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Is Chiropractic Care Good For Painful Problems?

Many people first visit a chiropractor because they are suffering some kind of pain – back pain, headaches, neck pain, shoulder pain, leg pain, or some other kind of discomfort. They are mainly seeking relief, often having tried other approaches like medications, pain-killers, bed rest, and heat.

In fact, many people do get relief from visiting their chiropractor. The reason, though, may be somewhat different from what you might think!

When you’re hurting, the pain seems like the problem, but this is usually not the case. Your body uses pain as an alarm system to alert you to the fact that something inside isn’t working right. So, the pain isn’t the problem, it’s your body’s way of telling you there is a problem.

If you just shut off the alarm, and the fire continues to burn, then the purpose of the alarm was ignored and the house burns down, even though the alarm rang. It’s the same in your body – if you just shut off the pain without finding out why it was happening, the fire in your body continues to burn, and the effect can be a more serious health condition. For example, stomach pain may mean a developing ulcer, but shutting off the stomach pain with antacids or drugs does not address the underlying cause of the ulcer, like stress or poor diet, and eventually the stomach wears out.

So, the pain usually isn’t the problem, it’s the evidence that there is a problem!

That’s why chiropractic care doesn’t really try to shut off the pain, but to find the underlying cause, and deal with that. Often, the cause of the pain is some malfunction in the body, and chiropractors are experts at finding such malfunctions.

Here’s the way it works. The body is designed with a wiring system that connects the brain, which runs the show, with all the body parts. This wiring system is called the nerve system, and nerves are the wires that go from the brain to the body parts, so the brain can direct their function and tell them what to do.

The brain and nerve system are protected by bone, the brain by the skull and the nerve wires by the spinal bones. That’s why chiropractors are trained to examine and correct misalignments in your spine – when those bones go out of position, they can interfere with nerve function, which may either cause pain, or cause some other body malfunction that leads to pain.

When someone decides to begin chiropractic care, the decision frequently stems from a desire to experience relief, and it would be inaccurate to say that this doesn’t happen – most of the time, the pain subsides fairly quickly, and if this is all the individual wants, there’s a tendency to discontinue chiropractic care prematurely, before the underlying problem is adjusted properly so it can heal.

That’s why many chiropractors recommend periodic check-ups, for early detection and the correction of structural problems before they progress.

Many families decide to come in for their adjustments together, as a health and wellness practice, whether or not anyone has a painful problem. They have found that their quality of life improves with regular chiropractic care, among other good lifestyle choices, like healthy diet, sufficient exercise, sleeping on a good mattress, drinking enough water, and practicing stress reduction techniques like meditation or yoga.

So, doctors of chiropractic do help people with painful problems by finding the cause of the problem, and they also help people who don’t have painful problems by coaching them on better lifestyle decisions and keeping their structure healthy. Chiropractic care has something to offer just about everybody.

Shingles

Pain is for most people in the world absolutely no fun.  Pain medications work in the brain to shut off the signals from the body to the brain that something hurts, so as a general rule I don’t want to use them.  I want to know when something hurts so that I can do something about it.  Sometimes, however, pain medications are vital. There have been very few instances in which I have found it necessary to use heavy duty pain medication since I developed a more holistic approach to life, but one of those instances happened when I got shingles.  I thought I was coming apart at the seams.  It was during one of the most stressful periods of my life when I was preparing for my National Board Examinations that I woke up one morning with a very odd tingling feeling on my right side and just a few hours later felt excruciating pain in the same area.  The pain was indescribable and my skin looked normal.  No redness was there.  No scratches were there.  Nothing was evident that would be a logical cause for this horrible pain I was feeling.  I went to an instructor of differential diagnosis at school and asked her what she thought.  As it turned out she told me it sounded to her that I was getting shingles.  Lo and behold, the next day a rash appeared and I could not bear even to have the weight of a bed sheet on the skin in the area of the rash.  Misery was mine.  I had never felt any pain like this before and thought that I would surely die.

Shingles is caused by the same virus that causes chicken pox.  If you have ever had chicken pox, the virus lies dormant in the nerve roots near your spine and might lie dormant forever, never causing a moment’s worry beyond the initial outbreak of chicken pox.  However, in certain cases the virus can be reactivated.  Certain illnesses, aging, and periods of high stress can all cause a reactivation of the chicken pox virus.   If the chicken pox virus (herpes zoster) becomes reactivated it causes shingles rather than another case of chicken pox.  Shingles causes neuralgia, or nerve pain, that can be severe.  It also causes a rash which develops usually on only one side of the body since shingles follows a dermatome, or nerve pattern, on the skin.  The rash will develop into blisters in a day or so, and it can take weeks for the blisters to heal.  The time during the healing is usually a very painful one, and at certain times the blisters can be contagious to others.  If others who have not been exposed to the chicken pox virus are infected with the virus during an active stage of shingles, though, the condition that erupts will be chicken pox and not shingles.

