Smoking and Men’s Health

The statistics on the harm smoking does keep rolling in:

  • Smoking causes more deaths annually in the USA than HIV, illegal drug use, alcohol use, motor vehicle injuries and firearm-related incidents, combined.
  • More than 10 times as many US citizens have died from smoking than have died in all the wars fought by the USA and 8 out of 10 COPD (chronic obstructive pulmonary disease) cases are caused by smoking.
  • Male smokers are 25 times more likely to develop lung cancer than non-smoking populations.
  • Cigarette smoking causes most cases of lung cancer in the US. If nobody smoked, it’s estimated that one of every three cancer deaths in the USA would not happen.
  • Smoking affects men’s sperm count, reducing fertility, while secondhand smoke increases incidence of birth defects and miscarriage.
  • Smoking affects hormonal balance, including testosterone and can decrease sexual desire and cause impotence. Male smokers have a higher risk of developing erectile dysfunction than any other population.

IH providers are encouraged to ask questions about smoking on intake forms. Ask patients if they smoke, how long, the quantity, and are they interested in quitting? If they say no, simply offer medical facts. If patients say, ‘yes’, offer advice on how to quit. The CDC has an excellent fact sheet at https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm and the NCCIH has integrative healthcare resources for persons who wish to quit smoking at https://nccih.nih.gov/health/tips/smoking?nav=govd


The CHP Group Announces Results from 2017 Patient Satisfaction Survey

Integrative Healthcare Leader Sees Increase in Patient Satisfaction and Achieving Triple Aim Goals While Driving Down Opioid Usage

Click here to download 2017 CHP Patient Satisfaction Survey Brief

Portland, OR. June 12, 2017: Today, The CHP Group, the authority and partner of choice in integrative healthcare (IH), announced the results from its 2017 Patient Satisfaction Survey. This survey, which has been conducted since 2000, measures the overall satisfaction of patients with their IH providers utilizing standardized questions from the Consumer Assessment of Healthcare and Systems (CAHPS®) survey tool with an additional set of questions intended to assess changes in opioid usage and progress towards the triple aim of healthcare, i.e. better care, smarter spending, and healthier people.

“The CHP Patient Satisfaction Survey is an integral part of our Quality Management Program,” says Michell Hay, President and CEO of The CHP Group. “It affords us the opportunity to benchmark our network of chiropractors (DC), acupuncturists (LAc), naturopathic physicians (ND), and massage therapists (LMT) against other medical providers, such as family practice and orthopedics, and demonstrates that our focus on delivering accessible, high-quality IH solutions promotes patient health and well-being.”

In addition to higher overall patient satisfaction with provider rates (95% combined for CHP providers versus 82% for both family practice and orthopedics), CHP saw an increase in the 10-year average of the overall CAHPS ® score to 98%. “These scores have remained consistent over many years,” explained Steve Sebers, DC, FACO, Chief Clinical Officer at CHP. “These rates of approval demonstrate a high level of long-term patient satisfaction and confirm the value of CHP’s emphasis on provider education and patient access to a medically-necessary, evidence-based approach to integrative healthcare.”

With the addition of four extra questions, CHP was also able to evaluate the success of its high-quality network in engaging patients, improving health, reducing use of opioids, and lowering costs. Survey responses to the question about opioid usage shows that 92% of CHP patients always or usually saw a reduction in use of these medications. Similarly, 92% of patients asserted that treatment from a CHP provider always or usually drove down the use of other conventional medical care. “These are key clinical components,” continues Dr. Sebers, “in driving down addiction, increasing the overall health of patients, and containing the costs of healthcare.”


Integrative Healthcare Approaches for Hypertension

According to the National Center for Complementary and Integrative Health (NCCIH), there are a number of complementary health approaches that may help with hypertension (high blood pressure) as part of a lifestyle change program. Some of these involve mind and body practices including yoga, qi gong, biofeedback, and Transcendental Meditation. Others approaches include dietary supplements including cocoa, coenzyme Q10, garlic, and fish oil (omega-3 fatty acids); it’s important to note the evidence for dietary supplements for hypertension is very limited and sometimes conflicting.

For more information about the integrative healthcare approaches to hypertension, visit the NCCIH website at https://nccih.nih.gov/health/hypertension?nav=govd.


Is that “good” or “bad” exercise-related pain?

We’ve all been there – stiff knees after a long hike, or sore arms after a lifting session. But what can help determine if the pain felt after exercise is “good” (i.e., nothing to worry about) or “bad” (needs to be evaluated by a medical provider). How do providers guide patients when workouts have associated pain? Use the following as guidance when advising patients.

It’s “good” pain when:

  • The pain is gone in 48 hours.
  • The pain is bilateral.
  • The pain is a muscle burn or fatigue, not sharp.
  • The pain is superficial, not deep and located in a joint.
  • The pain is felt in the ‘targeted’ muscles. Example: Plank pose hurts the stomach muscles, not the low back, neck, wrist, elbow.
  • Clicking or popping in a joint without any pain. (Most of the time, movement helps chronically stiff joints.)

It’s “bad” pain when:

  • The pain is sharp.
  • The pain is felt deep in the joint.
  • The pain is felt only on one side.
  • Pain is felt with audible clicking and popping of a joint or tendon.
  • Pain is felt in areas not targeted by the exercise, for example, plank pose hurts the back, neck, elbow, wrist.

