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December 2009

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• Headaches Resolved With Chiropractic in 13 Year Old Boy - A Case Study
• Swine Flu May be Mildest Pandemic Ever, Researchers Say
• Improvement in Learning and Speech Disorder with Chiropractic - A Case Study
• Holiday Stress Raises Health Challenges, Chiropractors Caution
• US Healthcare Spends More and Gets Less
• Nine Percent of Surgeons Have Made ‘Major’ Errors Recently

A case study published in the November 30, 2009 issue of the scientific periodical, the Journal of Pediatric, Maternal & Family Health, documents the improvement, with chiropractic care, of a young boy suffering from headaches.

In this case a 13 year old boy had been suffering from daily headaches for the previous 4 years. The young boy reported that his headaches would occur for a minimum of 5 hours per day, and nothing seemed to help the pain. The boy never took medication for the condition but, after 4 years of suffering from these headaches, he was brought to a chiropractic clinic for care.

The study notes that about 66% of the population will suffer from headaches at some time. Additionally the authors report that according to the International Headache Society, there are 14 distinct types of headaches. The author also notes that, "Standard medical care in treating headaches is often unsuccessful due to the complicated nature of headaches, and proper medical management is largely dependant upon a proper diagnosis." Most medical care involves the use of medications and does not use a structural approach used in chiropractic.

The Chiropractic analysis and x-rays revealed a reversal of the cervical (neck) curvature. Normally when looking at a side x-ray of the cervical spine, the neck should have an even and smooth bowing curvature toward the front. Care was initiated with specific adjustment and procedures designed to correct the loss of the neck curve.

After only 6 weeks of care a follow up x-ray was taken that showed a complete restoration of the normal neck curvature. The author reported, "In addition to the positive changes in the radiographic measurements of the patient, the headaches he suffered from for 4 years subsided until, by the end of the care plan, they were completely eliminated."

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The above headline comes from the December 8, 2009 edition of the Los Angeles Times. This was also echoed by the headline in the December 11, 2009 USA Today, which read, "Swine flu far less severe in latest calculations".  The stories from these publications were based on new studies showing that the H1N1, or Swine Flu will be far less severe than originally feared.

One study published in the December 10, 2009 issue of the British Medical Journal looked at the mortality rates associated with the H1N1 pandemic. The second study published in the December 2009 issue of PLoS Medicine looked at 2 US cities and reviewed H1N1 numbers in those cities and extrapolated these numbers nation wide.

According to the LA Times article, original estimates of deaths due to H1N1 were as high as 90,000. These new studies now show that the death toll in the US will probably be 10 - 15 thousand. According to the CDC the typical number of deaths per year averages to be about 36,000 per year. The researchers showed that the death rates for this pandemic will be seven to nine times lower than anticipated. Researchers also found that 91% of those who died suffered from underlying medical conditions, such as heart disease and respiratory illnesses like asthma, and 72% of those who died were obese.

Noting that the Flu season has two peaks, one mid summer and one in late fall, the PLoS Medicine report wrote as part of their conclusion, "These estimates suggest that an autumn–winter pandemic wave of H1N1 with comparable severity per case could lead to a number of deaths in the range from considerably below that associated with seasonal influenza to slightly higher."

Study senior author Marc Lipsitch, professor of epidemiology at Harvard School of Public Health, said in a news release, "As more detailed data have become available, we have been able to improve our estimates of how severe this disease is. Early on, it was difficult to measure the flu’s impact and it was crucial to plan for the full range of possible outcomes. Fortunately, the virus now appears to be near the milder end." In an interview with NPS Dr. Lipsitch added, "It is probably going to be the mildest pandemic on record — compared to the three that happened in the 20th century."

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A case study research article published on November 17, 2009 in the scientific periodical, the Journal of Pediatric, Maternal and Family Health, documented a case showing improvement in learning disorder and speech delay in a four year old child undergoing chiropractic care to correct vertebral subluxations.

In this case a 4 year old boy was brought to the chiropractor having been diagnosed with a learning disorder and speech delay. The study noted that his speech was so severely impaired that others could not understand him. The boy's mother reported that her son was not speaking when he started school which caused him much frustration and anger. He was under the care of a speech therapist.

The history in this case revealed that the boy was born by Caesarean section. According to the study he was pulled out by his head and his mother reports that she remembers hearing him crying while he was still inside her.  The boy has one sister with no development issues and has above average intelligence.

The chiropractic examination showed imbalances in his posture and spinal curvatures. X-rays were also performed which confirmed a loss of cervical (neck) curve and vertebral misalignments. The primary diagnosis listed was vertebral subluxation of the top vertebrae in the neck called the Atlas.

The study noted that this patient was seen for a total of 44 visits over an 8 month period. Care initially started with three adjustments per week for 30 days, then followed by two adjustments per week for 30 days and then once weekly thereafter.

The results were startling as immediately following the first adjustment the patient began speaking and putting together full sentences that were coherent and understandable. Additionally, after the first adjustment, the young boy was also able to recognize his written name, which he had never been able to do before. As care continued the boy was able to color with crayons and began to understand and follow verbal directions.

Other improvements noted in this case were that prior to care the boy was fairly emotionless but as care continued he began to smile or cry at appropriate times.  Additionally it was noted that the boy had difficulty standing or lying still prior to the introduction of chiropractic care, but after initiating care he could remain still and undistracted while getting his chiropractic adjustments.