Treatment of shingles is difficult.  There are some antiviral medications on the market today, but shingles is hard to predict if you have never felt the initial symptoms before.  The antiviral medications can reduce pain and the otherwise untreated duration of the shingles outbreak, but will not prevent the condition from developing.  When I had my experience with shingles seven years ago I saw a medical doctor who gave me narcotic pain relievers in order for me to get enough relief to go to sleep.  Just turning over in bed was excruciating, and I could not sleep because I was afraid to have a need to turn over during the night.  Aveeno oatmeal baths were very helpful in relieving the itching as the rash healed. Aveeno also helped in drying up the spots so that they would go away sooner.  A friend of mine in school was very involved in Chinese medicine and gave me some awful smelling salve that made me feel better if only temporarily.  I tried everything.  The last thing I tried was, I believe, the very best treatment of all.  One of my nutrition professors told me that an amino acid called L-Lysine when combined with vitamin C was extremely successful in speeding up the rate at which the virus returned to dormancy.  I raced off to the health food store and loaded my basket with Lysine and vitamin C and began a regimen of that.  Within two days the pain was completely gone.  The actual rash took a bit longer to heal completely, but the unpleasant symptoms that I was having were resolved. I finally was able to sleep without the numbing medication.   I have since run into other people who have reinforced the opinion that the Lysine cure works.  It certainly seemed to help me, and if I even think that I feel anything that closely resembles the tingling precursor to shingles, I immediately begin taking it again for a few days until I think the coast is clear.

You might be at risk for shingles if you have ever had chicken pox and are over the age of 50, have any autoimmune disorder, have any immune system weakening disease, or are under excessive amounts of stress.  The early symptoms include flu-like symptoms without the fever of the flu, unexplained itching, tingling, or extreme pain in an area where a rash will develop a few days later.  Get educated about it and pay attention to your body.  If there is no reason for you not to take Lysine or vitamin C, try it.  It is better to try the combination of them than to endure the misery of shingles.  Treat your body well.

Sciatica

There was a time last weekend when I thought my chronic sciatica was going to act up.  We were in Chicago for a conference and were prepared for temperatures in the upper 70’s and lower 80’s since that is what the most accurate weather in the universe – up to the minute satellite forecasts from The Weather Channel – told us.  I was so excited to be able to pack only Capri pants and sleeveless tops with my open-toed Birkenstock sandals because that meant only one suitcase and I could avoid the long lines at baggage claim by using a carry-on.  On Thursday morning I needed to call into the office to check in and couldn’t get a good signal on my phone inside the Marriott in downtown Chicago, so I stepped outside to see if it was better.  This Southern girl almost came undone!  On May 13, it was 45 degrees and raining.  My teeth were chattering as I stood outside in the cold with hardly anything on in comparison to the mid-westerners I was watching walk by.  My body almost went into shock.  It was a good thing that the best shopping in the mid-west is on the Magnificent Mile in Chicago, because my task was set before me and I needed some clothes.  I feverishly ran up Michigan Avenue looking for anything with long sleeves that might still be on the racks in the middle of May.  This power shopping is what got my sciatic nerve upset.  I had not prepared my body for the physical demand of running in the cold with the wrong shoes on, and soon the tell-tale pain was shooting down the back of my right thigh.  This was a forecast of a more accurate nature because we have seen no fewer than 25 people this week with sciatica and I thought it would be appropriate to visit the subject for those of you who might be suffering with it.

Sciatica is the name for the condition which involves inflammation and pain that result from irritation of the sciatic nerve.  As wide as your thumb, the sciatic nerve is the largest nerve in the body.  It originates at the roots of the nerves that stem from the lowest segments of the spine and travels through the muscles of the buttocks, the back of the thigh and calf, down the leg, and to the sole of the foot.  This makes it one of the longest nerves in the body.  Since its path is so long and tortuous, there are many opportunities for damage to it to occur.  Pain associated with sciatica can vary widely depending on where the damage occurred, what activities of daily living aggravate it, and how long the problem has existed.  Most often it is characterized by a burning pain that goes from the buttocks down the back of the thigh and into the leg.  Occasionally sufferers report that the pain is so severe that they can’t put weight fully on one foot because the nerve is irritated on the sole of the foot.  Tingling sometimes accompanies the pain, but will come and go erratically.

