Another Reason to Communicate With Your Doctor

What's your relationship with your health care provider? Do you talk about your health problems openly and honestly, or do you keep most of your opinions and feelings inside - perhaps out of fear that your doctor "won't listen" or "won't understand"?

Communication is the key to optimizing treatment, say Swiss researchers after conducting a controlled clinical trial on rheumatoid arthritis (RA) sufferers. Findings suggest that feedback sessions should be held on a monthly basis between patients and their doctors, due to the changing patterns of RA and the uniqueness of its effect on each patient. The trial, which included 228 patients and 48 rheumatologists, used a rheumatoid arthritis disease activity index (RADAI) questionnaire. Patients who saw the largest advantage of feedback were those with "high disease activity," with a reduction of more than three points in their RADAI scores.

While the stats indicate success through patient-to-doctor updates, they echo a common complaint among health care administrators: "Tell us what's wrong - on an ongoing basis."

The doctor-patient relationship is one of the keys to making sure you stay healthy, and if you have an illness or disease that requires constant assessment, it's an even more important tool to get you back on the road to health. If you don't feel comfortable talking to your doctor - or if you don't think your doctor is comfortable or interested in talking/listening to you - try to open the communication lines, or find another doctor. Your health is that important.

Reference: Fransen J, Stucki G, Twisk J, et al. Effectiveness of a measurement feedback system on outcome in rheumatoid arthritis: a controlled clinical trial. Annals of the Rheumatic Diseases July 2003: Volume 62, pp.624 - 629.

To learn more about chiropractic click here.

Rupture Risks Rise With Antibiotics?

A warning to elderly patients currently taking "quinolones": You may be at a higher risk of suffering an Achilles tendon rupture, and the risk may grow exponentially with age.

What are quinolones, you ask? They're a group of commonly used antibiotics you probably know best by some of their brand names: Cipro, Floxin and Noroxin. A recent study conducted by researchers from the Netherlands compared antibiotic use among 1,367 patients with Achilles tendon rupture and 50,000 people without rupture. Patients in their 60s and 70s who used quinolones had a six times greater risk sustaining a rupture than nonusers, and patients in their 80s and 90s were 20 times more likely to suffer a rupture.

Of the top three antibiotics associated with Achilles tendon rupture, Floxin led, followed by Noroxin and Cipro. Patients using oral steroid drugs were even more likely to sustain a rupture than those using quinolones.

Admittedly, only 4 percent of Achilles tendon ruptures are related to quinolones, but the researchers are quick to admonish doctors of their risks and suggest prescribing alternative antibiotics. Older patients are also recommended to consult their doctors, especially those suffering from potentially serious orthopedic injuries (usually requiring surgery).

More importantly, this is yet another example of the well-documented potential side-effects of various prescription and over-the-counter medications. Always talk to your doctor about the risks and benefits before starting any medication, and don't be afraid to inquire about the possible nonpharmaceutical options for managing your condition.

For more information on the dangers of drugs click here.

Reference: Van der Linden P, Sturkenboom MCJM, Herings RMC, et al. Increased risk of Achilles tendon rupture with quinolone antibacterial use, especially in elderly patients taking oral corticosteroids. Archives of Internal Medicine 2003: Volume163, pp.1801-1807.

Fatty Foods May Put More Than Women's Waistlines at Risk

Several studies have shown that women who consume fatty foods may increase their risk of developing breast cancer, although most of these studies involved postmenopausal women. Now (perhaps for the first time), a study appears to correlate diet with breast cancer risk in younger women who have not yet reached menopause - and perhaps more significantly, it suggests that eating specific types of fatty foods may increase your risk of developing this frightening disease.

The results of an eight-year study of more than 90,000 premenopausal women were reported recently in the Journal of the National Cancer Institute (JNCI). Participants in the Nurses' Health Study II were administered two health questionnaires over a five-year period that asked about how often they ate fatty foods; 714 developed breast cancer over eight years. The study's lead author, Dr. Eunyoung Cho, of Boston's Harvard Medical School, noted the majority of the subjects were premenopausal at the time of diagnosis.

Even more intriguing was the observation that the quality, rather than the quantity of foods consumed seemed to account for the increased risk. Consumption of animal fats (e.g., red meat and/or high-fat dairy products) appeared to increase the risk for developing breast cancer, whereas consumption of vegetable fats did not.

