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May 2016

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• Baby's Life Changed With Chiropractic
• Scoliosis Helped by Chiropractic According to Study
• Resolution of Breastfeeding Difficulties With Chiropractic
• Medical Error—the Third Leading Cause of Death in the US
• Millions of Antibiotic Prescriptions Each Year are Unnecessary, Study Finds
• Paralyzed Dog Walks Again With Chiropractic

The Journal of Pediatric, Maternal & Family Health published a case study on April 14, 2016, documenting the case of a baby girl who was suffering with a variety of digestive and neurological problems being helped by chiropractic. The baby had been diagnosed medically with Sandifer syndrome since birth.

The study reports that Sandifer syndrome is when a baby exhibits contortions of the head and neck, sometimes the chest, and abnormal postures,  in an effort to relieve their symptoms from severe gastro-esophageal reflux with or without hiatal hernia. It is believed that these spasms may actually be seizures and appear as sudden extensions of the head and neck where the head may be twisted from side to side and the upper part of the trunk bent from side to side.

In this case, a 12-pound, 11-week-old baby girl suffering from reflux and digestive problems, possible seizures, and possible colic, was brought to the chiropractor.  She had been diagnosed by a pediatric neurologist and pediatric GI specialist with Sandifer syndrome. Her symptoms included explosive bowel movements since birth, but she started to become constipated, going 3-5 days without a bowel movement. It was reported that the infant screamed uncontrollably during her first week of life.

The infant girl also experienced regular hiccups, vomiting, and difficulty lying flat which would cause her hands to shake, eyes bounce, face to become red, and she would scream. Due to the severity of her suffering, the baby was placed on the powerful medication Zantac twice per day.

A chiropractic examination with spinal palpation was performed.  Vertebral subluxations were found and specific adjustments were done as needed.  By the seventh visit, the study reports that the baby showed more frequent bowel movements, decreased reflux, decreased gagging, decreased spitting up, and was able to lay flat again.

As care continued, by the 10th visit it was noted that the patient began sleeping in her crib for six hours a night and was having bowel movements daily. On the 12th visit, the baby's mother was asked to fill out an evaluation, form to report on the progress of her baby girl. In the evaluation, she noted that her daughter was less congested, had no more episodes of shaking, was better during tummy time, showed less fighting when eating, had better sleeping, and more frequent bowel movements. The baby girl also exhibited more energy, and an overall increase in playfulness.

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The Journal of Physical Therapy Science released a study in their April 2016 issue that showed that chiropractic care can help reduce or correct scoliosis in young children.  In their abstract, the study authors state, "The purpose of this study was to examine whether chiropractic techniques would reduce the curvature of idiopathic scoliosis, which commonly occurs in elementary school children."

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, "Scoliosis is a musculoskeletal disorder in which there is a sideways curvature of the spine, or backbone." Scoliosis is measured using a system known as the "Cobb angle." The Cobb angle is determined by comparing the tilt of two vertebrae at different points in the spine. When the angle measured is more than 10 degrees, it is classified as scoliosis. 

In this study, five healthy elementary school students who had scoliosis were examined and measured to document the degree of scoliosis. The five participants each had a scoliosis that measured at least 10 degrees. The average age was between 11 and 12 years. Four of the children were boys and one was a girl.

A chiropractic examination was performed on each of the five participants and chiropractic adjustments were given to areas that, according to the study, did not show proper alignment.  Chiropractic care was rendered three times per week for a period of 8 weeks. A measurement of the scoliosis was taken at the forth and eighth week of care to compare with the initial Cobb angles.

Results of chiropractic care for each of the subjects was dramatic. Two of the boys had an initial Cobb angle of 10 degrees. In both of these cases the Cobb angle was corrected to 0 (zero) degrees after just four weeks of chiropractic care. One boy with an initial 13 degree Cobb angle was reduced to 7 degrees by week four, and down to 0 degrees by week eight. The fourth boy had an initial Cobb angle of 11 which was reduced to 5 degrees at 4 weeks and remained at 5 degrees at the 8 week check. The one girl in the study started at 12 degrees of Cobb angle and was completely corrected to 0 degrees by week four.

In all, three of the five children showed total correction within 4 weeks, with one child taking 8 weeks. Only one child showed a partial correction of better than half by week four.