The two types of sciatica that we deal with regularly are those that are lumbogenic (originating from one or more of the lumbar vertebrae) or musculogenic (originating from a muscle).  If the pain is lumbogenic, the cause is usually a slight bulge in a disc which is putting pressure on the nerve roots from which the sciatic nerve originates. This is treated by first discovering which segment is causing the problem then systematically adjusting that segment to decrease the disc bulge and thereby remove the pressure from the nerve roots.  The pain is usually better immediately, but might take a few days to go away completely due to inflammation that has built up in the area.  Several adjustments along with the use of a strategically placed ice pack usually take care of the problem.  Rehabilitation is necessary to prevent the return of lumbogenic sciatica.

Musculogenic sciatica can be trickier to treat.  We must first isolate exactly which muscle is causing the problem.  If a lower back or large buttock muscle is the culprit, it is due to spasm in the muscle and should be treated with trigger point therapy and muscle stimulation to ease the muscular tension and inflammation.  If another small muscle in the buttock is causing the problem, it is generally too lax and is therefore lying directly on the sciatic nerve.  The most common offender is the piriformis, or pear-shaped, muscle.  This muscle must be lifted off the nerve and exercised so that the irritation goes away.  There are specialized techniques which exercise this particular muscle.  Muscle stimulation, ice, and rehabilitation are all necessary to maintain the correction of musculogenic sciatica, and lifestyle alterations have to be made to prevent its return.

If you are prone to have exacerbations of sciatica, taking off in a dead run in 45 degree rainy weather is certain to leave you wondering why you were temporarily insane.   As some of the members of our practice can attest, so can kamikaze gardening, cleaning out the attic, driving for hundreds of miles without stopping, and just about anything else that you know deep in your heart you have no business doing.  Lucky for me I was in a room full of chiropractors for the whole weekend, so I did not have a full-blown flare-up.

I will never trust The Weather Channel again, however, even though it gave me a great excuse to do some power shopping.  Treat your body well.

Psoriatic Arthritis

If you were to ask just about anyone on the street what psoriasis is, almost everyone can give you some idea about it.  It is not an uncommon disorder of the skin.  What is very uncommon and sometimes goes undiagnosed, however, is an arthropathy (disease or pathology of the joints) called psoriatic arthritis.  In keeping with my recent pattern of discussing arthropathies, I thought it was a good idea to bring up psoriatic arthritis.  Psoriasis is an aggravating and sometimes embarrassing problem.  I was riding on an airport shuttle the other day with a friend of mine who happens to have psoriasis, and someone asked out of the blue, “Oooohhh.  What happened to your knee?”  Of course nothing had happened.  This sort of encounter happens all the time and the usual explanation that it is not a scrape but is psoriasis ensued.

Psoriasis is a skin disorder which affects about 3 million Americans, according to the American College of Rheumatology.  It is characterized by a thick, rough, scaly sort of rash that appears most commonly on the elbows, knees, and scalp.  It can also occur on areas of the body where there are skin folds.  Some of the more severe cases involve pitting of the nails or thickening of the nails which causes the nails to lift off the surface of the fingers.  Some sufferers also experience a burning or itching sensation in the eyes.  In a person without psoriasis the skin replaces itself about once a month from the inside out.  New layers of skin form underneath as the old outer layers slough off.  If a person has psoriasis, however, this skin layer replacement happens much too quickly.  Rather than taking a month or more to replace itself, it takes only a few days.  The outer layers of skin don’t have time to slough off before a new layer is ready to take over.  This results in a buildup of dead skin cells which causes an itchy thick patch of skin to form.  These areas might be red, cracked, and raised or they might have a silvery scale appearance.  Psoriasis is not contagious, so coming into contact with the skin which is affected by it is harmless.

In roughly ten percent of the people with psoriasis, psoriatic arthritis develops.  Psoriatic arthritis is an inflammatory type of arthritis in which the soft tissues and the capsule which holds lubricating fluid for joints become irritated, swollen, and very painful.  It causes symptoms very similar to the ones caused by rheumatoid arthritis, but rheumatoid usually affects the wrists and joints closer to the wrist in the hand.  Most commonly the small joints of the fingers and toes closest to the ends of the digits are involved in psoriatic arthritis.  In most cases the arthritis associated with psoriasis is a mild form that affects fewer than four joints in the body, but in five percent of the cases a form of the disease called psoriatic arthritis mutilans develops. This form of the disease attacks the joint itself and not just the soft tissue surrounding the joint.  This results in severe deformation of primarily the joints in the hands and feet.

There is no particular known cause of psoriasis and psoriatic arthritis.  Some doctors suggest that heredity plays a role since forty percent of those with these conditions have at least one family member with the disorder.  The symptoms of the disease are sometimes made more severe if the sufferer is immunosuppressed such as those who are taking chemotherapy and those with HIV.  Stress, lack of or overexposure to the sun, injury to the skin, or some insect bites can aggravate the condition also.  There is no known cure for psoriasis or psoriatic arthritis, but the conditions are definitely treatable.

