Week of: Monday Nov. 11, 2019
John H. Keefe III, D.C.
IN THE NEWS: The Study: Observational retrospective study of the association of initial healthcare provider for new-onset low back pain with early and long-term opioid use--a. The authors wanted to find out if the type of provider that patients suffering from new-onset low back pain saw initially affected early and long term opioid usage. b. Several previous studies have suggested that seeing a conservative therapist “(defined as chiropractors, physical therapists, acupuncturists)” may decrease the likelihood of opioid use in low back pain patients as compared to seeing a primary care physician. c. The authors noted that the primary independent variable that they used for this study was the “type of initial healthcare provider including physicians and conservative therapists (physical therapists, chiropractors, acupuncturists)” seeing the patient. e. “ Initial treatment from conservative therapists in those with LBP was associated with a marked decrease in the odds of early and long-term opioid use.” f. The authors felt there were a number of factors that might account for the decrease in opioid usage in those seeking conservative therapies. g. They noted that it could be because non-MDs do not prescribe opioids, or that the patients who sought care from non-MD may have “educational level or preferences which may also result in decreased desire for those patients to use opioids” or that the conservative care may result in improvement in pain and back function so the conservative care patients did not have a desire to use opioids. h. “the most frequent initial conservative provider seen was a chiropractor” Take Home: In patients who suffered from new-onset low back pain, opioid usage was lower in patients who initially sought care from chiropractors or physical therapists as opposed to primary care physicians.
WELLNESS: Humidity And Your Health In the wintertime humidity is a big issue. As the weather turns colder and the heaters start working 24/7 then the indoor air will start drying out. Studies have shown that dry air has four main effects on the human body: 1. Breathing dry air is a potential health hazard that can cause such respiratory ailments as asthma, bronchitis, sinusitis, and nosebleeds or general dehydration since body fluids are depleted during respiration. 2. Skin moisture evaporation can cause skin irritations and eye itching. 3. Irritative effects, such as static electricity which causes mild shocks when metal is touched, are common when the air moisture is low. 4. The “apparent temperature” of the air is lower than what the thermometer indicates, and the body “feels” colder. As your body fights the dry air you start to use up your vitamin A stores. This enhances the dry skin and sinus problems as well as weakens your immune system. It is important that you have a humidity gauge in each bedroom and a cool-mist humidifier to combat the dry air. I recommend the ultrasonic humidifiers as they put the most water in the air. Summary of some of the effects of dry air: Dry skin, Chapped lips, Clogged sinuses, Itchy skin, Dry throat coughs, Cracked nasal membranes, Increased risk of bacterial infection, Aggravated asthma & allergy symptoms. Studies have shown that the body's immune system will function better when the relative humidity in a home is between 45%-65%. pneumococcus, staphylococcus, and streptococcus bacteria die up to 20 times faster at a relative humidity between 45% and 55%, than above 70% or below 20%. Dehydration can also cause negative health effects. Symptoms of dehydration include dry skin, chronic joint and muscle pain, raspy throat, sinus, and nasal pain, sore eyes, a lack of mental concentration, and a decrease in the body's immune system.
CONDITION OF THE WEEK: EATING FOODS FOR WINTER--While nothing can completely stop a cold in its tracks, a healthy immune system can help ward off the germs that cause colds and the flu. A healthy immune system can even minimize a cold’s duration. One way to boost the immune system is to maintain a vitamin C regimen. “Studies have shown that 1,000 milligrams of vitamin C supplements may make colds milder and even shorten them by half a day,” says Tsang. Also, advise clients to increase their intake of fruits and vegetables rich in powerful nutrients. “Foods rich in the antioxidants vitamin C and beta-carotene, such as citrus fruit, cabbage, broccoli, pumpkin, sweet potato, and spinach, have immune-boosting power,” says Amy Cartwright, MS, RD, LDN, who is in private practice in Conyngham, Pa. “To fight off infections, you should increase your intake of zinc, which is found in fish, oysters, poultry, eggs, milk, unprocessed grains, and cereals.” In addition, diets should include a healthy level of good bacteria. “Including adequate amounts of probiotics or friendly flora is valuable in restoring levels of these healthy bacteria in our body to protect us from other infection,” notes Robinett. “Typically, fermented dairy products such as kefir and yogurt—and sauerkraut—provide live cultures but also contain calories, sugar, or salt. I generally recommend taking a probiotic as a dietary supplement, especially during the winter months and always after antibiotic use.”
FUNNY BONE: After I paid for my items in an adorable Italian shop, the salesperson smiled and said “Grazie,” Italian for “thank you.” My Italian isn’t very good, but I knew that the Italian word for “you’re welcome” was the same as the name of a spaghetti sauce. So I confidently replied “Ragú!” and walked out of the store. A few blocks later, it hit me: I had the wrong spaghetti sauce. “You’re welcome” is prego.@@ Two regulars are sitting at a bar when one of them casually points to a couple of drunks across from them. “That’s us in ten years,” he says. His friend takes a sip from his beer, sets it down on the bar, turns to his friend, and slurs, “That’s a mirror.”@@ Sleep is a weak substitute for coffee.@@ After a long time, I told my hot coworker how I felt. Turns out she felt the same way. So I turned on the air conditioning.@@ My paramedic team was called to an emergency. Before we took the patient to the hospital, I had a question for his wife. “Does your husband have any cardiac problems?” I asked. “Yes,” she said with a note of concern. “His cardiologist just died.”@@ A doctor told his patient, “There’s good news and bad news. The bad news is, you have partial short-term memory loss.” The patient said, “Oh no, Doctor. What’s the bad news?”@@ The graveside service had just ended when there was a frightening clap of thunder, followed by a tremendous bolt of lightning accompanied by even louder thunder. The little old man looked at the pastor and said calmly, “Well, she’s there.”
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