Thursday, March 5, 2015

Whiplash

BY 

Whiplash is a slang term for an injury to the neck that’s typically associated with a motor vehicle collision (MVC). A better term for “whiplash” is “whiplash associated disorder” (WAD) as it includes specific history and exam findings. There are usually two phases to an MVC: 1) an acceleration phase that is followed by 2) a deceleration phase. Injury can arise during either phase depending on the following: 1) The direction or angle of the collision (head-on, rear-end, T-bone, etc.); 2) The size of the bullet vs. target vehicle; 3) The speed the vehicles are traveling; 4) The size of the injured person’s neck (short/stocky vs. long/thin), 5) Head rotation at impact; 6) Position of the headrest (ideally ≤1 inch from the back of the head and raised up to bottom of the ears); 7) The angle and “springiness” of the seatback; 8) Seat belt use and position; 9) Collision anticipation, 10) Condition of the road (dry vs. wet/slippery), and more!

Anatomically, injury can occur to muscles and/or their tendon attachments, the ligaments that firmly hold bone to bone, the fascia (or the covering of the muscles), the bones, the joints, the skin, the nerves, and/or blood vessels. It all boils down to the ten or more factors listed above, and as discussed in last month’s topic on PTSD, depending on whether concussion occurs and how well the injured person reacts or copes with the injury (the psychosocial part). Obviously, A LOT of factors drive the outcome of a whiplash injury!

One of the more vulnerable parts of the neck that is frequently injured are the small facet joints and/or their coverings (called joint capsules). This is referred to as a WAD II injury. Picture a vertebrae as a bony tripod with one leg being big and wide representing the vertebral body and shock absorbing disk. This large leg is the main weight-bearing part of the tripod supporting up to 80% of the weight. The other two legs represent the facet joints that lie in the back of the vertebrae that open and close as we look down (opens) and look up (closes). When we turn our head, the movement primarily occurs in the first two vertebrae high up in the neck. Injury here most commonly occurs when the head twists or rotates, which can result from either the angle the chest portion of the seat belt lays against and/or if the head is rotated upon impact, such as looking in the rear view mirror. In other words, it’s probable that head rotation occurs in MOST motor vehicle collisions due to the seat belt’s angled position as it crosses the chest. When this twisting / rotation movement of the head occurs suddenly, it can result in brain injury or concussion, as studies show that delicate axons and nerve fibers can literally twist and tear due to this rotational component of the injury. Also, it’s WELL ESTABLISHED that the head DOES NOT have to hit anything to cause a concussion injury, as simply the force of the brain hitting the inside walls of the skull is enough to do this!

Another slightly less common WAD injury involves the pinching of the nerve root as it exits the spine (referred to as a WAD III injury). Think of the nerves as wires between a switch and a light, each having a specific area that they “run” (innervate). For example, if tingling/numbness occurs in the thumb and index finger, it can mean the C6 nerve could be interfered with at some point in between the spine and the fingers. We also test specific muscles for weakness associated with each individual nerve to identify the main culprit! When a nerve gets pinched, sensory and/or motor deficits can occur, which is validated by the neurological examination. The disk is basically like a “jelly donut” where the jelly is located in the central part of the disk and held in place by a tough fibroelastic tissue (called the annulus fibrosis). When this “jelly-like” substance (called nucleus pulposis) breaks through the tough, outer “annulus” and pushes against the nerve, loss of sensation and/or specific muscle weakness can occur. As chiropractors, we will carefully examine you and render many highly effective treatment methods!