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The International Chiropractors Association (ICA) issued a November 23, 2009 release to help people deal with the holiday stress.  The ICA opens the release by noting that with the holiday season underway and increasing the tempo of daily demands, it is important to your good health to observe some simple guidelines to reduce the stress and strain of this busy time.

One of the recommendations the ICA makes is to use good judgment when it comes to food. "The process of making healthy choices in both quality and quantity may help prevent an unhealthy scenario as you make your way through this holiday season." 

Dr. Gary L. Walsemann, ICA president, warned that overeating can have effects not normally thought of, "A bulging stomach can put pressure on your body’s support systems, including your spine and spinal nerves.” He continued, "Every extra pound in the abdominal region could generate 10 pounds more stress on the lower back. This stress can last a short time, such as just after eating a heavy meal or lifting a package improperly. It may also become chronic, as heavy eating during the holidays may lead to weight gain, and carrying extra pounds can put added strain on the supporting structures of the spine and nervous system."

The ICA release further explained that additional weight can force the pelvis and torso to shift and cause changes in spinal balance, leading to spinal misalignments (vertebral subluxations) and malfunctions in the entire body, explains Dr. Walsemann.

The ICA release had several recommendations which included the following:

• Lift carefully and consciously. When lifting, whether it involves packages, firewood, your frozen holiday turkey or other items, remember the prompt “lift with your legs, not your back”.
• When seated and when traveling by car or plane, place a pillow or folded towel behind the small of the back to help maintain the arch in your lower back and support the rest of the body properly.
• Get sufficient rest! Many health problems that occur with the holidays are triggered or intensified by fatigue.
• Don’t wait until you are hurting to see your doctor of chiropractic. Chiropractic adjustments can keep you going at your peak and help you get extra enjoyment from the holiday season.

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A series of news stories were published based upon a report by the Organization for Economic Cooperation and Development, (OECD), that showed that the United States spent the most on healthcare, yet was not doing well when compared to other wealthy nations in several key areas of health measurements.

The Organization for Economic Cooperation and Development issued a report on December 8, 2009 called the "OECD Health Data 2009: Statistics and Indicators for 30 Countries" which included a detailed study on the US healthcare system. The portion of the report specific to the US called, "OECD Health Data 2009, How Does the United States Compare", has with it some telling statistics about the US healthcare system and the results we get for the money spent.

Some of the interesting facts uncovered by the report are the following:

The United States ranks far ahead of other OECD countries in terms of total health spending per capita, with spending of $7,290 . That represents almost two-and-a-half times greater than the other nations average of $2,964 in 2007. The next closest nation is Norway which follows, with spending of $4,763 per capita, followed by Switzerland with spending of $4,417 per capita.

The US spends 16% of its Gross Domestic Product on healthcare, compared with France, Switzerland and Germany, which allocated 11.0%, 10.8% and 10.4% of their GDP to health respectively.

The US pays a smaller portion of the health care bill from public funding than other nations. Only 45% of healthcare expenses are paid by public funds which is a much smaller amount compared to an average of 73% for other OECD nations.

Infant mortality in the US is at 6.7 deaths per 1,000 live births which is well above the average of 3.9 per 1,000 live births.

Life expectancy at birth in the U.S. was 78.1 years in 2007 which is a year less than the OECD average of 79.1, and puts the U.S. just ahead of the Czech Republic, Poland and Mexico. Norway and Switzerland have a 2 to 4 year longer life expectancy over the US.

The study also noted that drug spending has increased everywhere with the US leading the way. According to the report, per capita spending on pharmaceuticals rose by almost 50 percent over the last 10 years in OECD countries, reaching a total of $650 billion in 2007. The U.S. was the world's biggest spender on pharmaceuticals, spending $878 per person, with Canada next at $691 per person and the OECD average at $461.

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The above is the headline from a Wall Street Journal article on November 23, 2009 reporting on a study that surveyed surgeons on their perceptions of job burn-out. A similar article titled, "Burned Out, Depressed Surgeons More Likely to Commit More Major Medical Errors" also appeared on November 23 in Science Daily. Both articles were based on research published in the September issue of Annals of Surgery, entitled, "Burnout and Career Satisfaction Among American Surgeons".

The study was in the form of a survey of surgeons who were asked questions about their jobs and mental health. Surprisingly 40% of surgeons responding to the survey said they were burned out. The study also showed that 30% screened positive for symptoms of depression, and 28% had mental scores below the population norm.

The Wall Street Journal article reported that nine percent of surgeons said they were concerned they had made a “major medical error” in the past three months. The study also noted that only 36% of surgeons felt their work schedule left enough time for personal/family life and only 51% would recommend their children pursue a career as a physician/surgeon.

Charles M. Balch, M.D., a professor of surgery at the Johns Hopkins University School of Medicine and one of the study's leaders commented, "People have talked about fatigue and long working hours, but our results indicate that the dominant contributors to self-reported medical errors are burnout and depression. All of us need to take this into account to a greater degree than in the past. Frankly, burnout and depression hadn't been on everybody's radar screen."

The study, however, was unable to determine whether stress created the errors, or the errors created stress. The authors wrote, "Since the present study is cross-sectional, we are unable to determine whether distress causes errors or errors cause distress. The findings are consistent with previous prospective studies in internal medicine and pediatric residents which demonstrate an increased risk of future medical errors among distressed physicians and imply that surgeon distress is a contributing factor to medical errors as well as a consequence."

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