Drug Spring Cleaning
April 27, 2013
Martz Hall

In my opinion, every household should take advantage of this program.  You can’t just flush the drugs down the toilet, it taints the water system, maybe poison the water system might be a better description.

We see patients at our office that have in excess of 14 medications that have been prescribed over the past 18 months.  A lot of patients tell us they no longer take a few of the medications.  This is a good time to go through your parent’s medicine cabinet.  Get rid of everything they are not currently taking.  Bring the drugs for proper disposal to Martz Hall, Pottsville on April 23 between 10:00 Am and 2:00 PM.  The service is free and anonymous.  Call 570.621.2966 for more information.

Dr. Dave

Back pain treatment failures

Schuylkill County: Back Pain Research Update

In my attempt to share with you some of the most up-to-date information that crosses my desk, there are two articles that really caught my attention:

 The first, from the journal Pain, found that even after adjusting for a substantial number of potential confounders, (things that can confuse the issue) prescription opioids (addictive medications used to relieve pain) were associated with slightly worse functioning in back pain patients at 6-month follow-up. ¹

The second article has incredibly important implications for the profession, and in my opinion what should be considered among the best practices for care of acute low-back pain. It was printed in the April 2013 edition of the Spine. ²

It found that in a subgroup of patients with acute nonspecific low-back pain, spinal manipulation was significantly better than the non-steroidal anti-inflammatory drug diclofenac (trade name Voltaren), and clinically superior to placebo.

For those of us that manipulate, these are not surprising research findings.  But, I bet they are surprising for you.  We can now start to put opioids in a worse category than epidural injections for back pain.  (Web MD states flat out that epidurals don’t work.)  The new category for opioids is; drugs that make your back problem worse.

Voltaren did help back pain, but not nearly as much as manipulation.  If you are having back pain ask your doc to send you to a doctor of chiropractic for manipulation.  In fact, you don’t even need to ask for the referral just call, no referral is needed.  Why would you settle for a second best treatment for back pain when you can easily get the first best treatment?

As always, watching your back;

Dr. Dave

1. http://www.painjournalonline.com/article/S0304-3959(13)00101-2/abstract
2. http://journals.lww.com/spinejournal/Abstract/2013/04010/Spinal_High_Velocity_Low_Amplitude_Manipulation_in.3.aspx

That can make all the difference, especially now that…

Winter’s Coming (for some of us it is here already)

The availability and strength of sunlight decreases during the winter months.  This means you’ll have to be deliberate about getting sun exposure.  During the summer, it’s almost automatic – you spend time outdoors wearing sleeveless shirts and shorts, for instance, and within a short period of time you’ve soaked up a lot of sunlight without even trying.

Even in the summer, though, you can still employ this handy trick to get the most vitamin D from the sunlight.  But it’s absolutely essential during the winter months.

Why Vitamin D?

Vitamin D supplementation is a good idea, in addition to sun exposure in the winter.  In other words, it would be best if you got sunlight and took a supplement.  Bear in mind that during the winter, you should increase your supplemental vitamin D to compensate for the lack of sunlight.

Vitamin D is very important to your overall health, particularly your bone health. Here are just some of the health benefits of vitamin D:

• Decreased risk of chronic disease
• Decreased risk of contracting influenza, colds, and other contagious illnesses
• Regulation of calcium and phosphorous in bone remodeling
• Maintenance of blood calcium levels
• Stimulation of intestinal calcium absorption

Some of these health benefits are because…

Vitamin D is Also a Hormone

Yes, this vitamin has a dual function. Because of this unique trait, vitamin D plays a vital role in an untold number of body functions.  It has the ability to “turn off” or “turn on” certain genes in the body, thereby making it an indispensable component of a properly functioning body.

How Much?

