The Healthy Back

I know this got sent out last week, but I entered the wrong date so you get to read it again!  Apparently I’m suffering from a little early Alzheimer’s myself!  Better go and get some more exercise.

How Exercise May Keep Alzheimer’s at Bay

If you’re in your twenties, you probably won’t be interested in this, but you should be.

An interesting thing happens as you get older – you begin to forget things, and the worst part is that in the beginning, you know that you’ve forgotten something – but what the heck was it?  I think that when you reach the point where you don’t remember that you’ve forgotten something, that it’s a blessing to you and a huge annoyance to everyone else.

There are lots for jokes about Alzheimer’s but the condition isn’t funny for the person who has it, or for the other people in that person’s life, so if we can help ourselves from getting it, that would be the ideal.

Currently there are no cures and few promising drug treatments.  But a cautiously encouraging new study from The Archives of Neurology suggests that for some people, a daily walk or jog could alter the risk of developing Alzheimer’s or change the course of the disease if it begins.

At Washington University in St. Louis, a study was conducted of people who, at the start of the study, did not have any symptoms of Alzheimer’s.  They were tested for a variety of things, but some of the participants carried a particular gene involved in cholesterol metabolism called APOE-e4 found in some families that show symptoms of dementia at a younger age, beginning in their late 60s on average, instead of in their early 80s like most people without the variant. These people are 15 times more likely to develop Alzheimer’s than the general population.

Participants were asked to fill out a detailed questionnaire about heir exercise habits during the past 10 years.  Recently many studies have looked at whether being active can lessen someone’s risk for Alzheimer’s but the results have been inconsistent, with some studies, in both animals and people, suggesting that regular exercise has a protective effect and others finding little discernible benefit.

One reason for the inconsistency may be that many earlier studies did not differentiate between people with the e4 variant of the APOE gene and those without, and each group, at least potentially, could respond differently to exercise.

That certainly proved to be the case in this study. For the Group as a whole, exercise provided marginal benefits.  The volunteers who reported walking or jogging often – meeting the American Heart Association’s exercise recommendation of 30 minutes of moderate or vigorous activity five times a week – had fewer amyloid plaques than the volunteers who reported almost never exercising.  But the preventive value of the exercise was small, barely reaching the level of statistical significance.

The situation changed, however, when the scientists examined the results for people with the e4 variant. Most of those who carried the APOE-e4 gene displayed much larger accumulations of the amyloid plaques than those without it.

Unless they exercised.   The carriers of the gene who reported walking or jogging for at least 30 minutes five times per week had plaque accumulation similar to the volunteers who were e4 negative.  In essence, the APOE-e4 gene carriers mitigated their inherited risk for developing Alzheimer’s by working out.  Or as the study authors wrote, a “physically active lifestyle may allow e4 carriers to experience brain amyloid levels equivalent of e4 negative individuals.

The good news here is that lifestyle – that is activity levels – have been shown to have an effect on plaque accumulation and therefore could change the course of Alzheimer’s in individuals.

The bad news is that the overwhelming majority of the people in the study were sedentary and their inactive lifestyle was accelerating the accumulations of amyloid plaques.

A few comments on this study. 

First of all, I think it’s great news about someone studying the effect of exercise on a condition like Alzheimer’s because the fewer drugs we can take the better.

Secondly, isn’t it interesting how exercise has an effect on a genetic condition.  Meaning that just because you have the gene doesn’t mean you have to manifest the condition if your environment doesn’t drive the gene to expression.  People should see this as empowering.

Thirdly, 30 minutes of exercise a day five days a week is not very much exercise and is nowhere near the ideal for optimum human health, so imagine how healthy people would be if they actually exercised enough – how many other genetic diseases wouldn’t be as much of a problem if people got enough movement.

One of the limits in the study is that they didn’t really talk about the accumulated effect of not exercising for years, and they didn’t study what the effects would be if someone already had symptoms and started to exercise – would their symptoms abate and would they be able to postpone their conditioning worsening?

So, do you want to stay healthy and keep your mental acuity until you are really old?  Get moving!  Having trouble moving, well you better get in for an adjustment. One of the benefits of regular chiropractic care is that you are better able to move and exercise on an ongoing basis.

Want to have some fun and help your memory – do crosswords, sudoku and get a book called The Playful Brain by Restak and Kim – it’s full of games that will challenge you and that have been proven to keep you sharp into your old age!.

When you need chiropractic adjustments Abbotsford is the place to be.  Dr. Dorothea McCallum provides General Chiropractic Care for people of all ages, Pre and Perinatal care for Moms and babies – Webster Technique Certified, Wellness Care and Coaching – Certified Chiropractic Wellness Practitioner (CCWP), Custom Corrective Orthotics.

Visit our office on-line by seeing our video on CanPages!  New Patients always welcome www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

Dr. McCallum’s office is located upstairs in the Bay SevenOaks,32900 South Fraser Way,Abbotsford,BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

Shake, Rattle and OOOps, Don’t Roll!