Although animal fats are thought to have an effect on hormones that can promote breast cancer, there is speculation that a chemical unique to animal fats is responsible for the increase, according to the researchers. Ask your chiropractor about the essentials of a sensible diet and exercise program that will keep you healthy, whatever your age.

To learn more about women's health click here.

Reference: Cho E, Spiegelman D, Hunter DJ, Chen WY, et al. Premenopausal fat intake and risk of breast cancer. Journal of the National Cancer Institute July 2003: Volume 95, Number 14, pp.1079-1085.

Figuring Out Fibromyalgia

Fibromyalgia is one of the most baffling illnesses on the planet. Characterized by chronic fatigue and widespread soft-tissue and muscle pain and tenderness, fibromyalgia has only been recognized as a medical disorder since the 1980s. While the cause of fibromyalgia remains unclear, scientists at Georgetown University may have found a link between the disease and another condition: sinusitis, an inflammation of the membranes that line the nose and sinus cavities.

In a study published in the Archives on Internal Medicine, researchers surveyed 297 patients age 40 or younger. While undergoing a general medical exam, they were asked questions about fatigue, body pain and symptoms typical of a sinus infection. Approximately 22 percent of the patients complained of unexplained chronic fatigue; 11 percent complained of unexplained chronic pain; and 9 percent reported both. These patients were 10 times more likely than other patients to have symptoms associated with sinusitis.

Sinus symptoms were more common among patients with unexplained fatigue than fatigue caused by mental or physical illness, suggesting a link between sinus problems and unexplained fatigue. In addition, most of the patients who met the criteria for chronic fatigue syndrome reported having sinus problems.

The results of this study suggest that while treating the sinuses won't cure fibromyalgia, there's a chance it may relieve some of the pain and fatigue associated with the condition. Your doctor of chiropractic can advise you of the treatments available for sinusitis, and also suggest ways to relieve muscle pain, improve sleep quality and increase energy.

Reference: Chester AC. Symptoms of rhinosinusitis in patients with unexplained chronic fatigue or bodily pain. Archives of Internal Medicine, Aug. 11, 2003: Volume. 163, Number 15, pp.1832-1836.

Try Exercise Instead of Surgery for Back Pain

While it's true that some back problems are so severe that they warrant surgical attention, the disturbing trend in medicine these days is to put patients under the knife, rather than investigate possible nonsurgical options.

Disc degeneration often necessitates a surgical procedure called "lumbar fusion," but as a new study shows, exercise combined with cognitive therapy (telling patients physical activity will not harm the back, and recommending exercise) may be just as effective - and without any of the risks associated with surgery.

In the study, patients with low back pain (LBP) lasting one year or longer, and evidence of disc degeneration on X-ray, were randomly selected to receive surgical fusion or cognitive intervention and exercise. At a one-year follow-up, improvements in back pain, use of analgesics, emotional distress, life satisfaction, and return to work were essentially the same in both groups. More significantly, according to the researchers, the "success rate" after one year was 70 percent in the surgical fusion group, compared to 76 percent in the nonsurgical group!

Do you suffer from back pain? If you do, it deserves the attention of a health care professional. Your chiropractor can evaluate your condition and determine the appropriate course of care.

For more information on the benefits of exercise click here

Reference: Brox JI, Sorensen R, Friis A, et al. Randomized clinical trial of lumbar instrumented fusion and cognitive intervention and exercises in patients with chronic low back pain and disc degeneration. Spine, Sept. 1, 2003:28(17), pp1913-21.

Don't Be So Hard on Yourself

Low back pain (LBP) sufferers know how frustrating it can be to sleep at night; no matter what position you try, the pain seems to move right with you. What they might not be aware of is how one type of mattress can affect LBP more than another.

A recent study published in the Lancet challenges the popular belief that a firm mattress is the best sleeping arrangement for easing the discomfort of LBP. Researchers compared firm mattresses with medium-firm mattresses by replacing the existing mattresses of 313 test subjects, who were unaware of which type of mattress they were receiving.

Users of medium-firm mattresses were twice as likely to report reduced LBP and associated disability (less pain in bed, during the day, and after a night's sleep) after three months of use, compared with those who used firm mattresses.

If you're struggling with LBP, the solution may be as close as the bed you're lying on! Talk to your chiropractor about the cause of your pain, and what can be done about it. A combination of chiropractic care in the office, and an appropriate mattress at home, may be just what's needed to get you on the fast road to recovery.