Inevitably, the question of how much vitamin D we need each day comes up.  And this will amaze you: a study published in the Journal of Steroid Biochemistry and Molecular Biology has shown that just one 20-minute exposure to summer sun in Hawaii wearing a bathing suit produced between 15,000 and 20,000 IU of vitamin D3.¹   The Vitamin D Counsel recommends 5000 IU per day of supplemental Vitamin D3.

The best part is that you can’t “overdose” on vitamin D obtained from sunlight. Your skin will automatically shut the process off when you’ve made enough of this vitamin, even if you are still in the sunlight when you’ve reached your maximum.

If you are in doubt as to your vitamin D levels, a simple blood test can let you know exactly where you are. Then you can customize your sun exposure and oral supplements to create the optimal levels of vitamin D in your body.  The Vitamin D counsel recommends your Vitamin D on the lab test should be 60 to 100.

I just had my Vitamin D checked in October.  It was 43 even though I was out twice a week with short sleeves and shorts all summer.   Everyone is different and the blood test is the only way to know your Vitamin D level.

The ‘Shadow’ Trick

The trick to getting the most Vitamin D out of your daily sun exposure is to sunbathe when your shadow is shorter than your height.  This means that in the winter, with the sunlight at a slant, your optimal sunbathing time is greatly narrowed down.

Typically, you’ll get the most vitamin D if you go out between 10am and 2pm.  That’s about the only window of time when your shadow will be shorter than your height.  And that’s when the UVB rays, which are what you need to make vitamin D, are at their strongest, and the time when most will tell you to hide from the sun!

But remember, the key to avoiding skin damage such as premature aging of the skin or the dreaded melanoma, is to keep sun exposure during these times for a short duration.

Summing It Up

• Expose as much skin as possible to the sun, aiming for full-body sun exposure for 20 minutes (20 for light-skinned individuals and 30 for those who are darker-skinned).  This might be impossible if it’s too cold outside, so that’s where my next suggestion is important.

• You can use a sun lamp.  Just be sure to follow the manufacturer’s instructions carefully, and be certain that your sun lamp is made for the purpose of vitamin D supplementation.

• Don’t wear any sunblock or sunscreen while you’re sunbathing for Vitamin D production.

• If you’re fair-skinned or haven’t exposed your skin to the sun for a long period of time, pay special attention, especially at the beginning, to make sure you never allow your skin to get burned (a pink tone is OK, though).

The research is clear, so don’t let your fear keep you away from the sun, because…

Responsible Sunshine Exposure is Crucial to Bone Health And Health in General

With this knowledge, you can embrace the sunlight without fear.

And here’s another piece of positive information: as you prepare to let your skin feel the warmth of sunlight this winter, remember that your mood will likely improve in the process.  Lack of sunlight can send many people into a season-induced slump. Exposure to light is an easy and effective remedy for the winter blues.

So let the sunshine in, be happy and healthy!

We have had incredible responses with patients that have rheumatoid arthritis. The reduction of pain has been astonishing, especially in their hands and feet.

Patients with chronic arthritis have also responded well.  Remo Piccioni of Pottsville could only walk one block because of his arthritic knees.  He was told his knees were so bad that they were bone on bone. He is now walking one half mile without pain.  Another patient could hardly walk without arthritic pain in both knees. She just returned from a cruise to Alaska and reported that she did well; she was able to move about the ship without pain and had no flare-ups.

We have had remarkable success with neuropathy with a number of patients.  Some responses have been very quick and others were slower but all responded.

Remo Piccioni receiving the “Pain Eraser” treatment

Some other conditions that we have treated with great success are carpal tunnel and all types of shoulder pain.  We also have treated dozens of Schuylkill County residents with foot and ankle pains with extraordinary results.

Some of the most astonishing pain patients have been chronic back pain sufferers. We have a few patients that have “tried everything” and ended up at our office as their last resort.  The back pain specialists at Jefferson Hospital in Philadelphia saw one patient. He had a complete work-up for this back pain.  Nevertheless, he was told there was nothing they could do. Just come back when the pain gets worse.  With one treatment, he was moving his back and legs unbelievably better.  Another patient had back surgery and was not doing well.  He was “all over” looking for help.  He even had a series of ozone shots in his back muscles that helped temporarily. But one treatment and the “Pain Eraser” he walked out of the office pain free.