As hard as it might be for people whose joints are inflamed, exercise is one of the very best things for them.  Often the pain associated with arthritis is alleviated when the joints are put into motion.  Exercise definitely achieves this actively, while chiropractic adjustments achieve this passively.  Patients who suffer from arthropathies benefit greatly from joint mobilization which is achieved by chiropractic.  Your chiropractor can study x-rays of your joints and thereby determine the degree of mobilization which is safe for you.

A diet low in saturated fats is helpful, and some supplements have been found to have merit.  While there are no double-blind studies to confirm it, evening primrose oil and some of the fish oils are known to be of great benefit in reducing the inflammation associated with psoriatic arthritis.

It is difficult sometimes to manage chronic conditions for which there is no known cure.  It often is an issue of trial and error, and early detection is essential to getting a handle on this and any other inflammatory condition.  Like wildfires out of control, inflammatory arthropathies can consume what is left of comfortable quality of life for those who have them.  If you suspect that you might have one, do your homework.  Find out what works for you, and treat your body well.

Parathroid Fun

In the past few weeks the thyroid gland and its functions have been the topics for discussion in this column.  A reader sent an e-mail after the last one and asked that I address the parathyroid gland and reasons that it might function improperly.  I did some homework to address her specific concerns and decided that it might just help someone else out there to know what the parathyroid is and how it works.

The parathyroid gland is actually a collection of small pea-shaped glands in the neck near the thyroid gland.  Humans usually have four of them, two on each side of the neck.  The primary purpose of the parathyroid gland is to secrete parathyroid hormone, which is responsible for increasing the level of calcium that is in the bloodstream.

Calcium is the most abundant mineral in the body and is best known for maintaining strong bones and teeth.  Its other functions are to keep nerve tissue and muscles functioning properly.  The heart, of course, is the most important muscle in the body, and calcium is an essential part of its healthy function.  When the level of calcium in the blood falls below normal, there is a steep increase in the secretion of parathyroid hormone.  Parathyroid hormone then signals the kidneys to reabsorb calcium rather than excrete it and triggers special cells in the bones to release calcium into the bloodstream.  If the body has an excessive amount of parathyroid hormone in circulation, too much calcium is taken from the bones and osteoporosis can occur.  The role of these tiny pea-shaped glands is extremely important in regulating many vital bodily functions, but sometimes the body’s natural regulation goes awry.

When the parathyroid gland is producing too much parathyroid hormone, the condition is called hyperparathyroidism.  Primary hyperparathyroidism is a condition in which the parathyroid gland itself is diseased.  Most often this condition is caused by a tumor on the gland and results in the secretion of parathyroid hormone randomly and in excessive amounts.  This materializes in the body by increasing blood calcium concentrations to levels which are much higher than those in normal range.  The body will form kidney stones and in some cases cause bone demineralization, or the removing of too much calcium from the bones.

Secondary hyperparathyroidism is caused by disease outside the parathyroid gland, most often kidney disease, which causes the body to secrete excessive parathyroid hormone.  If the kidneys are unable to absorb calcium properly, blood calcium concentrations fall and this sets up a cycle in which the body constantly secretes parathyroid hormone in order to maintain proper blood calcium levels.  The body robs the calcium it needs from bones, resulting often in severe osteoporosis.  In this case, people are highly susceptible to pathological fractures and all of the trouble that accompanies those.  Poor nutrition can also cause secondary hyperparathyroidism.  If a diet is low in vitamin D or calcium or if a diet contains too much phosphorous the condition can occur.  Diets which contain excessive amounts of meat are high in phosphorous.  This is one of the dangers of the ultra-high protein diets which do not balance with the proper amounts of vegetables and whole grains.

Treatment for hyperparathyroidism has historically involved removal of the diseased tissue under general anesthesia.  In 1996, a radio-guided surgical procedure was developed specifically for this disorder and can be done under local anesthesia in less than half an hour.  If surgery is recommended for you, request the radio-guided procedure for a less dangerous operation with a much shorter recovery time.

Our bodies are amazing chemical factories.  If all of the biological and biochemical processes are balanced, our bodies maintain homeostasis and all is well.  It takes only a small imbalance, however, to upset the proverbial applecart. I think it was George Burns who said, “If I knew I was going to live this long I’d have taken better care of myself.”  With all of the technology available today and the advances in healthcare that put us in control of prevention of many diseases, our lives are becoming longer and in many cases better.  It is up to us to become informed and proactive about our health.  Treat your body well.

