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February 2003 Issue

In this issue:

 

Canadian Chiropractors Want Ban on Kids Bodychecking in Hockey

The Canadian Hockey Association, after a three-year pilot project, made the decision  to allow checking for the 2002-2003 season at the Atom level, which drops the age in which bodychecking begins from twelve to nine.  Shortly after this decision the Canadian Chiropractic Association opposed allowing young minor hockey players to bodycheck, saying it can lead to long-term developmental problems.

Dr. Greg Stewart, president of the Canadian Chiropractic Association responded by saying, "It's a move I think they should reconsider."  He went on to say, "Boys who are aged nine, they don't have the skill development to take a proper hit or to give one. They don't have the stability, they don't have the balance in the skates and they definitely don't have the muscular strength. There's more to it than the catastrophic injuries," he said. "Tissue injuries at that age can lead to longer-term consequences."

The article on this debate appeared in the Canadian Press of Wednesday, January 29, 2003.  The article noted that bone formation does not begin to mature until a child reaches puberty, Stewart explained, and injuries to immature bone structures in young players can cause deviations in bone development.

The Canadian Hockey Association based its decision on a study out of Lakehead University which compared injuries in a group of children that was allowed to bodycheck to a group that was not. The study concluded introducing bodychecking at the age of nine to twelve didn't significantly increase the risk of injuries to players.  The Canadian Chiropractic Association recently criticized the Lakehead study's methodology, saying it was flawed and actually proved the reverse, that there were more injuries.  "We're not actually jumping on anyone else's bandwagon," said Dr. Stewart. "We're looking at it from a profession that treats all ages and we want young boys to develop into healthy young men.

 

Surgical Tools Left in 1,500 Patients Per YearImage: Surgical Tools

A study done by researchers at Brigham and Women’s Hospital and Harvard School of Public Health, in Boston was published in the January 16, 2003 New England Journal of Medicine reported on the high number of surgical tools left inside patients during surgery.

The study on medical mistakes found that operating room teams around the country leave sponges, clamps and other tools inside about 1,500 patients every year, largely because of stress from emergencies or complications discovered during surgery.  The researchers checked insurance records from about 800,000 operations in Massachusetts for 16 years ending in 2001. They counted 61 forgotten pieces of surgical equipment in 54 patients.  From that, they calculated a national estimate of 1,500 cases yearly. A total of $3 million was paid out in the Massachusetts cases, mostly in settlements.

The study showed that two-thirds of the mistakes happened even though the equipment was counted before and after the procedure, in keeping with the standard practice.  It also claimed that these types of mistakes happen more often to fat patients, simply because there is more room inside them to lose equipment.

Most lost objects were sponges, but also included were metal clamps and electrodes. In two cases, 11-inch retractors, metal strips used to hold back tissue, were forgotten inside patients. The study found that emergency operations are nine times more likely to lead to such mistakes, and operating-room complications requiring a change in procedure are four times more likely.  The lost objects were usually lodged around the abdomen or hips but sometimes in the chest, vagina or other cavities. They often caused tears, obstructions or infections. One patient died of complications.

Dr. Sidney Wolfe, health research director of the public-interest lobby group Public Citizen, said the real number of lost instruments may be even higher, because hospitals are not required to report such mistakes to public agencies. Dr. Kaveh Shojania, author of a 2001 federal study on medical mistakes, summed the report up by saying, "Something has to be done about this. It's just a very tough balance to decide."

 

Antibiotics To Bear New Warnings

Antibiotics soon will bear a big new warning that overusing them makes them less effective.  From the February 6, 2003 release of the Associated Press Health News, comes the news that antibiotics will soon carry a new warning message mandated by the US Food and Drug Administration.

The new action was prompted because it has long been known that antibiotics have been drastically overused.  According to the AP story, the new warning says that doctors must be sure a patient is suffering a bacterial infection, not a virus with similar symptoms, before prescribing antibiotics.  The article notes that all too often, doctors prescribe antibiotics for children with earaches caused by viruses, or for adults with colds or viral coughs.

Antibiotics have no effect on viruses; they only fight bacteria. However, the US government estimates that half of the 100 million antibiotic prescriptions written in physician offices each year are unnecessary. 

One of the reasons that the FDA action has become so important is that bacteria are growing increasingly resistant to antibiotics. Many common infections no longer are treatable with old standbys like penicillin, and some have become untreatable by every antibiotic on the market. Anytime antibiotics are used, survivor germs can emerge stronger and spread. It is the overuse of antibiotics that has lead to the increased resistance by bacteria.

The FDA proposed the new warnings two years ago. They will go into effect Feb. 6, 2004. Unfortunately, the warnings would be only on the drugs' official label, and the AP story reports that very few doctors read drug labels. Because of this the FDA is working on additional ways to spread their concern over the use of antibiotics, including future ads aimed at consumers.

 

Move Toward Chiropractic is Consumer-Driven

From the November 18, 2002 issue of New York Magazine comes a feature article about many famous New Yorkers receiving chiropractic care.  The article starts off by dropping the names of famous people who depend on chiropractic care.  Those names include the likes of Henry and Nancy Kissinger, Ralph and Ricky Lauren, and Oscar de la Renta. 

De la Renta recounts his story for the article, "I had back surgery a year and a half ago, but after the surgery, I was in a car accident and had whiplash and horrible pain in my elbows and arms.  The doctor said I would need another surgery on my cervical vertebrae, and I have to tell you, I went to my chiropractor every day for six weeks and not only did I not have to have the surgery, I have never again had any pain."