For more information on back pain click here.

Reference: Kovacs FM, Abraira V, Pena A, et al. Effect of firmness of mattress on chronic, non-specific low-back pain: randomized, double-blind, controlled, multicentre trial. Lancet, Nov. 15, 2003:362, 9396, pp1599-1604.

Vitamin C Keeps the Stomach Smiling

Do you know that ascorbic acid can help prevent stomach problems, including peptic ulcers and stomach cancer? OK, OK, first things first: Do you know what ascorbic acid is? It's vitamin C!

Chronic infection with a specific strain of the Heliobacter Pylori bacteria has been linked to the abovementioned gastric problems, but a study that appeared in the Journal of the American College of Nutrition suggests that vitamin C can reduce the risk of infection. In Caucasian men and women, levels of ascorbic acid in the bloodstream were inversely related to the risk of infection with H. Pylori: the more vitamin C in the blood, the less risk of being infected. This association was not significant for men and women of other races.

So, now that you know what ascorbic acid is, and that it can prevent gastrointestinal problems, here's the final question: Where do you find vitamin C? Well, good sources include citrus fruits (oranges, grapefruit, lemons, mangos, etc.), asparagus, broccoli, spinach, green peppers, tomatoes, potatoes and cabbage.

Your chiropractor can tell you more about the importance of a healthy diet that includes adequate amounts of vitamin C and all of the other essential vitamins to keep you - and your stomach - healthy and smiling.

To learn more about vitamins and minerals click here.

Reference: Simon JA, Hudes ES, Perez-Perez G. Relation of serum ascorbic acid to helicobacter pylori serology in U.S. adults: the Third National Health and Nutrition Examination Survey. Journal of the American College of Nutrition 2003:22(4), pp283-9.

To Err Is Human, to Forgive Is ... Good for Your Health

Eighteenth-century English poet and essayist Alexander Pope is credited with saying, "To err is human, to forgive, divine." Nearly 200 years later, researchers at the University of Tennessee in Knoxville believe forgiveness may not only be divine, but a good way to stay healthy.

The survey of 108 college students gathered data on specific situations in which they had felt betrayed, and whether the students seemed to have forgiving personalities ("trait" forgiveness) and how recalling the situation affected them during the interview ("state" forgiveness). During the interviews, the researchers monitored students' vital signs, including blood pressure and heart rate.

Trait forgiveness was associated with lower blood pressure readings, while state forgiveness was associated with lower blood pressure and heart rate. Additionally, signs of sympathetic nervous system arousal (e.g., the stress response) that elevated when betrayal events were brought up also seemed to return to normal faster in students deemed "forgiving types."

Think of the ability to forgive as the ability to reduce stress in your life. We all know how debilitating stress can be, particularly in the long-term; in fact, considerable research shows that stress can contribute to chronic diseases such as cancer and heart disease. So don't hold a grudge - it's bad for your health!

To learn more about stress relief click here.

Reference: Lawler KA, Younger JW, Piferi RL, et al. A change of heart: cardiovascular correlates of forgiveness in response to cardiovascular fitness. Journal of Behavioral Medicine October 2003:26(5), pp373-93.

Back and Neck Pain: Heavy Burdens

You duck into your car and rush to work: neck and back pain come along for the ride. You sit at the computer all day: neck and back pain sit right there with you. You drive home from work: neck and back pain distract you all the way. You crawl into bed for what you hope will be a good night's sleep: there's neck and back pain again.

Why don't neck and back pain seem to go away? According to a study published in the June 1, 2003 issue of Spine, neck and back pain may be your constant companions because of something else that's with you all the time: excess weight. Nearly 6,000 adult patients from three general practices completed a questionnaire that asked about the existence and severity of spinal pain (neck and/or back) in the previous month. Results showed that nearly one in three (29 percent) reported pain, of which approximately half was chronic, 40 percent was disabling, and 20 percent was intense, chronic and disabling. An independent association between neck and/or back pain and high body mass index (BMI) was demonstrated, even when considering other potential influences.

Are back and neck pain weighing you down? Treating spinal pain depends on the cause, which may or may not be those excess pounds you're carrying around. But one thing's for certain: Doctors of chiropractic are the experts when it comes to helping patients get rid of those two annoying companions that can make your life miserable.

To locate a chiropractor near you click here.