Neuropathy

The end is near for 2003, and what a year it has been!  Thank you to everyone who reads and comments on this column.  I have thoroughly enjoyed answering your questions and providing a chiropractic perspective on a variety of topics this year.  It is my sincere hope that the material covered here has been informative and in certain cases empowering for those who have read it and who needed to have a different slant on issues relating to their health.  A request came a couple of weeks ago for information regarding a condition known as neuropathy, and here is what I have found.

Neuropathy is a term which describes a condition of dysfunction or pathology (disease) in a nerve.  Most often the term neuropathy is used in conjunction with the peripheral nervous system, or the portion of the nervous system which sends messages from the brain and spinal cord out to organs and tissues of the body and messages from the body back to the brain.  When this type of nerve is affected, the more complete term is peripheral neuropathy.  Symptoms associated with peripheral neuropathy include pain, numbness, tingling, muscle weakness, burning sensations, and paralysis.  These symptoms most commonly affect the arms, legs, hands, and feet.

Peripheral neuropathy is not a specific disease itself, but describes a culmination of other disease processes which result in the actual damage to peripheral nerves.  Peripheral neuropathy is very frequently associated with diabetes, since approximately 60 percent of those who have diabetes also have some degree of peripheral neuropathy.  There are, however, many more causes of peripheral neuropathy and there is even evidence of the presence of neuropathy without any directly assigned cause, especially in people over 60 years of age.  This is known as idiopathic peripheral neuropathy.  Peripheral nerve damage is often caused by alcoholism, autoimmune disorders, liver failure, one of several infectious diseases like Lyme disease, HIV, hepatitis B and others, kidney failure, and of course, diabetes.

There is another cause of peripheral nerve damage, though, and this is the one that a chiropractor can definitely help.  Entrapment syndromes have been known to result in transient (temporary) peripheral neuropathy.  Carpal tunnel syndrome, tarsal tunnel syndrome, thoracic outlet syndrome, piriformis syndrome, and other entrapments can result in long-term nerve compression and give the body pathological nerve function.  If there is something putting pressure on a nerve and it is moved off the nerve the nerve can then function normally as long as the pressure has not been on the nerve for a long enough period of time to cause permanent damage.  Numbness and tingling along with pain in the feet and legs are common symptoms of sciatica, and sciatic nerve pressure is often easily remedied by chiropractic adjustments.  Sometimes the bones in the feet are out of proper alignment and cause nerve pressure.  A chiropractor who is trained in extremity adjusting can adjust the bones of the feet and restore proper sensation if that is the source of the problem.  Very commonly bones in the elbow, wrist, and hand are misaligned and cause nerve pressure which can be very painful.  When these bones are realigned the sensation returns to normal if their misalignment is what is causing the paresthesia.

If you are suffering from what you believe is neuropathy and there is no readily apparent disease process associated with the discomfort you are feeling, start the process of elimination to determine the cause of the problem and perhaps find a way to get better.  There are several tests that can be performed to help figure out just how badly damaged the nerves in your body are, but some of them can be somewhat invasive procedures.  Nerve conduction velocity studies and needle EMG are commonly used.  It might be helpful to start with the least invasive procedures first then proceed up to the more complicated ones if the conservative route does not produce results for you.  Ask your chiropractor if he or she can work on possible entrapment sites to free the nerve compression and see how much normal function might be restored to the peripheral nerves.  You just might be pleasantly surprised and find that what you thought was a serious problem is just another day at the office for your chiropractor.  Treat your body well.  Merry Christmas and may you have a prosperous New Year.

Managing Type 2 Diabetes

Recently I accompanied a dear friend on a visit to her great aunt who was dying in a hospital.  The first thing Aunt Gert said to us was, “Girls, whatever you do don’t get diabetes.  It’s the one thing I would have changed about my life.”  Aunt Gert had been in the hospital for three months trying to get a wound on her foot to heal.  The foot became gangrenous and two days after our visit she died from sepsis.  After such a sobering talk with this sweet, gentle lady, I decided to set my sights on prevention of such a horrible fate.

Type II diabetes is adult onset diabetes.  You are at risk if you are over 40, overweight, not physically active, have high blood pressure, have a family history of diabetes, have low HDL cholesterol and high triglycerides, have a history of gestational diabetes, or have had a baby weighing more than 9 pounds.  Other risk factors come into play according to the American Association of Diabetes Educators, but these are the main factors.  Type II diabetes occurs from the gradual development of increased blood sugar levels.  In its early stages there are no symptoms and when symptoms do occur, they are often passed off as being the result of some other disease process or aging.  Most frequent symptoms include increased thirst, increased urination, weight loss, and blurred vision.  Since people often pass these symptoms off as those of something else, this condition can go undiagnosed for years.  Most often the symptoms have gotten to the point where long-term damage has occurred before diabetes is suspected as the culprit.