The Silent Whiplash

BY 
If you’ve watched small kids tumble and play, it can seem pretty rough to an adult. As we age, we know that balancing on our heads or whipping our necks around can only cause trouble. Most adults understand this point but seem to think children are more immune to problems for some reason. But is this plausible? Are kids really injury-proof? Not likely and recent research shows that degeneration of the spinal disks can occur at a much earlier age than previously thought. MRI studies of child athletes show this to be the case.
So what happens when a kid takes a whollup to the head, or slips and falls onto the kitchen floor? Besides a blow to the head, the neck can, and does, get injured from these types of forces. Because of a child’s age, the pain may only last a few days, but a silent problem can develop. A small sprain to the ligaments of the neck that hold the vertebrae in their proper position can only be diagnosed through x-ray, but most kids don’t get films taken. When the pain goes away we think the actual problem has gone away too.
Over time, the improper alignment and disrupted motion can lead to degeneration arthritis. This, in turn, will lead to stiffness and interfere with our quality of life.
So can a whiplash be a silent injury? Most likely yes, but over time it will eventually rear its ugly head. Then, when we finally visit a doctor, we are told of disk degeneration and we really don’t know why this is the case. Is it old age? Well, the disks that are not degenerated are the same age as the disks that are a problem. So it really can’t be an old age problem. Maybe it’s an older discovery, but the problem existed long before. These minor tumbles and whiplashes we experience in our youth do have lasting consequences.

Wednesday, March 4, 2015

Some Pediatric Research for Variety of Issues.