Detoxes & Cleanses – What to do when a patient inquires

There is no convincing evidence that detox programs remove toxins form your body or improve health. Detox programs cover a wide variety of suggestions including, but not limited to: fasting, taking only juice or liquids for days, eating restricted selections of foods, using dietary supplements, enemas, laxatives, colonics, or combinations of plans.

Here are some cautions to consider when patients ask about detox plans:

  • Unpasteurized juices have a potential to make people sick if harmful bacteria are present. This is especially dangerous for children, elderly and those with weakened immune systems.
  • Consuming large quantities of juice can be harmful to people with kidney disease or for patients who form kidney stones, if the juice is high in oxalate such as spinach, rhubarb, almonds, beets, raspberries and stevia sweeteners.
  • Use caution and coordinate care, when recommending fasting with any Diabetic patient. They have higher risk factors when attempting dramatic calorie changes.
  • Diets that dramatically restrict calorie intake will usually cause temporary weight loss. This weight loss is not long lasting.
  • Serious side effects are seen in people with a history of GI disease, colon surgery, kidney or heart disease.
  • Laxatives used in detox programs can cause diarrhea and dehydration. This can lead to serious electrolyte imbalances.
  • Fasting can cause headaches, fainting, weakness and dehydration. Patients should be warned of potential side effects.

Massage Therapy in Children with Asthma: A systematic Review and Meta-Analysis

A 2017 meta-analysis of five databases ranging from January 1, 1990 to December 13, 2016 were reviewed. The review included 14 researches with 1299 patients. Conclusions show massage therapy has a significantly positive effect on children with asthma, improving pulmonary function of large airways and reducing plasma concentrations of PAF (platelet activating factor) and prostoglandin, which are known bronchoconstrictors and edema inducers. The search showed a need for studies with less risk of bias and better methodology to further confirm effectiveness of massage treatments for asthma. Still, compared with the control group, there was remarkable improvement with respect to pulmonary function. The calming effect of massage may be worth discussing with parents of asthmatic children.


Chronic Pediatric Asthma and Chiropractic Spinal Manipulation

A 2002 Journal of Manipulative Physiology Therapy reported a pilot study of 36 patients, age 6-17 years of age, with persistent mild to moderate asthma, who received 20 spinal manipulative therapy sessions over three months. Spinal therapy was sham SMT or active SMT. Objective lung function tests and symptom questionnaire were administered at the 12-week mark. Subjects were asked to grade symptoms and use of bronchodilator. After three months subjects rated their quality of life improved by a reported 10-28%, a 20% reduction in bronchodilator use was reported, and activity scale showed the  most improvement by 50%-75%. Pulmonologist-rated improvement was small. Asthma severity ratings reduced by 39%. Benefits lasted through the 12-month follow-up.

Although this study is small, it should be noted the recorded changes remain significantly positive and allows for a hopeful prognosis. Providers should record pediatric asthma symptoms at each visit, using best practice measures on all changes related to activities of daily living. Further research may be needed to assess which components of the chiropractic encounter are responsible for patient improvements. Improved activity scales suggests chiropractic manipulative therapies may offer significant relief to pediatric asthma patients.


Aaaa-choo! Seasonal allergies are here

Spring has sprung and it’s time to sneeze again….achoo! Runny nose, where’s the tissue… it can be a miserable time of year for seasonal allergy sufferers.  The National Center for Complementary and Integrative Health (NCCIH) provides some information here https://nccih.nih.gov/health/allergies/seasonal?nav=govd on complementary health approaches to this common problem.  There are mind and body practices to consider as well as natural products that may help.

The ‘body’ approaches of note include acupuncture and rinsing the sinuses using a neti pot, nebulizers, or spray, pump, or squirt bottles. As a safety measure when using the sinus rinsing devices, it’s important to use sterile saline water or over-the-counter nasal rinsing products with sterile water. More information on how to rinse your sinuses safely is available here https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm316375.htm.

Of the natural products that are available for seasonal allergies, the herb butterbur may be helpful, probiotics and honey have been inconsistent, and there are a number of other products such as grape seed extract, omega-3 fatty acids, astragalus, capsaicin, Pycnogenol, quercetin, spirulina, stinging nettles, and tinospora/guduchi where the evidence is either inconsistent or too limited to demonstrate if these products are helpful.

Be aware that some supplements may interact with medications and other supplements can have side effects of their own.


Patterns and Perceived Benefits of Utilizing Seven Major Complementary Health Approaches in U.S. Older Adults

Recent analysis of 2012 NIH data on integrative healthcare usage by older adults indicates that overall, 29.2% of older adults used any of seven CHA in the past year. Most commonly used CHA included herbal therapies (18.1%), chiropractic (8.4%), and massage (5.7%). More than 60% of older CHA users reported that CHA was important for maintaining health and well-being. Other perceived benefits included improving overall health and feeling better (52.3%), giving a better sense of control over health (27.4%), and making it easier to cope with health problems (24.7%).


The Effectiveness of Acupuncture for Osteoporosis: A Systematic Review and Meta-Analysis

The goal of this paper is to summarise the existing evidence and evaluate the efficacy of acupuncture as a clinical treatment for osteoporosis. Six English and four Chinese databases were searched from their inception to April 2017. Randomized controlled trials were included, in which warm acupuncture, needling or electroacupuncture were compared with sole Western medicine with osteoporosis.

This results of this present systematic review indicated that acupuncture could be an effective therapy for treating osteoporosis. Warm acupuncture seemed to more effective than electroacupuncture and needling for osteoporosis in comparison to sole Western medicine.