Elevated blood sugar levels over long periods of time have very serious effects on the body.  Some of those include decreased circulation, delayed healing of wounds and illnesses, gum disease that can lead to tooth loss, persistent infections, foot problems, nervous system damage, and blindness.  Acceptable ranges of blood sugar levels vary according to the source, so the best advice about how to gauge yours is to talk to your doctor and  research it in your own.  Numerous websites are available with direct links to the foremost institutions in this country with a wealth of information.

Once diabetes develops, treatment options must be considered. Blood sugar levels must be kept at levels which are safe for the body. Overwhelmingly, sources say to begin a regimen of exercise that includes at least thirty minutes of activity five days a week.  This will decrease the likelihood of your developing complications like heart disease which is common to those who have diabetes.  It also increases HDL levels and directly decreases blood sugar levels.  The second part of this prescription for health is to eat a nutritious diet.  There is no magic bullet for the nutritious diet part.  Avoiding foods with high glycemic indexes is a major part of the healthy diet for those who have diabetes and for those who want to avoid it.  A food’s glycemic index is the rate at which a carbohydrate food is digested into glucose and how much it causes the blood sugar level to rise.  The best source for the healthiest diet in my estimation is the book Sugar Busters , which should be available in the local bookstore.  It outlines the whole diabetes story and how it has become such an epidemic in our country.  Foods that are white are generally bad for us.  White bread, white potatoes, white rice, and certainly white sugar all have outrageously high glycemic indexes, and are bad for the body.  The body utilizes insulin more efficiently when it consumes foods that are low on the glycemic index scale rather than those that are high.  Some sources suggest that diabetes is the result of spiking of insulin requirements by the body.  As the spikes occur more and more frequently the pancreas, which is the organ that produces insulin, in effect burns out and is no longer able to produce the amounts of insulin that are necessary to maintain healthy blood sugar levels.  If the body requires insulin in more controlled amounts, the production is more level and the pancreas works at a steadier pace rather than frenzy at one moment and absolute shutdown at the next.  Diet is the best way to make this happen, and should be investigated by anyone facing the problems of diabetes. If eating a nutritious diet and getting regular exercise should fail to keep the blood sugar levels in a safe range, there are a number of drugs on the market which make the body produce more insulin.

Several people who are dear to me have type II diabetes.  It is no joking matter when someone has blood sugar control problems.  I have seen its devastation in action, and I implore you to get yourself checked and make the necessary changes in your lifestyle to keep blood sugar levels in safe ranges for your body.  Many health fairs offer free blood glucose level screenings.  In fact, on September 27, Kroger will hold a diabetes screening.  Give them a call and treat your body well.

Juvenile Rheumatoid Arthritis

Many conditions bring parents to our office concerned for the health of their children.  A full twenty percent of our practice consists of pediatrics.   We see a plethora of ailments from sports injuries to scoliosis, but the most difficult to treat are chronic arthropathies including juvenile rheumatoid arthritis.  This condition can be difficult to manage in the sense that it is hard to imagine the lives of children who are suffering.  Just like anything else, however, it helps to be aware of the facts involved.  Early intervention can make a world of difference in the amount of suffering a child must endure.  While chiropractic can certainly help ease the pain of juvenile rheumatoid arthritis, it cannot cure it.  Nothing can.  Presently there is active research by the Arthritis Foundation and many other groups who are trying to find an answer to this sometimes crippling nuisance.

Juvenile rheumatoid arthritis (JRA) is the most common form of arthritis found in children.  The cause is not completely understood, and there is no one definitive test for the disease.  If a child under the age of 16 has joint pain and inflammation which lasts for more than six weeks, JRA is immediately suspected.  A pediatrician might perform certain blood tests to rule out other conditions then refer the child to a rheumatologist (doctor who specializes in joint disorders) for further evaluation.

JRA is thought to be an autoimmune disorder.  Autoimmune disorders are those in which the body for some unknown reason attacks its own cells and tissues.  In the case of JRA, the joint capsules and soft tissues around them are the targets of the errant attacks.  This results in painful, warm joints at best and disfigured ones at worst.  Although most researchers agree that JRA is an autoimmune disorder, genetics and environmental factors are also thought to play roles in the occurrence of the disease.  Some genetic markers are present that can be tested for, but they are not necessarily specific for JRA.  Some people with the markers will not develop JRA while some others without it will.  Research is still ongoing for better ways to detect the disease.

