spinal or
paraspinal structures may lead to segmentally organized reflex responses
of the autonomic nervous system, which in turn may alter visceral
function.
In exploring the application of music alongside chiropractic care,
Miller and Redmond8 noted there is a philosophical basis for the
integration of treatment using music therapy and chiropractic.
Perception is intimately linked to the nervous system. A relationship
between spinal integrity and consciousness does exist.They noted that as
spinal distortions diminish and awareness increases, there is a natural
attraction toward the higher or more loving state of consciousness.They
say that rhythms of healing and suffering are a key concept in
combining music therapy with chiropractic manipulation. Although this is
conceptual, they subscribe to Donald Epstein’s model of the rhythmic
stages of consciousness corresponding to prescribed physiological
patterns that serve as a starting point for the use of rhythm in the
healing process. They state that music can be used as a significant tool
in chiropractic work to aid healing.
Patient Encounters
For a more practical application and clinical reference, anecdotal
references shed light on the importance of including music as an
integral part of chiropractic treatment: for example, patient CT, a
43-year-old white male who was diagnosed with rectal cancer in February
2012. His treatment consisted of surgery followed by radiation. CT
received adjunct therapy throughout his oncology treatment, including
rehabilitation exercises, acupuncture, Reiki, massage, mind-body
medicine (included guided imagery), naturopathic and nutritional
supplementation and chiropractic care. The patient was monitored for
side effects. After surgery, CT received six weeks of radiation daily.
At the completion of treatment, the patient reported the integrative
support played a key role in his accelerated recovery from surgery and
he experienced minimal side effects from his radiation treatments. He
also attributed a major part of treatment success to chiropractic, which
he received three times per week. He reported that during his initial
visit, the chiropractic physician offered to play his choice of music
genre on Pandora. The patient, a practicing Hindu, requested chanting,
and he believes that this expedited his healing process and assisted in
keeping his body, mind and spirit in a state of optimal wellness.
Music healing is not by any means genrespecific, as emphasized by the
story of patient BB, a 63-year-old man diagnosed in May 2012 with
adenocarcinoma of the head of the pancreas. The patient was a physical
laborer most of his life and had a history of low-back pain with
stenosis and degenerative disk disease. He used a cane daily. During his
cancer treatment, he experienced an exacerbation of back pain and
requested to be seen by the chiropractic physician. The DC took a genre
request for music from him. The patient asked for bluegrass. The music
seemed to help him transcend his state of pain during treatment (i.e.,
flexion distraction and drop adjustments). At the completion of his
adjustment, the patient sprung up from a prone position, stood up, shook
the doctor’s hand and headed down the hall. The chiropractic physician
chased after him, yelling, “Sir, you forgot your cane!”
The knowledge that chiropractic is a patient-centered (not
disease-centered) healing arts profession brings to light the need to
offer patients any natural and available means of healing. Using music
in combination with the adjustment may be a method for improving the
effectiveness of the treatment as well as patient satisfaction. With the
innovation of websites like Pandora, and the evidence-based literature
that music can facilitate many positive physiological aspects of being,
there should be mindful efforts made by not only DCs but all healthcare
providers to furnish treatment rooms with music.
Footnotes
1. Routhieaux RL, Tansik DA. The benefits of music in hospital waiting rooms. Health Care Supervisor. 16(2):31-40, 1997 Dec.
2. Holm L, Fitzmaurice L. Emergency department waiting room stress: can
music or aromatherapy improve anxiety scores? Pediatric Emergency Care.
24(12):836-8, 2008 Dec.
3. Verheecke G, Troch E. Music while you wait. Patient acceptance of
music in the preanesthetic period. Acta Anaesthesiologica Belgica.
31(1):61-7, 1980.
4. Umemura M, Honda K. Influence of music on heart rate variability and
comfort—a consideration through comparison of music and noise. J Hum
Ergol (Tokyo). 1998 Dec; 27(1-2):30-8. Department of Management Science,
Science University of Tokyo, Shinjuku-ku, Tokyo, 162-8601 Japan.
5. Cepeda MS, Carr DB, Lau J, Alvarez H. Literature review of music for
pain relief. Cochrane Database of Systematic Reviews. (2):CD004843,
2006.
6. Montserrat Gimeno, M. The Effect of Music and Imagery to Induce
Relaxation and Reduce Nausea and Emesis in Patients With Cancer
Undergoing Chemotherapy Treatment. Music and Medicine. July 2010 vol. 2
no. 3 174-181, first published on June 25, 2010.
7. Budgell, B. Reflex effects of subluxation: the autonomic nervous
system. Journal of Manipulative & Physiological Therapeutics Volume
23, Issue 2, Pages 104–106, Feb 2000.
8. Miller EB, Redmond P. Music therapy and chiropractic: an integrative
model of tonal and rhythmic spinal adjustment. Alternative Therapies in
Health & Medicine. 5(2):102-4, 1999 Mar.
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