Medicated Nation

How many of you have gone to your family physician because of a health problem you felt you had and left with OUT a prescription? How many of you expect your family doctor to prescribe something if you show up with a concern? After all…that’s why your there and that’s what they do.

According to Men’s Journal, in 1996 13 million Americans were prescribed an antidepressant. In 9 years that number more than doubled to 27 million. From 1999, pharmaceutical companies spent $32 million dollars on antidepressants and by 2005 (6 years later) they were spending $122 million. Are they doing it for a reason? Are they convincing you that you might have a problem before you even get another opinion about it? In 2009 Americans spent $10 Billion on antidepressant medication.

Antidepressant medication may be the most over prescribed and under prescribed drug in America. I am in no way saying that Depression doesn’t exist and it’s not something that can be helped by medication. But are we really so much more depressed now than we were even 20 years ago?

Americans may have been sold on the idea that life is perfect, and that you should be happy all the time. That life always has a happy ending. But we are starting to see that happiness is relative. We know we are happy based off of when we are sad. We listen to the antidepressant commercials that tell us that if we have trouble sleeping, having bad thoughts, or feel that we aren’t where we should be we need to be taking their drug; then following that idea is 40 seconds of side effects including thoughts of suicide or worsening of depression.

There is absolutely a time and a need for antidepressants. But according to Columbia University psychiatrist Mark Olfson there is 10% of Americans that are prescribed antidepressants every year, and there is a good chance that some of them don’t need it. He also states that there are 15 million Americans that probably aren’t getting the medication they need to treat their depression.

Financial incentives for health insurance companies and the willingness of primary care physicians to hand out those prescriptions are a few of the reasons for this sharp increase. Unfortunately, psychiatry doesn’t have biologically based tests to help guide us in making decisions on diagnosis. Depression clinically requires five symptoms:

·        Loss of interest or pleasure in usual activities

·        Anxiety; feelings of hopelessness, worthlessness, and despair

·        Memory problems

·        Changes in sleep patterns

·        Changes in weight

Seeing these spelled out many of you can recall a time where you have had one or more of these symptoms, possibly all five.

Most people understand that the drugs they take aren’t a cure. They realize that if they are suffering from depression or another illness, it’s not because they aren’t taking enough medication. But in reality most people don’t take the steps they need to figure out the cause and a solution that actually addresses the cause.

Stop and think for a moment if the problems you suffer from are something you were seeking a solution for, or if you were told you have a problem and there is a solution out there.

Does that toy come with fries?

A popular debate has risen based off the suggestion from the Journal of the American Medical Association (JAMA) that obese children should be put into foster care so they can get the dietary help they need to reduce their weight and protect them from long term health problems caused by obesity. This is not a new idea, another article in Pediatrics mentioned similar ideas in 2009. To me the main argument of this debate comes down to “who’s responsible?”

There is no argument that weight gain in children and adolescents has grown to epic proportions. The focus of the article centered around a 3 year old that weighed 90 lbs, and by 12 years of age grew to 400 lbs. To most parents there is no debate on whether or not this child was obese. A closer look at the family showed that the parents had some physical disabilities and financial difficulties. Other examples were teenagers who weighed four and five hundred pounds, all of them with health problems that stemmed from their weight.

Are parents responsible for having children that are overweight? Absolutely, just as responsible as they are for their children’s behavior in every other area. Despite arguments about thyroid problems, slow metabolisms, depression, hormone imbalances and evil marketing ploys by fast food chains, until we can absorb calories through the air, obesity is a behavioral choice. And parents are responsible for their children’s behavior.  Do I agree that the government should step in and use foster care to help children get back on the right track and make better diet choices? Absolutely not.

This is one more area that government does not need to take responsibility. Any effort to help overweight children should be addressed in education, at school and in some cases possibly with social services making house calls to help parents make better choices as well. As we learned with the 90 lb. 3 year old there might be some home problems that need to be addressed before a solution to the child’s weight problem can be helped. What we don’t need is the government monitoring our children with the threat of taking them away. Not only is this dangerously leading to other areas of restrictions, but at some point there will and has to be a magic number that this happens with. What number is that? And who makes that decision? What about children who are too thin?

One argument for putting children into foster care homes is child abuse.  There are obvious dangers to letting children become obese, and some of those dangers may not affect the child until they are an adult. In some cases, there may be more abuse than just lack of diet control. But in cases where poor food choices are the reason for obesity, there is no intent of abuse. Education and follow up should be adequate.

It’s time to take responsibility for our own health choices, and those of our children. I do not want to see that responsibility in the government’s hands either taken forcibly or in apathy. Teach children and families to make healthy decisions and hold them accountable for their actions, but let them have the responsibility.