If you have pain, and are tired of “living with it”, you owe it to yourself to try the “Pain Eraser”.

Click on the link below to watch the Dr. Oz show on the “Pain Eraser”.

Dr. Oz: The Revolutionary Cure for Pain

Dr Manny Foot Pain Treatment

http://www.scribd.com/fullscreen/40759388

Many Schuylkill County residents as well as millions as others throughout the state insured by Highmark Inc. are about to have some of their medical treatments decided by a computer software program, rather than their doctor or therapist.  this was announced in a June 14, 2012 Highmark newsletter to providers.  The company is dramatically changing coverage for chiropractic and physical and occupational therapy treatments starting on September 1, 2012.  Healthcare consumers and medical professionals are urging the state insurance department to prevent the controversial program from being implemented.

Highmark’s usage of the new Physical Medicine Management Program (PMMP), a computer software program, is at the heart of the devastating changes being made by Highmark.  The computer program will begin making treatment decisions for these patients, rather than the doctor or therapist who is actually examining the patient and making the disgnosis.

Doctors and therapists who are actually seeing the patient will no longer have control over that patient’s treatment.  Instead, a computer algorithm will decide if a patient is even eligible for treatment, and if they are, how and when they will be treated.

If you have Highmark Blue Shield for health insiurance this program will have a devastating impact on your quality of life and economic productivity.  You will be forced to live with greater pain and discomfort, or be forced into more expensive drug or surgical solutions for your illness, which not coincidentally generate far higher profits for Highmark.

Highmark’s new PMMP will just add to its existing $3.7 billion in cash reserves.

I urge you who depend upon chiropractic, physical therapy, and occupational services to immediately contact your state legislators and the office of state insurance commissioner Michael Consedine to express their opposition to the Highmark PMMP plan.

I also recommend that you call, write, or e-mail the following Highmark executives to stop the PMMP:

• Get the right amount for you. Every person has different skin. We all live in different places.  We all need different exposure times. We recommend you expose your naked skin for half the time it takes to turn pink.  This way, you won’t burn and you’ll produce vitamin D.  This amount of time is going to be different for everyone.

• Sun is important for good health.  Last year I golfed twice a week in shorts and a short sleeve shirt.  When I got my Vitamin D tested in November, it was only 27, for good health it should be 60 and above.  After 6 months I got it up to 48 taking 6000 units a day.  I have had patients as low as me and went up to over 60 on the same dose.   Almost everyone we test for Vitamin D is lower than 35, below 35 is disease level deficiency.

• What are some of the symptoms of Vitamin D deficiency?
• Impaired immune system
• Pain in muscles
• Chronic fatigue
• Depression
• Bone fractures
• Soft bones/osteoporosis
• Low vitamin D levels can increase the risk of cardiovascular disease, asthma (severe forms of asthma); hypertension (high blood pressure), diabetes (type II), MS (multiple sclerosis), glucose intolerance, certain types of cancer (the most common ones are breast cancer in women and prostate cancer in men), cognitive impairment (in old people), etc.

• Did you get that, sunlight is anticancer; you never hear that, do you?

• The more skin you can expose, the more vitamin D you will produce.    Don’t settle for exposing just your legs and arms.  Take your shirt off or wear your bathing suit if you can!  This way, you can produce much more vitamin D in a shorter amount of time.  Again, don’t bake! Follow the first principal.

• Don’t use sunscreen. That’s right, no sunscreen!  Sunscreen doesn’t allow your body to produce as much vitamin D as it wants to.  Plus, sunscreen has not been shown to prevent all types of skin cancers.

• Cover up. Got a little sun exposure?  Good. Now cover up with clothing or shade.  It’s important not to burn!  Got it, sun good- burn bad!