There are some serious complications that can result from the incidence of JRA.  They include eye inflammation that, if left untreated, can lead to glaucoma, cataracts, calcium buildup in the cornea, and ultimately, blindness.  It is recommended that patients with JRA be seen by an ophthalmologist at least every six months and in some cases every three months.  These regular visits can avoid some types of eye disorders that might occur without any early symptoms.  JRA has also been known to inhibit proper bone growth and development.  Many doctors choose to treat JRA with corticosteroids to battle chronic inflammation.  Corticosteroids such as prednisone can interfere with normal growth and development and increase a child’s susceptibility to infections.  These drugs are used mainly in the more severe cases, and their usefulness and risks should be heavily considered by parents whose children are advised to take them.  In many cases, pain relievers and non-steroidal anti-inflammatory drugs are all that are required to keep the pain at bay.  Sometimes a drug known as a disease-modifying antirheumatic drug is used if the NSAIDs alone are ineffective.  These drugs are used in conjunction with NSAIDs to slow the progression of JRA.

Also important in the management of JRA is the restoration of motion that has been lost in joints.  There are many ways to achieve this, including exercise, physical therapy, and chiropractic manipulative treatment.  If a joint has lost its mobility, it is important to restore it in order to avoid degeneration.  There is no substitute for motion, and it is vital for all of our joints.  It is essential for children with JRA to remain as active as possible to maintain flexibility and build strong muscles.  Swimming is an excellent way to exercise the joints since it alleviates stress on joints while it encourages flexibility and builds muscles. Chiropractors and physical therapists can be of enormous help in managing the pain and restoring the lost motion of JRA.

Helen Keller was once quoted as saying, “Although the world is full of suffering, it is also full of the overcoming of it.”  A diagnosis of JRA is not the end of the world.  A child is not necessarily doomed to a steady diet of harmful medications that retard his growth and development.  Proactive parents who get involved with overcoming the suffering of their ailing children are guardian angels in disguise.  Treat your body and your spirit well.

Hypothyroidism

I often get the topics for this column from people I see in my office for various conditions, and people with the same conditions show up in droves when the timing is right for the topic to be discussed.  Invariably someone will come up to me at the grocery store or Wal-Mart and say thanks for the recent column on whatever the most recent topic was.  Many people have mailed the column to Aunt Bessie in Mississippi who desperately needed to hear what I had to say that week or subtly laid a copy of it on their boss’s desk for a confidential hint.  This week I have been urged to write about a situation that crops up for more than 6 million people in America, most of them women, and most of them over 40 – hypothyroidism.

The thyroid gland is a butterfly-shaped gland located at the base of the neck just under the Adam’s apple.  It weighs about an ounce, and its major function is to produce thyroid hormones, which regulate metabolism in the body.  This means it regulates the rate at which you burn calories, use fats and carbohydrates, maintain body temperature, and produce certain proteins.  When it is functioning below normal levels, the thyroid gland does not produce enough thyroid hormones and the delicate balance for maintaining homeostasis, or internal stability, in your body is upset.  Every organ system in the body slows down when there is not enough thyroid hormone being produced by the thyroid gland.  The digestive system slows down and causes constipation, metabolism slows down and weight gain occurs, and even the brain’s functions slow down and it becomes difficult to concentrate and focus when you need to.  Since everything else slows down, you of ten become tired and sluggish.

There are many different causes of hypothyroidism, but they all result in the same general set of symptoms.  Common causes include autoimmune disorders, or those disorders which cause the body to attack its own organs and systems instead of fighting off infections and viruses.  When an autoimmune disorder is present, antibodies which would normally fight other diseases attack the thyroid gland and affect the proper production of thyroid hormones.  The most common of these disorders which affects thyroid hormone production is Hashimoto’s Thyroiditis, a condition which is characterized by chronic inflammation of and damage to the thyroid tissue.  Another cause of hypothyroidism is the use of radioactive iodine.  If people suffer from a condition in which the thyroid gland produces too much thyroid hormone, the most common treatment is radioactive iodine, which reduces the function of the thyroid gland.  However, people are often over-treated with this substance and the thyroid gland’s function is reduced too much, causing hypothyroidism.  If radiation therapy is used to treat cancers of the head and neck, often the thyroid gland is damaged and hypothyroidism results.  The use of certain medications, especially lithium products, has been shown to put people at risk for an under active thyroid.  Another common cause of decreased thyroid function is pregnancy.  In the postpartum period, in fact, hypothyroidism is often mistaken as postpartum depression.  Of course, if surgery is performed to remove the thyroid gland it will not be providing any hormones and hypothyroidism will occur.