In the article, Woodson Merrell, executive director of the Continuum Center for Health and Healing states, "A lot of patients are really ticked off with medicine right now.  They want nothing to do with conventional therapy."  The Continuum Center for Health and Healing is a lower Fifth Avenue outpost of Beth Israel Medical Center, offering chiropractic, acupuncture, and aromatherapy along with their standard services of pediatrics, gynecology, and internal medicine.

Playwright Warren Leight, whose play Side Man won the Tony in 1999, is another advocate of chiropractic care.  He related his story in the article when he stated, "I was sent to the chiropractor by a friend who had migraines. I was skeptical, but I'm a writer. I'm skeptical of everything. I thought I'd give it a try because the painkillers were a drag. It had not occurred to me that you could go to someone who would run her hand down your spine and know where it's hurting. She always knows where it hurts. I go to my chiropractor like an 80-year-old and come out like a 45-year-old. I also haven't gotten as sick as often since seeing her," Leight adds, saying of his visits with her, "It seems to re-center your body's immune system."

 

More Kids Receiving Psychiatric Drugs

In the January 14, 2003 issue of the Washington Post is a news story that reported the results of a study done at the University of Maryland in Baltimore on the drastic increase in psychiatric drug use in children.  The study, which evaluated 900,000 children on Medicaid in a Midwest state, showed that more than 6 percent of children were taking drugs such as Prozac, Ritalin and Risperdal.

This means that the number of American children being treated with psychiatric drugs has grown sharply in the past 15 years, tripling from 1987 to 1996 with no sign of slowing.  The authors of the study said they fear that cost-saving techniques by insurance companies, marketing by the pharmaceutical industry and increased demands on parents and doctors may be driving the increase.

In response to the study, Michael Jellinek, chief of child psychiatry at Massachusetts General Hospital, said, "There are fewer options other than medication."  He noted that insurers have increased their profits by decreasing the use of psychotherapy, which is more expensive than drugs in the short term. He continued, "The insurance system gave an incentive for medications and a disincentive for therapy."

Julie Zito, lead author and researcher at the University of Maryland, points out, "Other than zonking you, we don't know that behavioral management by drug control is the way to learn to behave properly. If we are using drugs to control behavior, that doesn't change the underlying problem if someone doesn't know how to get along with their peers."

"The medicine may help the symptoms but not address issues of self-esteem, interpersonal relationships and family relationships, all of which are part of recovery," said Jellinek, who analyzed Zito's study. He continued, "You can get a lot of benefit from behavioral treatments. If someone is getting medicines for obsessive-compulsive disorder, I would like to see them be given a trial of behavioral therapy to see if that helps them and maybe decrease the medication."

 

Smallpox Vaccine Risky Even for Those Who Don't Get It

The January 19, 2003 issue of the Seattle Times adds more controversy and fire to the debate on the idea of performing mass smallpox vaccinations in response to the threat of a terrorist attack.  The article starts off by stating, "More than 800,000 people in Washington state — about one in seven residents — could risk a severe reaction from close contact with a person recently vaccinated against smallpox, combined estimates from health authorities and state officials indicate.

The article says that the authorities define severe reactions as ranging from a painful, widespread rash to death.  In explaining the process the article states that the smallpox vaccine is not given as a regular shot; instead, it is inserted into layers of the skin with repeated pricks of a small needle. The vaccination site is then kept covered until it heals. Direct skin contact with secretions from vaccination wounds could set off the complications. These contacts include touching bedding, towels or clothing thus spreading the secretions.

These secretions contain live vaccinia virus, a cousin of the smallpox virus which supposedly tricks healthy immune systems into building a smallpox defense. The vaccinia virus is the active component of the smallpox vaccine. These vaccination sites are contagious for about three weeks, until the scab falls off. The problem is then that those who are vulnerable can contract severe "vaccinia," which is caused by this virus.  Additionally, secretions that touch healthy people could cause a rash that, if it gets into the eye, could cause permanent damage.

Judith Billings, chair of the Washington State Governor's Advisory Council on HIV/AIDS says, "We do not want to discourage people from getting health care because they are scared (of vaccinated healthcare workers)   But we want them to know there are risks and that they should take the appropriate actions."

The article stated that there are groups of people who would be more at risk from contact with people who have been vaccinated.  These groups include anyone who has had eczema or atopic dermatitis, or anyone who has had one of many other types of skin disorders.  Additionally at risk are pregnant women, infants under age 1, people with HIV, cancer patients, patients who have had organ transplants, and the elderly.

 

Study Touts Benefits of Chiropractic Care for Kids With Low Back Pain

Published in the January 2003 issue of the peer-reviewed periodical, Journal of Manipulative and Physiological Therapeutics (JMPT), is the results of a study on lower back pain in children.  The journal article starts off by noting that about 50% of children suffer from lower back pain at one time or another.  It also notes that about 15% of children experience frequent or continual pain.

The study was conducted on 54 children between the ages of 4 and 18 in  the cities of Calgary, Alberta, and Toronto, Ontario, Canada.  In the study the children with lower back pain received chiropractic care from a variety of volunteer chiropractors in Canada.  The children were tracked regularly during the study to monitor their progress. Results were obtained in several ways including responses from the patients themselves on how they felt their progress was coming. 

Results of the study showed improvement over the follow-up period was observed in 46% to 92% of the children for various criteria. In a period of 30 days 82% of the children reported that they were "much improved."

The researchers conclusions were, "Patients responded favorably to chiropractic management, and there were no reported complications."

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