Vibration, Bone Density and Strength in the Elderly

If you’re getting along in years and worried about your bones and falling and breaking something you may have looked into a number of things to help keep yourself healthy.  Researchers are interested in this too, because osteoporosis, and the resulting pain and fractures, especially of the hip joints causes a lot of suffering and costs the health system a lot of money.

One surefire way of promoting bone mass and decreasing the risk of falling is physical exercise.  The problem here is that exercise not performed properly can increase the risk of falling.  Because of this, researchers and other health practitioners have sought new ways to help seniors stay on their feet and stay active. One of the strategies that’s been investigated is whole body vibration. Something that’s available in many gyms are vibration platforms.

Whole body vibration is most often delivered to the body through a vibrating platform that a person stands on.  Exercise can be performed while on the platform.  The science behind this is based on the neurophysiological theory that exercising on the platform activates muscle spindles (sensory receptors in muscles), which in turn cause a reflexive muscle contraction.  In theory, this should cause an increase in muscle strength.

This idea also theorizes that this kind of exercise will promote bone growth.  We know that the tension that muscles exert on bones causes the bones to maintain or increase their strength.  At the same time, muscle strength is highly related to bone mineral density.

Let’s look at what a recent study says about exercising on a vibration platform before you get too excited about an easy way to prevent osteoporosis and falls.  The study I’m looking at is called The Effects of Whole Body Vibration Therapy on Bone Mineral Density and leg Muscle Strength in Older Adults; A Systemic Review and Meta-analysis, by Lau RWK, Lin Rong L & Yu F et al. published in clinical Rehabilitation 2011; 25(11):975-988.

When compared to sham vibration, whole body vibration has no significant effect on hip bone mineral density unless the person exercising is 86% or more compliant in doing their exercises.

In fact the study showed that vibration platform exercise generally was no better than active exercise (the usual kind) for increasing bone density.  Interestingly, where the vibration exercise showed significant benefit was for functional tests and increased muscle strength -  things like straightening your leg to resistance, getting up out of a chair, jumping higher.  So, vibration platform exercise is beneficial for helping older people carry on doing their daily activities – staying active and flexible and strong.  It would be interesting to see a comparison study between vibration platform exercising and weight training, since weight training has been shown to be more beneficial for older people than aerobic exercising.  Apparently the stress of lifting and moving weights against resistence is good for the heart and cardiovascular system, it has more of an effect on muscle strength than other exercise and requires bending, twisting and other flexibility movements.

The review that I read about this study basically said that more and better research needs to be done on vibration platform exercise.  One of the things that I thought might be involved with the platforms was an increase in proprioceptive input, which is always a good thing for balance. This wasn’t mentioned in the study, but would be something that could be investigated.

Otherwise, the conclusions from this study is that you don’t actually need to go out and buy an expensive vibration platform, or a costly gym membership where they have vibration platforms in order to get and stays strong when you get old.  Just get moving.

When you need chiropractic adjustments Abbotsford is the place to be.  Dr. Dorothea McCallum provides General Chiropractic Care for people of all ages, Pre and Perinatal care for Moms and babies – Webster Technique Certified, Wellness Care and Coaching – Certified Chiropractic Wellness Practitioner (CCWP), Custom Corrective Orthotics.

Visit our office on-line by seeing our video on CanPages!  New Patients always welcome www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

Dr. McCallum’s office is located upstairs in the Bay SevenOaks,32900 South Fraser Way,Abbotsford,BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

FEAR AVOIDANCE BELIEFS AND PAIN AVOIDANCE IN LOW BACK PAIN part 2

Last week we began our discussion about how you think about pain and movement affects how well you heal and how well you feel.  This week, I show you how smart health providers figure out which one you are so they can help you get better faster.

The following information is from a paper in The Spine Journal 2011;11:895-903, titled Fear-avoidance beliefs and pain avoidance in low back pain – translating research into clinical practice, authored by Rainville J, Smeets RJEM, Bendix T et al.

Problematic Fear Avoidance Beliefs can be classified into 3 categories:

1. Misinformed avoiders:  Most people fall into this category, and hold the belief that certain movements and activities will cause re-injury and/or increase pain.  They then avoid these activities. In general, they do not report high distress, low self-efficacy or profound disability.  Their beliefs are based on reasoning and are likely to change with new information and new experiences.  Recommended Interventions: Educational interventions that explain the causes and process of low back pain.  These should be delivered by a recognized spine expert in a compelling format.
2. Learned Avoiders: Patients in this category do not express fear of re-injury, and do not have explicit beliefs about physical activities causing re-injury or increased pain.  They view activities as painful and avoid these activities in order to avoid pain.  Recommended Interventions: No approach has been established, but quota-based exercise has been suggested.
3. Affective Avoiders: considered the most challenging patients, they are profoundly distressed by back pain, exhibit excessive pain inhibitions during physical examination, and are strongly committed to their disabilities.  They exhibit persistent, irrational fear of physical activities due to its perceived likelihood of producing back pain.  This group would benefit from treatments that address dysfunctional cognitions and catastrophic thinking. Recommended Interventions: “exposure in vivo” technique that addressed phobias (gradually expose patient to feared physical activities); “functional restoration” treatment that integrates quota-based exercise and counseling.