Reference: Webb R, Brammah T, Lunt M, et al. Prevalence and predictors of intense, chronic, and disabling neck and back pain in the UK general population. Spine, June 1, 2003:28(11), pp1195-1202.

Just Do It!

There's no getting around the benefits of consistent exercise, especially when it comes to disease prevention. The risk of developing diabetes, heart disease, high blood pressure, or one of a number of types of cancer goes down as your physical activity goes up.

But how much exercise is enough? According to several studies, the latest of which was published in the Sept. 10, 2003 issue of the Journal of the American Medical Association, it's not necessarily how intensely or how long you work out, but that - to borrow a line from Nike's famous commercials - you "just do it."

In the study, 201 sedentary women (reporting exercising less than 20 minutes per day for fewer than three days per week in the previous six months) were assigned to one of four exercise groups: vigorous intensity/high duration; moderate intensity/high duration; moderate intensity/moderate duration; or vigorous intensity/moderate duration. All women were instructed to reduce daily energy intake to 1,200-1,500 calories and limit dietary fat to 20-30 percent of total energy intake.

Results: After 12 months, significant weight loss and cardiorespiratory fitness were achieved by women in all four groups, with no significant differences between groups. In other words, longer and more strenuous workouts weren't particularly more effective than shorter workouts of moderate intensity.

As these results show, you may not need to slave away in the gym for hours to lose weight. What's most important is that you (and your chiropractor) develop a sensible, consistent exercise program. And of course, the hardest part is up to you: sticking to it!

For more information on the many benefits of exercise and fitness click here.

Reference: Jakicic JM, Marcus BH, Gallagher KI, et al. Effect of exercise duration and intensity on weight loss in overweight, sedentary women: a randomized trial. Journal of the American Medical Association, Sept. 10, 2003:290(10), pp1323-30.

A Multivitamin a Day Keeps Birth Defects Away

As if diabetes isn't challenging enough, evidence suggests that pregnant women who suffer from the condition also have an increased chance that their children will be born with birth defects. However, there is hope: A recent study provides evidence that multivitamin supplementation can help prevent birth defects.

In the study, researchers obtained information on maternal diabetes and multivitamin use from the mothers of 3,278 babies born with diabetes-associated birth defects, and 3,029 infants with no defects. Mothers were asked if they had taken multivitamin supplements at any time in the three months prior to conception, through the first three months of pregnancy. Based on their responses, the mothers were divided into four categories: nonusers; users during the six-month period; users at other times; and unknown.

Data analysis indicated that while infants of mothers with diabetes were at increased risk for suffering birth defects, this risk was limit to the infants of diabetic mothers who reported no multivitamin supplementation in the three months before pregnancy or the first three months of pregnancy.

If you're planning to have a child, or are already pregnant, it's important to schedule regular visits with your doctor. Diet and exercise modifications are just a few of the many considerations that will help ensure a smooth pregnancy. You and your child deserve nothing less.

And if you're not convinced by the results of this single study, bear in mind that ample evidence links multivitamin supplementation (particularly supplementation with folic acid) to a reduced risk of infant birth defects.

To read summaries of the previous research click here.

Reference: Correa A, Botto L, Liu Y, et al. Do multivitamin supplements attenuate the risk for diabetes-associated birth defects? Pediatrics May 2003:111(5), pp1146-51.

How About a Nice Game of Chess?

Worried that growing older will affect your mental awareness? Worry no more! Keeping your wits in tact throughout middle age and into your senior years may require nothing more than playing cards, reading a book or doing a crossword puzzle, according to a study that appeared in the Journal of Epidemiology and Community Health.

In the study, 5,000 people ages of 35-55 were tested for their mathematical, vocabulary and short-term memory capabilities to assess levels of mental acuity. Participants with higher mental functioning were also more involved in leisure activities; moreover, participants who engaged in leisure activities were more likely to meet others who spent more time engaging in intellectual pursuits.

From the study, researchers concluded that people can help keep their minds sharp by taking up a hobby or participating in extracurricular social activities, including taking classes, volunteering or visiting cultural centers, such as art museums.

Why not start improving your mental ability by taking up a new activity? You'll not only stay on the ball, you'll probably make some new friends, too.

For more information on senior health click here

Reference: Manoux-Singh A, Richards M, Marmot M. Leisure activities and cognitive function in middle age; evidence from the Whitehall II study. Journal of Epidemiology and Community Health. (2003):57, pp 907-913.