Now you’re all set to be safe and produce some vitamin D this weekend and summer!

Arthritis: I just have to live with it

There are many different types of arthritis, but I am going to limit this article to osteoarthritis, because by far it is the most common type.  More than half of arthritics have this type.  Statistically speaking it affects 1 in 13 people.  It is probably higher in Schuylkill County because of our aged population.  That means there are about 12,000 to 13,000 with osteoarthritis in Schuylkill County. 

If you are arthritic, you may feel the ache, pain, and stiffness in any of your joints, but most commonly in your hips, knees, back, neck, or fingers.  Risk factors for osteoarthritis include:

• Being overweight
• Previously injuring the affected joint
• Using the affected joint in a repetitive action that puts stress on the joint (like walking and working)
• A diet that is pro-inflammatory.

The first three alters normal biomechanics, in other words arthritics move differently.  Think of your body frame as the frame of a car and the tires as your joints.  If the car frame is bent, the car can still run but very soon, the tires wear out.  At first, it might be hard to see the increase wear on the tires but it is happening.  This will eventually lead to the tire going flat or blowing out.

In your body, if the frame is bent or dysfunctional the joints wear out just the same way the tires do.  You never saw anyone with arthritis walk without a gimp or abnormal gait, did you?

Phase One: Dysfunction

Dysfunction occurs when there is injury to a joint or body frame.  Muscle tightness and shortness follows leading to restricted movement.  Muscles opposing the tight and shortened muscles usually become weak.  At this stage, people generally only complain of stiffness or tightness.  With time, a slight misalignment occurs at the joint and scar tissue begins to form.

Phase Two: Instability

Prolonged dysfunction and scar tissue (which is weaker than then original tissue) leads to instability or loosening of the joint.  Because the joint is weaker, it is not stable.  There is an increased risk for additional injury; inflammation, pain, and increased muscle tightness as the muscle try to provide the stability of the weakened ligaments.  At this point, you might be aware of clicking or shifting of the joint with certain movements.  X-rays are still normal.

Phase Three: Stabilization

At this stage, degenerative changes begin to appear.  Decreased joint space and bone spurs will start to show up on x-rays.  There is also thickening of scar tissue and the muscles even become tighter and shorter.  This is the body’s attempt to tighten up the loose joint.  Decreased motion leads to increased pain.

Treatment

According to PubMed Heath, a division of the U.S National Library of Medicine, National Institutes of Health “It is possible to greatly improve your symptoms from osteoarthritis and other long-term types of arthritis without medications.  In fact, making lifestyle changes without medications is preferable for osteoarthritis and other forms of joint inflammation.  If needed, medications should be used in addition to lifestyle changes.”

Restoring joint motion and balancing the muscles (lengthening the shortened and strengthening the weak muscles) is a critical first step.  Exercise for arthritis is necessary to maintain healthy joints, relieve stiffness, reduce pain and fatigue, and improve muscle and bone strength.  Your exercise program must be tailored to you as an individual.  For example, not all knee arthritis has the same shortened and weakened muscles.  All joint dysfunctions are unique.  I general exercise program will not work very well.

At our office, we use the Functional Movement Evaluation of the National Academy of Sports Medicine to determine the muscle imbalances and treatment protocol.  One of the cutting-edge exercises we use is Whole Body Vibration (WBV).  It helps relax the tight muscles and strengthens the weak muscles without any movement to the arthritic joint.  We had patients as old as 96 on the WBV machine to exercise.  Most people cannot believe how much better they feel in just a few weeks.  Contrary to what most people think, there is a lot that can be done for arthritis, especially without all the side effects of medications.

We are committed to help you or a loved one that is suffering with arthritis and sharing this information may be one of the most evident acts of kindness you can give.

This information is solely advisory and should not be substituted for medical or chiropractic advice.  Any and all health concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your medical history.

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