The authors of the study are PhDs and not chiropractors, from Department of Physical Therapy, College of Health and Welfare, Silla University, Republic of Korea.  They explained the study and the results in their discussion by saying, "In application of chiropractic techniques, a specific area of the vertebrae and joint is identified, and a rapid, low-amplitude stimulus is applied to correct the joint by applying force to it so that the joint moves into the physiological range and past the elastic range, which is the normal motion range of the joint. Therefore, chiropractic techniques are known to correct a twisted spine, restore muscle imbalance, help restore functions of spinal nerves."

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A study published on April 25, 2016, in the  Journal of Pediatric, Maternal & Family Health documented the case of an infant who was having difficulties with breastfeeding being helped with chiropractic care.

The authors of this study begin by noting the seriousness of breastfeeding problems. "Breastfeeding difficulties in the newborn can have dire consequences. Beyond the obvious need for sustenance, studies indicate that breastfed infants have fewer ear and respiratory tract infections, diarrheal illnesses, and atopic skin disorders."

In this case, a 2-week-old boy was brought to the chiropractor for help with difficulties of latching to breastfeed.  The infant had not had any previous medical care for this problem and was not on any medication. Examination of the baby's abdomen and lungs were normal, as were his neurological reflexes. 

The history also showed that the baby was born vaginally by vacuum extraction. In many cases, this procedure can lead to damage and nerve impingement of the structure of the upper neck. This process is known as subluxation.

Palpation of the spine along with visual inspection led to the conclusion that multiple subluxations were present in this infant's spine. With parental consent, the infant started receiving specific forms of adjustments designed for infants.

The study reports that the infant started showing improvement early in care. Over a period of four months, the infant continued to improve to the point where there was no longer a problem breastfeeding.

The authors reviewed additional literature on chiropractic helping breastfeeding problems and found 24 articles and research on this issue showing similar findings to their own.  A common thread through all these studies was the finding of subluxations in the child or infant's spine. Correction of the subluxations led to the positive results.

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The title above comes from a May 3, 2016, paper published in the prestigious British Medical Journal.  The study was also reported on by a number of news outlets and articles.

According to study author Dr. Martin Makary, surgical director of the Johns Hopkins Multidisciplinary Pancreas Clinic and a professor of surgery at Johns Hopkins Medicine, "Medical error has been defined as an unintended act (either of omission or commission) or one that does not achieve its intended outcome,3 the failure of a planned action to be completed as intended (an error of execution), the use of a wrong plan to achieve an aim (an error of planning),4 or a deviation from the process of care that may or may not cause harm to the patient."

The paper notes that many times medical error is not listed as the cause of death because there was no specific code for the event. Additionally, if an error leads to a fatal heart attack, the cause of death will most likely be listed as a heart attack.

In a May 4, 2016, CBS News article on this subject, Dr. Makary explained that there is very little funding for research to decrease medical errors. "One of the big issues that we in the patient safety research field face, that we run up against, is a problem where there's very little funding for research in making care safer and better. Part of the problem is that our national funding is informed from our national health statistics. But those statistics don't recognize medical care gone awry as a cause of death."

In a May 3, 2016, Washington Post article, Kenneth Sands, director of health-care quality at Beth Israel Deaconess Medical Center, an affiliate of Harvard Medical School, noted that the problem is not getting better. "The overall numbers haven’t changed, and that’s discouraging and alarming."

In comparing medical care to the airline industry, Sands commented that airlines have a much stricter standardization of procedure compared to medical care. "There has just been a higher degree of tolerance for variability in practice than you would see in other industries."

In his paper, Dr. Makary offered steps on how to combat this problem by stating, "Human error is inevitable. Although we cannot eliminate human error, we can better measure the problem to design safer systems mitigating its frequency, visibility, and consequences. Strategies to reduce death from medical care should include three steps."

The three remedies laid out by Dr. Makary are:

1. Making errors more visible when they occur so their effects can be intercepted.
2. Having remedies at hand to rescue patients.
3. Making errors less frequent by following principles that take human limitations into account.

Using the airline analogy, Dr. Makary said, "When a plane crashes, we don't say this is confidential proprietary information the airline company owns. We consider this part of public safety. Hospitals should be held to the same standards."

