June 2003 Issue
In this issue:
Bill Passes US Congress That Shortens Timeline for Implementation of Chiropractic Program in the U.S. Armed Forces
On May 22, 2003 the U.S. House of Representatives passed legislation that included a provision to step up the timeframe of the new chiropractic benefit in the Department of Defense health care system. This means that, if implemented, chiropractic care will be available to the US armed forces sooner than originally planned. The bill has gone to the Senate and is in the process of negotiations between the two houses.
This bill with the accelerated timetable is aimed at full implementation of the chiropractic program by Oct. 1, 2005. Just prior to the bill's passage, the chairman of the House Armed Services Committee, Rep. Duncan Hunter (R-CA), and the chairman of the Total Force Subcommittee, Rep. John McHugh (R-NY), wrote to every member of Congress to urge support for passage of the accelerated bill. In their joint statement they said, "HR 1588 (the bill) presents an array of initiatives that improves the quality of the world wide health care benefit for the men and women of our armed forces (whether active, National Guard or Reserve) for their families and for retirees and their families."
There are still many hurdles and steps that have to be overcome for this benefit to be enacted. There are forces within the military bureaucracy that are opposed to the inclusion of chiropractic in the military. However, with the benefit of having pilot studies that show the cost effectiveness of chiropractic, (click here for that story) and with the ongoing demand for chiropractic from military personnel, it is inevitable that chiropractic will eventually be fully included in care to the military.
US Congress Passes Ban on Forcing Kids' Medication
The Associated Press reported on May 22, 2003 that the US Congress voted to prohibit schools from making children with behavioral problems take medication in order to attend class. According to this bill which passed 425-1, states receiving federal education money must make sure schools do not coerce parents into medicating their children.
Representative Max Burns of Georgia, who sponsored the legislation stated, "School personnel may have good intentions, but parents should never be required to decide between their child's education and keeping them off potentially harmful drugs." House Speaker Dennis Hastert of Illinois, a former schoolteacher, said he sympathizes with the need for orderly classrooms but said, "School personnel should never presume to know the medication needs of a child."
The bill, called the Child Medication Safety Act, provides for a congressional investigation into the use of psychotropic medication in schools. The bill was initiated because of reports that parents were being pressured to place their children on psychotropic drugs if it was interpreted that their child was disruptive or may show signs of hyperactivity. Testifying before a House panel in May, Dr. William B. Carey, director of behavioral pediatrics at Childrenís Hospital of Philadelphia, asked, ďWhy is eighty percent of the worldís methylphenidate being fed to American children?Ē As Dr. Carey noted in his testimony, "These drugs have the potential for serious harm and abuse. They are listed on Schedule II of the Controlled Substances Act. They can lead to 'severe psychological or physical dependence'."
Chiropractic Helps Race Horses
From the May 29, 2003 issues of the Daily Racing Forum and the Johnson County Sun, comes a story of how a top level race horse, "Ten Most Wanted" was helped by chiropractic. The story reports that the day after the Kentucky Derby, he had been bumped sharply leaving the gate, putting his back out of alignment. "He wouldn't jog," his trainer, Wally Dollase, remembered. "He had displaced his back about a half an inch."
Dr. Herb Warren, a veterinarian who worked on Ten Most Wanted said, "There was severe pressure on his spinal cord. His back was out of whack. He didn't want to move behind." This is where the chiropractor Dr. Dave Hand came in. Dr. Hand is a former trainer who for more than a decade has been sought out by some of the top trainers to work on their horses. During the week leading up to the Derby, Hand did adjustments on four horses - Atswhatimtalknbout, Scrimshaw, Ten Cents a Shine, and Ten Most Wanted. Hand worked on Touch Gold prior to his victory in the 1997 Belmont Stakes, but his most consistent client has been Dollase, for whom Hand has treated the likes of Grade 1 stakes winners Deputy Commander, Jewel Princess, and Windsharp.
"He's good at what he does," trainer Wally Dollase said. "I call him in if I think a horse needs him. He puts a horse back in place with his own arms. He adjusts the back to where it's normal." According to Dollase, "He is moving fine now, and Ten Most Wanted is scheduled to run in the June 7 Belmont Stakes. One of the reasons he will be there is the long-term care he has received from an equine chiropractor"
The Daily Racing Forum article was written before the running of the Belmont stakes. The chiropractic care that Ten Most Wanted received must have been effective as the horse finished second in the Belmont Stakes.
Doctors Urged to Delay Kids' Earache Drugs
The above headline comes from the June 6, 2003 edition of the Atlanta Journal Constitution (AJC). The article starts off by saying, "Doctors are being advised to withhold antibiotics for two to three days for many children with earaches in an effort to curb the growing problem of antibiotic resistance." The Academy of Pediatrics is planning on initiating a campaign called, "watchful waiting" this fall in response to the growing problem.