The treatment for hypothyroidism is thyroid hormone replacement medication.  The most common one is levothyroxine, which is a synthetic thyroid hormone.  It might take several weeks for your body to get the appropriate level of thyroid level in your bloodstream, but it is essential for you to be sure your doctor is giving you the proper dosage of this medication.  If you are given excess levothyroxine you might be at risk for osteoporosis.  If you already have osteoporosis, excess levothyroxine can accelerate bone loss.  Check with your doctor and express any concerns you might have about your bone density and how it is affected by your hormone replacement.  There are natural alternatives to levothyroxine, but it is even harder to regulate the amount of thyroid hormone that is present in some of the over-the-counter extracts that are taken from animals.  Do your homework thoroughly before you try a natural alternative.  Other than the increased osteoporosis risk in the presence of too much levothyroxine, it can be used fairly safely without side effects.

As usual, be aware of your body and any specific problems you have.  Your body will send signals that will alert you about any deficiencies in most cases.  On a gut level, you know when things just are not as they should be.  Pay attention to your body, and treat it well.

Hyperthyroidism

My last column discussed the thyroid gland and what happens when it is under-active, a disorder called hypothyroidism.  This week’s offering will explore the opposite ailment, hyperthyroidism, a condition in which the thyroid gland is over-active and produces too much of the thyroid hormones.  The thyroid gland is a butterfly-shaped gland which is located at the base of the neck just below the Adam’s apple.  In healthy individuals it produces just the right amounts of hormones which regulate the rate of metabolism in the body.  Since the body’s metabolism sets the tone for every action in most organ systems, it is essential that it not get out of balance.

Hyperthyroidism causes an increase in the metabolic rate, so people who are affected by it often feel hotter than usual.  People who suffer from this disorder might also experience gradual weight loss even in the presence of an increased appetite.  The body burns calories much faster than normal if too much thyroid hormone is being produced.  At the end of the day a person with hyperthyroidism feels fatigued but finds it very difficult to fall asleep.  Sufferers might also develop trembling hands, heart palpitations, and shortness of breath.  Some people have reported warm, moist skin, hair loss, weak muscles, and a blank staring gaze.  Most often the symptoms of hyperthyroidism have a gradual onset and people tend to brush them off as symptoms of something else until they become severe.  This is one danger of this disorder since people can be sick for weeks or even months before they realize it.  Another danger of hyperthyroidism is malnourishment.  Many nutrients, especially minerals, become more quickly depleted in the presence of a hyper-metabolic state such as that caused by the presence of excess thyroid hormones.  This is an often overlooked problem, and can set a person up for other disorders which might result from improper nutrition.

There are several causes of hyperthyroidism, but the most common one by far is Graves’ disease.  It is named for the Irish physician who first described the disorder.  Graves’ disease is an autoimmune disorder, or one in which the body’s antibodies are working against it instead of for it and they attack the thyroid gland.  These antibodies attach to the thyroid gland and cause it to make too much thyroid hormone.  The thyroid gland becomes enlarged (produces a goiter) in response to the overproduction of thyroid hormones.  About one out of twenty patients with Graves’ disease will develop an eye condition in which the eyes bulge.  Otherwise, in addition to hyperthyroidism, people with Graves’ disease suffer from inflammation of the soft tissue around the eyes which might cause swelling, irritation, and thickening of the skin over the lower portions of the legs.  Graves’ disease is most common in women, and for some unknown reason it tends to be inherited.  Other less common causes of hyperthyroidism include inflammation of the thyroid gland which might cause the gland to overproduce the thyroid hormones, non-cancerous nodules inside the gland, and overdosing on any of the several pharmaceutical thyroid hormone replacements.

Treatment for those with hyperthyroidism is fairly simple once the diagnosis is confirmed by a blood test.  Anti-thyroid medications work to suppress the function of the thyroid gland, surgical removal of the gland itself certainly curtails its function, and radioactive iodine treatment specifically targets thyroid gland cells to destroy them.  The latter is the most widely recommended treatment since the only cells in the body which absorb iodine are those in the thyroid gland, and radioactive iodine is not shown to affect any other part of the body.  Surgical removal poses a small risk of damage to the nerve to the voice box, the recurrent laryngeal nerve, and can result in leaving one unable to speak.  (This actually happened to a friend of mine who was an English professor, and she was forced to retire.)  Some of the treatments for hyperthyroidism can (and often do) cause hypothyroidism, and result in the need for permanent use of levothyroxine to replace thyroid hormones in the body.  There are some dietary considerations and natural treatments for hyperthyroidism, but the balance in the body is so delicate that sometimes treatment without knowing the extent of the problem with the thyroid gland can be dangerous.

Pay attention to your body, and if you have been experiencing any of the symptoms of hyperthyroidism, ask your doctor to run a simple blood test to check the levels of your thyroid hormones.  Since the symptoms appear gradually, you can spend a long time chasing them.   A simple blood test can easily confirm hyperthyroidism and allow you to begin treatment right away or eliminate it completely from the list of possible causes of your trouble.  Treat your body well.

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