In the conclusion of the CBS News article, Dr. Makary sums up the issue by pointing out, "We've spent a tremendous effort tracking cancer, by state, by subtype, and we report all that to our national cancer registry. But we don't do any of that for people who die of medical error gone wrong."

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The above headline comes from a May 3, 2016, article reported by CBS News. This article and several other on this subject were based on a new study released on May 3, 2016, in the Journal of the American Medical Association, (JAMA).

The title of the JAMA study was, "Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011." The study begins by stating the importance of the study saying, "The National Action Plan for Combating Antibiotic-Resistant Bacteria set a goal of reducing inappropriate outpatient antibiotic use by 50% by 2020, but the extent of inappropriate outpatient antibiotic use is unknown."

According to the study, approximately one-third of all antibiotic prescriptions are inappropriate. The problem is that heavy usage of antibiotics has resulted in more antibiotic resistant bacteria, commonly referred to as superbugs. Because of the rise in antibiotic resistance, and the increased strength of the bacteria, more deaths due  to these types of infections have been occurring. Estimates are that each year antibiotic-resistant bacteria infect 2 million Americans of which about 23,000 die.

Lead researcher, Dr. Katherine Fleming-Dutra, stated in a HealthDay news article, "We were able to conclude that at least 30 percent of the antibiotics that are given in doctors' offices, emergency departments and hospital-based clinics are unnecessary, meaning that no antibiotics were needed at all."

Fleming also noted that about half of the antibiotics given for acute respiratory infections were not needed. She stated, "Nobody should be giving antibiotics for the common cold, it gets better without antibiotics.

In a companion editorial in the same issue of JAMA,  Drs. Tamma and Cosgrove stated, "The statement 'If you cannot measure it, you cannot improve it,' attributed to Lord Kelvin, is of particular relevance to the field of antibiotic stewardship. Whereas the plea for optimizing how antibiotics are used in the United States has been ongoing for more than 50 years, improvement has been slow."

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In what may be the first report of its kind published in a scientific journal, the Annals of Vertebral Subluxation Research published a study on May 2, 2016, about dog who was paralyzed in his rear legs being helped with chiropractic. 

Chiropractic on animals has been around for decades. Many chiropractors have incorporated caring for animals into their practice. More recently associations have been started to formally teach animal adjusting.

The study authors note that, "Chiropractic adjustments address vertebral subluxations. A subluxation, in terms of animal chiropractic, is defined as a shift in the normal structure of one vertebrae compared to those above and below, causing a biomechanical change that can interfere with nervous system function." They continue, "This interference can lead to a variety of symptoms depending on where the subluxation is found in the body."

This case involved a four-year old shih tzu/bichon mix named Ziggy. It was reported that Ziggy had always been a happy and active dog. His owner stated that he had not had any prior major injuries. Before his current condition, he had experienced this problem on two separate times in his past. Ziggy was a jumper and it was reported that he would leap from the back of a couch onto the floor.

The first instance of this problem was minor and Ziggy was given some medications. The second incidence was more severe as he lost the use of his back legs and appeared to be in pain. Again, he was given medications.  However, his recovery took much longer this time. The third time, Ziggy had the problem he was worse and he did not seem to make any progress under traditional veterinary care. The options presented to Ziggy's owner were surgery, lifelong medication, a wheeling cart, and possibly euthanasia if he continued to worsen.

Upon being brought in for chiropractic care, Ziggy was completely paralyzed in his back end. An examination confirmed that Ziggy had no reflexes in his back limbs and minimal feeling there as well. His muscles in his hind end showed considerable atrophy while his muscles in his upper spine showed spasm. Palpation of his spine showed problems in his lower spine believed to be subluxations.

Chiropractic care was begun on Ziggy at the rate of two visits per week. After the first visit it was reported that Ziggy slept much better and seemed to be more at ease. After the second visit, Ziggy was able to pull himself up and use his right hind leg.  By the eighth visit, his pain sensation had returned to his hind legs. After 12 visits, Ziggy was able to stand up and walk without falling and without using the grip socks. By his 16th visit, it was reported that all his problems had been corrected.

In their conclusion, the authors state, "This case study provides supporting evidence that canines suffering from paraplegia may benefit from chiropractic adjustments to sites of vertebral subluxation."

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