According to the AJC article, about 10 million prescriptions for antibiotics are written every year for kids with ear infections. This number represents nearly half of all antibiotics used among preschoolers. However the article notes that 81 percent of the ear problems go away without medication, according to the U.S. Agency for Healthcare Research and Quality, a division of the Department of Health and Human Services. (see article here)
Dr. Richard Rosenfeld, a pediatric ear, nose and throat specialist at Long Island College Hospital in Brooklyn, says, "You're not getting a lot of bang for your antibiotic buck with this disease." Dr. Rosenfeld spoke at a Centers for Disease Control and Prevention conference in Atlanta and is helping the Academy of Pediatrics finalize its guidelines. Those new guidelines tell pediatricians and family physicians to hold off on antibiotics for children older than 6 months if doctors aren't sure of a true ear infection. The new guidelines also suggest that antibiotics should be given for just five days, instead of seven to 10 days, for children older than 2.
The AJC article also noted that many earaches are viral and don't involve fluid in the middle ear, a sign of infection. Nearly 20 percent of true ear infections are caused by viruses for which antibiotics don't work. Dr. Gerald Reisman, with Dunwoody Pediatrics in Atlanta noted, "It may take a while for parents to accept the new approach away from routinely using antibiotics to treat their children. Parents often have the expectation that their child is sick and needs an antibiotic to get well, and some really put the pressure on," he said. "But now we can say, 'It's not just me. It's the CDC and the Academy of Pediatrics.' "
Dr. Rich Bessler, a CDC infectious disease specialist, noted that other countries in Europe have successfully implemented campaigns to delay antibiotic use for earaches. Dr. Rosenfeld closed the article by suggesting that parents need to realize that an earache, even though sometimes painful, is almost always harmless.
Clinical Case Study: Chiropractic Care of a Patient with Vertebral Subluxation and Bellís Palsy
In the May 2003 issue of the peer reviewed scientific publication, Journal of Manipulative and Physiological Therapeutics, is a case study report of a patient with Bells Palsy and the response with chiropractic care. Bellís palsy is a common condition that results in weakness or total paralysis of one half of the face. Bellís palsy affects men and women equally and may occur at any age and at any time of year. Symptoms begin to occur over a short period of time and full weakness of the face usually occurs after two to five days. Early symptoms may include pain in or behind the ear. This is followed by a rapidly worsening weakness of one half of the face. It becomes difficult to close one eye completely, and one corner of the mouth on the same side begins to droop.
The case report involved a 49-year-old woman with a medical diagnosis of Bellís palsy. Her symptoms included right facial paralysis, extreme sensitivity to sound, pain in the right TMJ joint, and neck pain. This patient had not responded to previous Dental or Medical care. She then decided to initiate chiropractic care. The study noted that chiropractic adjustments were initiated. The study also noted that after 20 visits, the patient began to show substantial improvement, such that her facial pain abated and she could close her right eye lightly, smile, move her eyebrows, and puff her cheeks.
The articles conclusions were, "There are indications that patients suffering from Bellís palsy may benefit from a holistic chiropractic approach that not only includes a focus of examination and care of the primary regional areas of complaint (eg, face, TMJ) but also potentially from significant vertebral subluxation concomitants."
Drug Advertisement Ban Upheld in Europe
In October of 2002 the European Parliament voted against plans to allow pharmaceutical companies to advertise or provide information on drugs directly to patients with certain conditions. Catherine Stihler, Labour's health spokesman in the European Parliament, said: "We don't want consumers sitting on their couches bombarded with a hard sell from big drug companies in the advertising break."
A challenge to that ruling was upheld by the European Union's Council of Ministers in a ruling that upheld the restrictions. In effect drug companies will not be able to advertise prescription medicines direct to the public. The latest reports appeared in the June 3, 2003 BBC News World Report.
The BBC article noted that consumer organizations welcomed the continuation of the ban on "direct to consumer" advertising. Jackie Glatter, spokeswoman for the Consumers' Association, said: "What patients need is high quality, independent, comparative information on medicines so that they are able to make informed choices about their health care." A report published earlier in 2002 suggested that the pharmaceutical industry is incapable of providing impartial information on its medicines and that such information should only come from independent sources.
"Today's decision sends a clear message to the pharmaceutical industry that drug promotion is not the same as good quality information." Glatter said: "The government now needs to take steps to significantly improve patient information. It must also prevent further industry attempts to circumvent the ban." The Consumers' Association also suggested advertising may lead to over-prescribing of expensive and heavily advertised drugs and the under-use of cheaper, more effective drugs.
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