  • Constipation
  • Nutritional Research References for children
    • Barrett, D. (2007). Maximizing the Nutritional Value of Fruits & Vegetables. Center for Excellence in Fruit and Vegetable Quality, University of California, Davis, 40-44.
    • Bruno RS, Traber MG. Vitamin E biokinetics, oxidative stress and cigarette smoking. Pathophysiology. 2006;13(3):143-149.
    • Brigelius-Flohé R, Traber MG. Vitamin E: function and metabolism. FASEB J. 1999;13(10):1145-1155.
    • Brooks, A. (2013). 15 Things Your Doctor Doesn’t Know About Your Child: Questions Answered About Developmental Delays. Dallas, TX: Ingram.
    • Chen TS, Liou SY, Chang YL. Supplementation of Emblica officinalis (Amla) extract reduces oxidative stress in uremic patients. Am J Chin Med 2009;37:19-25.
    • Clark JH, Rhoden DK, Turner DS. Symptomatic vitamin A and D defi ciencies in an eightyear-old with autism. JPEN J Parenter Enteral Nutr. 1993;17(3):284-286.
    • Ip SP, Poon MK, Che CT, et al. Schisandrin B protects against carbon tetrachloride toxicity by enhancing the mitochondrial glutathione redox status in mouse liver. Free Radic Biol Med 1996;21:709-12.
    • Cornish E. Gluten and casein free diets in autism: a study of the effects on food choice and nutrition. J Hum Nutr Diet. 2002;15(4):261-269.
    • Ivanova KG, Stankova KG, et al. The biliprotein C-phycocyanin modulates the early radiation response: a pilot study. Mutat Res 2010;695:40-5.
    • Kay CD, Holub BJ. The effect of wild blueberry (Vaccinium angustifolium) consumption on postprandial serum antioxidant status in human subjects. Br J Nutr 2002;88:389-98.
    • Kondo H, Park SH, Watanabe K, et al. Polyphenol (-)-epigallocatechin gallate inhibits apoptosis induced by irradiation in human HaCaT keratinocytes. Biochem Biophys Res Commun 2004;316:59-64.
    • Lynch, B. MTHFR Research documents. Retrieved December 1, 2014
    • Mangialasche F, Xu W, Kivipelto M, et al. Tocopherols and tocotrienols plasma levels are associated with cognitive impairment. Neurobiol Aging 2012;33:2282-90.
    • McCarty MF. Clinical potential of Spirulina as a source of phycocyanobilin. J Med Food 2007;10:566-70.
    • Milesi MA, Lacan D, Brosse H, et al. Effect of an oral supplementation with a proprietary melon juice concentrate (Extramel) on stress and fatigue in healthy people: a pilot, double-blind, placebo-controlled clinical trial. Nutr J 2009;8:40.
    • Morris, C, Agin, M. Syndrome of Allergy, Apraxia, and Malabsorption: characterization of a neurodevelopmental phenotype that responds to omega 3 and vitamin E supplementation. Alternative Therapies. 34-43, July/Aug 2009.
    • Myrdal, A. American kids’ poor food choices: Fewer than 15 percent eat recommended fruits and vegetables. Retrieved November 20, 2014
    • Pantuck AJ, Leppert JT, Zomorodian N, et al. Phase II study of pomegranate juice for men with rising prostate-specific antigen following surgery or radiation for prostate cancer. Clin Cancer Res 2006;12:4018-26.
    • Pietrzik K, Bailey L, Shane B. Folic acid and L-5-methyltetrahydrofolate: comparison of clinical pharmacokinetics and pharmacodynamics. Clin Pharmacokinet 2010;49:535-48.
    • Prakash L, et al. A “Superfruit” extract from the Ayurvedic Tradition: authenticated and redefined. NutraCos 2009;Sept/Oct:12-15.
    • Rege NN, et al. Adaptogenic properties of six rasayana herbs used in Ayurvedic medicine. Phytother Res 1999;13:275-91.
    • Rickman, J., Barrett, D., Bruhn, C. (2007). Nutritional comparison of fresh, frozen and
      canned fruits and vegetables. Part 1. Vitamins C and B and phenolic compounds. Journal of the Science of Food and Agriculture. 87: 930-944.
    • Sahin K, Tuzcu M, Orhan C, et al. The effects of chromium complex and level on glucose metabolism and memory acquisition in rats fed high-fat diet. Biol Trace Elem Res 2011;143:1018-30.
    • Shih CM, Cheng SN, Wong CS, et al. Antiinflammatory and antihyperalgesic activity of C-phycocyanin. Anesth Analg 2009;108:1303-10.
    • Sokol RJ. Vitamin E and neurologic deficits. Adv Pediatr. 1990;37:119-148.
    • Sokol RJ. Vitamin E and neurologic function in man. Free Radic Biol Med. 1989;6(2):189-207.
    • Stuart EC, Scandlyn MJ, Rosengren RJ. Role of epigallocatechin gallate (EGCG) in the treatment of breast and prostate cancer. Life Sci 2006;79:2329-36.
    • Traber MG, Packer L. Vitamin E: beyond antioxidant function. Am J Clin Nutr. 1995;62(6Suppl):1501S-1509S.
    • Traber MG. How much vitamin E? . . .Just enough! Am J Clin Nutr. 2006;84(5):959-960.
    • Traber MG. Vitamin E, oxidative stress and “healthy ageing.” Eur J Clin Invest.
      1997;27(10):822-824.
    • Traber MG. Vitamin E. In: Shils ME, Olson JA, eds. Modern Nutrition in Health and Disease. 9th ed. Baltimore, MD: Williams and Wilkens; 1999:347-362
    • UC Davis (2014, November). Center of Excellence for Nutritional Genomics (CENG).
    • Vasudevan M, Parle M. Memory enhancing activity of Anwala churna (Emblica officinalis Gaertn.): an Ayurvedic preparation. Physiol Behav 2007;91:46-54.
    • Vitamin E. In: Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academies Press; 2000:186-283.