Please give me your opinions and ideas! If I’m wrong, show me!

Getting old ain't for wimps!

Arthritis is a term you hear from just about every pain pill and infomercial on TV today. I’m sure everyone knows someone who suffers from the pain of arthritis, and maybe know someone who is debilitated by it. So how do you avoid it? What do you do once you have it? Can it be cured?

To begin with, let’s explain what arthritis really is: Joint inflammation. There are many different kinds, some you are genetically predisposed to (thanks Mom and Dad), and others you get like wear and tear from a car. Some can be caught from an infection; others can be influenced by diet. It’s very important to understand which type you have because treatment can differ a lot between them.

Rheumatoid Arthritis (RA) is a progressive arthritis that is very destructive. Unfortunately this comes on through no fault of your own. Typically the symptoms start from middle to late middle age, and usually occur in women more than men. Symptoms tend to start in both sides of the body at once, especially in the hands. Rheumatoid occurs from your body attacking healthy tissues, mainly cartilage in your joints. Other organs can be affected, and severity depends on how early the disease starts. Juvenile Rheumatoid Arthritis (JVRA) starts at a very young age, usually early teens, and can be devastating if not treated early. Corticosteroids are the medication most commonly used, and while they can have damaging side effects of their own, often are minimal compared with living with RA or JVRA.

Gout, or gouty arthritis, may have a genetic component, but diet influences the flare ups. Uric acid, which is not properly metabolized, can build up in the joints and cause pain. Usually one joint is affected at a time, a toe, ankle or foot. These attacks can come once and not appear again, or some have many episodes. Diet restrictions help, but there are medications that can help reduce the uric acid in your blood as well as corticosteroids to reduce inflammation.

Some arthritis may come about due to joint infections, called bacterial arthritis or septic arthritis. Typically once the infection is stopped the arthritis goes away.   The most common causes of septic arthritis are injuries to the joint and surgeries, especially joint replacements. IV antibiotics are usually given, and as long as the synovial fluid hasn’t built up (fluid found inside the joint), there are no side effects. This type of arthritis can also be found in infants, most commonly the hip joint. Watch for fever, redness, and unwillingness to move hip.

A group of arthritis called spondyloarthropathies is due to some genetic variant. The most common of these, Psoriatic Arthritis, happens to about 1 out of 20 people. It is usually associated with psoriasis of the skin and affects the hips and low back most often. Ankylosing Spondylitis and Reiter’s Syndrome are two other spondyloarthropathies. Both are generally managed with corticosteroids. Although they can do damage to the joints, usually they are not as aggressive as rheumatoid arthritis.

The most common arthritis is osteoarthritis. This is due to wear and tear on the joints. Everyone has or will have osteoarthritis, but those that get this type early are in for many problems in the future. It is also one of the leading causes for consumption of pain medication. Unfortunately there is no “cure” for osteoarthritis, and it’s usually a one way street. The best way to avoid getting it is to keep your joints healthy with full range of motion activities. Joints get nutrition from movement of fluid that comes naturally with joint movement. When this stops, the joints become desiccated, or dry up, and your body starts breaking the joint down and adding bone, which become bone spurs. Bone spurs, or osteophytes, reduce the joint’s natural range of motion, cause pressure and wear on surrounding soft tissue, and along the spine can cause stenosis, or narrowing of the much needed room for nerves. Stretching and gentle exercise can help joints stay healthy. For those joints that are fixated due to muscle tension or inflammation, chiropractic adjustments restore normal movement. The more freely moveable a joint is the healthier it stays, no matter what kind of arthritis you have!

For those of you suffering from arthritis, or pain you believe is coming from arthritis, the first step is to find out what kind you may have, then get on track to slowing it down with the proper treatment. The longer you wait, the less recovery you will have!

Who's picking up the check?

Recently a story of a man willing to go to jail has hit the media. For those of you who've missed this, here is a quick recap and a link if you would like more info:


http://www.msnbc.msn.com/id/43479572/ns/health-health_care/?GT1=43001


Basically he's not financially stable and has no insurance, and while this may cover a majority of Americans right now, this man believes he has a health problem and needs to get it taken care of. And to get that done for free, he is willing to sacrifice his freedom. 


This isn't the first story someone taking advantage of our current system, nor will it be the last. Although going to jail might seem extreme, others make major sacrifices to get the perks that the government offers. The other day while listening to a popular call in radio show that dealt with personal finance, a lady who was unfortunate enough to be diagnosed with a debilitating disease called in to get financial advice on how to distance herself from her family. She was willing to divorce the husband she loved in order to preserve their nest egg they had grown to retire on. Her idea was to divorce and show no possessions as to be eligible for welfare and medicaid when her disease got so bad that she would need full time care. As heart breaking of a story this is for the family, I think she's missing the point. 