  • Integrative Pediatrics


Thursday, February 26, 2015

Positive Affirmations

We function a lot like computers: garbage in produces garbage out, while great stuff in produces great stuff out. We talk to ourselves far more than we talk to others. In fact, most experts agree that about eighty percent of all conversations we have are with ourselves. All too often, we talk to ourselves with anger, fear, belittlement and negativity. "I knew there wouldn't be any parking" or "I knew that they were going to be mad at me," or "I am always depressed this time of year," or even "I just can't seem to do anything right" are examples of the kind of negative inner talk we play over and over again in our minds. We acknowledge our ability to manifest our inner thinking and yet the majority of our inner thinking is negative and demeaning.
This raises a very important point. If we are powerful enough to manifest our negative thoughts, why can't we also manifest our positive thoughts? The answer is that we can. In order to create positive thoughts instead of negative ones, we must decide in advance to be proactive and to discipline ourselves to take out the old mental program of negativity and immediately replace it with the new mental program of being positive and kind. I have found the best way to do this is through the use of affirmations.
Affirmations are positive self-talk designed to help you create the life of your dreams. Using affirmations on a daily basis is a simple step you can take to get what you want out of life and to reduce stress, fear, and depression. Making positive, affirmative statements to yourself will change your self-image, raise your self-esteem, and create an attitude of expectancy.
Here are some of the keys that allow you to maximize the power of your daily affirmations:
  • Affirmations should be written down. This allows you to crystallize your thoughts and gives you a reference to refer back to daily.
  • Affirmations should be in the first person and in the current time frame. They should always contain the word "I" and be in the "now" time frame, as they are the truth, told in advance. Remember the rule, "To Become, Act As If."
  • Affirmations are best done in the morning to start your day or in the evening before going to sleep. This helps to program your subconscious mind with positive thoughts.
  • Affirmations can be either memorized or read, and need to be said aloud with emotion. This is what is necessary to open the trap door between your educated and innate mind.
Let me share some possible affirmations with you to get you thinking properly about creating your own. Remember that you can and should create affirmations for all parts of your life. Affirm professionally, spiritually, financially, and in all other areas. For example: "I am happy, I am healthy, and I am wise. My potential is unlimited and I am growing every day. I am a magnet that attracts all the good of the universe to me daily. I am committed to constant and never-ending personal improvement, and I take massive action steps to create the future, as I want it to be. I will do whatever it takes to become the winner I know I am.
"My beliefs create my reality! I choose robust health, abundant wealth, constant happiness and eternal love. I attract and positively influence the lives of people in my community. I think big thoughts, relish small pleasures and handle setbacks gracefully. I give thanks for the opportunity to serve humanity and I willingly accept the rewards being sent to me by an abundant universe. I am deeply grateful for all I create and receive. My life is now in total balance and I am a master!"

Monday, February 23, 2015

Over 80 scientific studies that link autism to vaccines.


I imagine there is a majority of physicians, and many self-proclaimed experts without a science or medical background, who are sure the link between vaccines and autism does not exist. Most of them will swear by the industry backed studies putting a spin on the lack of any connection between the sacred vaccines and the brain damage we are seeing in our children. Nonetheless, it appears that not even the true science is enough to make people wake up. They either have to experience a deterioration in the health of their children to actually believe what vaccines are doing to their children's brains, or they have to wait until the government declares martial law, and then takes away their rights to informed choice. - Lawrence B. Palevsky, M.D. 

http://www.scribd.com/doc/220807175/86-Research-Papers-Supporting-the-Vaccine-Autism-Link

Monday, February 16, 2015

Pediatrician's letter about the measles

Measles Matters: News You Can Use
Dear Parent,

As a board certified pediatrician, I took the same oath as all physicians, "to do no harm."
The latest media presentation of the measles outbreak at Disneyland as a result of unvaccinated children is very upsetting to me. We are being fed information that is essentially inaccurate by media journalists - none of whom have medical degrees - which may actually be promoting medical harm to our children.

The latest reports blaming a failure of the measles vaccine on the unvaccinated population are not accurate, and in some reports, not true at all. In fact, over the past 30 years, there have been similar numbers of measles cases reported in various areas of the United States. Studies published in leading medical journals, such as the New England Journal of Medicine, American Journal of Epidemiology, American Journal of Public Health and others around the world have confirmed small numbers, 75-140 cases of measles annually. So why then is the latest statistic of over 90 cases of measles spread over 14 states, representing tens of millions of people being billed as an epidemic?

The media would have us believe that this is a result of the fringe population of anti-vaxers who refuse to have their children vaccinated according the guidelines of the current vaccine schedule. Medical reporting has brought to light the glaring ineffectiveness of the measles vaccines in fulfilling their widely claimed promise of preventing outbreaks in highly vaccine compliant populations.
In fact, measles outbreaks have occurred in populations that have been vaccinated on the average of 77%- 99%, not the so-called anti-vaxers.

Last year 1 in every 500,000 Americans came down with the measles. Nearly all recovered in a few days without serious consequences. At the same time 1 in 68 American children were diagnosed with autism or for every case of measles there were 7000 cases of autism. I ask myself which is the real epidemic here?

Frank Bruni in an editorial in the New York Times on February 1, 2015 states that this measles outbreak is a result of "wealthy, educated people who deliberately didn't vaccinate their children." He refers to measles as "the scourge once essentially eliminated in this country is back" when, in fact, it never left! He refers to all links between autism and MMR vaccines as having been discredited yet he obviously has not read all the studies from the U.S. and around the world proving his information false. As a recent example, I would ask him to justify the 340% increase in autism in African-American boys in Chicago - a report that was supposedly squelched by the CDC . While he reports that the incidence of measles has increased over the past 10 years, no patients have died.

Scare tactics were used to terrorize those who attended this year's SuperBowl in Phoenix because of one woman who sat in a clinic without being properly isolated or that every one of the thousands of people passing through Penn Station are at risk because of one man who rode an Amtrak train. It appears that the saturation of the media amplifies the hypotheses to a point that seems misleadingly worthy of consideration. In other words, if enough people say things enough times there must be some truth to it. Does that justify USA Today publishing an article claiming that non-vaccinated parents should be jailed or sued or have their children removed from the home if they chose not to vaccinate their children against the measles? Does that justify the immediate vaccination of every child and adult in this country regardless of their immune status or overall medical health? Will the local pharmacies be hooking pedestrians into their stores for MMR vaccines as they have been doing for the less than effective flu vaccines?

As I write this piece, the director of the CDC states that the overall vaccination rate in this country is 92% !! Yet he is very concerned of a large outbreak because of the trend in not vaccinating certain children. Does this make sense?

I wish these journalists, vaccinologists and infectious disease specialists spent a week in my office. I wish they would actually listen to the testimonials given to me by parents of autistic children who were obviously affected by these vaccines adversely. I wish they would tell parents that the risk of dying from the measles in the United States is around zero. I wish they would admit that they are being told by pharmaceutical companies not to report certain statistics or to cover up factual scientific information. I wish they could be free to report honestly about vaccines rather than being dependent upon drug advertising and internet information.

This is an emotional debate for sure. If we discount emotion and fear, we would realize that a child may have a greater chance of getting struck by lightning, accidental drowning or possibly from adverse side effects of the MMR vaccination itself than from acquiring live measles infection. I wish that my pediatric colleagues would offer parents factual pros and cons of vaccines in general so that a parent can make an informed decision and then give consent to vaccinate rather than being told that if their child isn't vaccinated they will be thrown out of school and they are guilty of child abuse!

I am not advocating that vaccines be discontinued. I am advocating that doctors and patients become aware of the ingredients of these vaccines, what they can potentially do to affect an adverse outcome in an immunologically compromised child. Adverse reactions to MMR and other vaccines have been reported in numerous clinical trials and studies. I am advocating that medical practitioners and researchers, not journalists, address the real medical epidemics of autism, asthma, GI disease and autoimmune diseases facing our society and people around the world. Stop hyping the safety of MMR vaccines which may actually be more dangerous than live measles and may be ineffective in preventing the illness which they are so anxious to report as a dangerous epidemic itself.

Let's stop believing that the mainstream media is telling us the truth when all they are doing is shutting down any intelligent and open discussion about vaccine safety and how to improve it.

Sincerely,
Dr. Michael Elice, M.D.



Please read! I do want to commend Dr. Elice for his bravery to go against the conventional grain. 

Thank you, 

Dr. Jon Wise