I have also heard stories of inmates in immigration holding facilities getting hip replacements, definitely not a life threatening surgery. Unfortunate things happen in life, and these things happen whether you are prepared or not financially. There is no shortage of sad stories involving health care, natural disasters, or even random violence. These are people that have taken no excessive risk but fall under the consequences. But the ideas that the government should be responsible for them are not only harbored by a few that live below the poverty level, but those that think it is a more attractive option than dealing with it themselves. 


I would love to hear feedback about your ideas or solutions to this problem. Personally from a health standpoint I think it is our own responsibility to stay proactive with our health care. While certain problems arise that we cannot foresee, many chronic health care problems that are extremely costly are avoidable. No matter what health problem you may have, there are many hospitals and clinics that will work with you on cost and payment plans. Many communities have groups that have money available for those that can not afford high medical costs. All of these may take some effort, but still fall in your responsibility. 


Please leave a comment on ideas that you feel would work to help people get the care they need with out having to "cheat" the system, leaving someone else with the bill. Or if you feel that too much of the health care burden is placed on us and we should be getting government support, state that as well! 

In case you lost sleep over it...

How important is sleep for staying healthy? Most of what we know about sleep we have discovered in the past 20 years. Unfortunately it has kept us up at nights! The 2002 National Sleep Foundation (NSF) Sleep in America poll found that 74 percent of American adults are experiencing a sleeping problem a few nights a week or more, 39% get less than seven hours of sleep each weeknight, and more than one in three (37%) are so sleepy during the day that it interferes with daily activities. Some studies show that one in six fatal car accidents are due to being sleepy. Seventeen hours of sustained wakefulness leads to a decrease in performance equivalent to a blood alcohol-level of 0.05%.

So how much is enough? And how do I know if I’m getting enough? Although everyone is different, there are some basic guidelines: Teenagers need as much sleep as small children (about 10 hrs) while those over 65 need the least of all (about six hours). For the average adult aged 25-55, eight hours is considered optimal. As a group, 18 to 24 year-olds deprived of sleep suffer more from impaired performance than older adults. Some studies suggest women need up to an hour's extra sleep a night compared to men, and not getting it may be one reason women are much more susceptible to depression than men.

Some research has shown that even those who aren’t getting enough sleep regularly may not know it. Although they feel the effects early on, their body starts to get used to those indicators and ignores them after a few days. Anything less than five minutes to fall asleep at night means you're sleep deprived. The ideal is between 10 and 15 minutes, meaning you're still tired enough to sleep deeply, but not so exhausted you feel sleepy by day. Ten per cent of snorers have sleep apnea, a disorder which causes sufferers to stop breathing up to 300 times a night and significantly increases the risk of suffering a heart attack or stroke. Snoring occurs only in non-REM sleep.

To drop off we must cool off; body temperature and the brain's sleep-wake cycle are closely linked. That's why hot summer nights can cause a restless sleep. The blood flow mechanism that transfers core body heat to the skin works best between 64 and 86 degrees Fahrenheit. But later in life, the comfort zone shrinks to between 73 and 77 degrees - one reason why older people have more sleep disorders.

As we get older, sleep can be disrupted due to pain or discomfort, the need to go to the bathroom, medical problems, medications, and sleep disorders as well as poor or irregular sleep schedules. Establishing a regular bed and wake schedule and achieving continuous sleep helps you sleep in accordance with your internal biological circadian clock and experience all of the sleep stages necessary to reap the restorative, energizing and revitalizing benefits of sleep. At the start of the 20^th century, sleeping schedules were kept with the setting and rising of the sun. In today’s reality, especially with the advent of 24 hour entertainment on the internet, our sleeping schedule is getting smaller and smaller. Night shifts ad to the problem, since a lot of your body’s internal clock runs on the sun’s schedule.

So what steps can you take to improve your sleeping habits? Many of my patients suffer from chronic pain, which is exacerbated by higher stress hormones, which you guessed it, get higher with less sleep. Here are some simple steps I suggest to those who aren’t sleeping great:

• ·         Avoid caffeine (coffee, tea, soft drinks, chocolate) and nicotine (cigarettes, tobacco products) close to bedtime.
• ·         Avoid alcohol as it can lead to disrupted sleep.
• ·         Exercise regularly, but complete your workout at least 3 hours before bedtime.
• ·         Establish a regular relaxing, not alerting, bedtime routine (e.g. taking a bath or relaxing in a hot tub).
• ·         Create a sleep-conducive environment that is dark, quiet and preferably cool and comfortable. Do not read or watch TV in bed and regardless of your work or holiday schedule, go to bed and get up at the same time.

Back pain and tightness can decrease quality of sleep, getting adjusted helps you stay relaxed and decreases stress that will keep you up wondering why you didn’t see your chiropractor!

Cooties

One day while having lunch with a friend I was asked skeptically..."So like...do you believe in germs? Because I knew a chiropractor that doesn't..." This got me thinking. I'm sure this quack believes there are germs out there, right? We all had biology class, we even got to see them under a microscope. So what's his deal? Most likely he was talking about the Germ Theory, which is popularly under scrutiny with chiropractors. 


What about you? Do you believe in the germ theory? For those of you that aren't sure, the germ theory basically states that germs are the cause of disease and sickness. Sounds pretty believable right? I mean...you wash your hands before you eat, and you don't want someone sick to sneeze in your direction. And we all know that germs are fairly slow because it takes 5 seconds for them to grab onto food that falls on the floor...


I'm betting you actually don't believe in the germ theory! Lets back away from the health part of it. Lets talk about...your roof. What causes a roof leak? Rain of course! I mean, if it doesn't rain...it doesn't leak. So what do you do if you have a roof leak? These aren't hardball questions, you put a giant umbrella over it, silly! Stop the rain...stop the leak. What better way to stop the rain than to get rid of the rain! The Chinese are already looking into ways to disperse rain clouds with rockets. How great would that be? Just get rid of the rain and no one would have a roof leak! 


In all seriousness, you can't stop the rain. There are too many rain drops out there to fight. Just as there are too many germs out there to fight. Germs are on your fork, your door handles, your cell phone, in the air you breath and...ew...I don't even want to think about your key board. I bet right now you can probably see a colony of them building up on the raised dot on letter "F" and "J" now! So how are we all not dead, or at least sick all the time? If the germ theory were true, we probably wouldn't be around to talk about it. 


So why get antibiotics? Well, even during a rain storm you probably don't want to do a lot of roof patching, so it'd be smart to get some help with a tarp or something to block the rain temporarily. But in the long run it's better to actually fix your roof. This goes for your body too. Sometimes we need help fighting them off, they can gain the upper hand because we aren't functioning at our best. But in the long run, fix your roof! Make sure your body has the defense to fight off the germs themselves. 


So in defense of that poor nut that doesn't believe in the germ theory, yes there are germs. But sickness and disease comes from your body not being able to defend itself, which is the primary problem you need to get fixed. Good nutrition, exercise and mobility will help keep you healthy enough to do this. Chiropractic care has been shown to boost immune function and may help resolve the original weakness that lead to getting sick in the first place! 

That's personal!

How much information is too much? In today’s hi-tech world, personal identity has become a major concern. And while try to become more and more careful with who you share your information, it seems more and more companies are demanding it. Businesses all over have keyed in to your shopping habits on line and at the store with your key tags. It’s hard to buck the system when they promise such great savings for just a little bit of your personal information.

Many high tech companies, like Facebook and some cell phone makers, have been questioned recently about how much information they are getting, and where that information is going. Some cell phone applications record a history of where you go and the time of day you are there. Great for checking up on your elusive teenager, bad for criminals who want to learn your daily habits.

What about your health care provider? How much information do they need? The government has made some laws to protect the information you give your healthcare provider. Assuming they follow these rules, your information can not be sold or distributed without your approval. Not even to a family member or another medical provider. But does your eye doctor really need to know about your cholesterol problem? Or does your chiropractor need to document your cosmetic surgery? In general…yes.

While many health issues do not concern one another, there are many things that do, as well as treatments for those health issues. For some of us we become our own judge when deciding the important issues regarding our back pain or poor eye sight. But some problems and treatments do cross body regions. For example, did you know that certain cholesterol medications have shown to weaken and even cause rupture in ligaments. This is important when dealing with joint injuries. Medications alone have a long list of side effects that are made up of body aches and pains. And while you’re seeing your podiatrist for a bunion on your foot, that problem may lead to limping, which affects your hips and low back.

Generally people understand that medications can cause side effects, but your supplements may have some important unwanted side effects as well, especially with medications you might be prescribed or other treatment such as surgeries. Just because they may be all natural doesn’t mean they aren’t important to tell your doctor about.

In a day in age where identity theft is rampant and personal information is all too easily available, be sure that you aren’t hiding anything from your doctor. Let them decide if it’s relevant or not so they can make an educated diagnosis and treatment plan for you.  It’s not a bad idea to have your medical records shared between offices as well. As far as the computer goes, I wouldn’t trust your great uncle’s attorney in Somalia with your bank account number and pin, I’ve already been mailed the $50 million he left…I’m just waiting on it to get here.