These categories of patients with problematic fear-avoidance beliefs allows health providers a way to tailor treatment plans according to the patient to improve low back outcome.

As mentioned, most patients are misinformed avoiders; These patients believe pain is harmful based on past experiences and multiple information sources.  They are generally unwilling to perform activities that (may) cause pain.  New information and experience (exercise) will reduce their fear avoidance beliefs.

Learned pain avoiders believe that pain should be avoided, and will choose to stop activities that are painful

Lastly affective avoiders have distorted beliefs about pain and spine conditions that are based on emotionally charged misinterpretation of past experiences and distortion of medical information.  They will not attempt activities that might be painful, and display profound pain inhibition for movement.  Their dysfunctional cognitions and catastrophic thinking needs to be addressed, and fears decreased through gradual exposure to feared activities.

As I heard a pain specialist once say, there is a difference between hurt and harm.  Many things may hurt, but are not harmful.  Sometimes, not moving, which does not hurt, causes the most harm.  I always advise people to move as much as possible, and most find that they feel a lot better when they do.  In fact, if reasonable movement does not improve symptoms, that is a reason to look deeper for something else going on.

Movement is life, and if you don’t keep moving, you soon won’t be able to.  If you ever hear a health provider tell you to stop moving or to rest until you feel better, I think you should probably look around for a second opinion, they could be making you worse instead of better.

CMCC Run/Walk for Chiropractic Education and Research

Dr. McCallum is again walking in the Annual CMCC Run/Walk for Chiropractic Education and Research in Toronto on April 29th.

Canadian Memorial Chiropractic College is considered the top chiropractic college in the world and is renowned for rigour and innovation.  It is a private institution and receives no government funding, but relies on membership, tuition and donations.  If you’ve been helped by Chiropractic, or know someone who has, please give generously. Just go to www.cmcc.ca/dorotheamccallum and follow the steps to donate online.

We are as close as the CanPages online. Please feel free to refer your family and friends using this link:

 www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

Dr. Dorothea McCallum is an Abbotsford back painrelief doctor who looks at so much more.  Your back is connected to every organ, cell and tissue in your body by the nervous system. Find out how chiropractic can help you live a longer, fuller life.

Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

Notice:

Dr. McCallum is in Toronto this weekend for CMCC Board Meetings and the Run Walk for Chiropractic Education and Research.  See my donation plea below!

FEAR AVOIDANCE BELIEFS AND PAIN AVOIDANCE IN LOW BACK PAIN

Over the next two weeks, I’m going to be exploring  – just a little bit – about how you think about your back pain affects how well you heal and how you feel.

The following information is from a paper in The Spine Journal 2011;11:895-903, titled Fear-avoidance beliefs and pain avoidance in low back pain – translating research into clinical practice, authored by Rainville J, Smeets RJEM, Bendix T et al.

Fear avoidance beliefs (FABs) are the avoidance of movement and/or activities due to fear of pain.  This fear may be based on emotion or reason, or both. To date, most research has investigated FABs in chronic low back pain (LBP) patients, while very few studies have been conducted on fear avoidance beliefs in acute low back patients. These factors are very important for determining how disabled a person becomes and how different people handle the situations they find themselves in regarding pain.  They are particularly important because they show how beliefs can affect actual physical symptoms – how much control a person has over how they feel.

Responses to the fear of pain – note, I didn’t say to pain, but the fear of pain – run in a continuum from “confrontation” to “avoidance” as the two extremes.  A person with confrontational behaviour will attempt to return to normal activity despite the pain, and eventually will have reduced fear of pain.  A person with avoidance behaviour will avoid activity that they associate with pain, and eventually will have increased fear of pain.

The paper I cited above describes the impact of fear avoidance beliefs of the patient and the health provider on low back pain outcomes, as well as a classification system of problematic fear avoidance beliefs.  You’ll note that the health provider’s beliefs about pain are just as important as the patient’s!

Fear Avoidance Beliefs

Your health provider’s behaviour and communication methods about pain greatly influence your experience and outcome.  A good explanation of low back pain can help relieve fears and avoidance beliefs by emphasizing the mechanical basis for the pain and the body’s many resources for healing and handling pain itself.

As a health provider who tends to be more confrontational in my approach – as many chiropractors are – I need to be mindful that fear avoidance beliefs exist quite strongly throughout the general population, for many things, not just back pain.  All you have to do is watch TV for a couple of hours and count the number of ads there are for pain relief medications, or look at the addiction problems created by prescription drugs like oxicontin in the people it has been prescribed to.

It’s natural to experience an increase in fear avoidance beliefs when you experience an episode of low back pain.  This increase is usually temporary and returns to normal once your symptoms subside.  In some people, though, the FABs persist or even escalate.

In chronic low back pain cases, the consequences of fear avoidance beliefs are more significant because they are strongly associated with disability and do not often decrease as symptoms subside.

Persistent fear avoidance beliefs in chronic pain reduce the effectiveness of treatments for reducing disability.

Health Care Providers & FABs

Health care providers are typically moderate fear avoidant overall, and their fear avoidance behaviour are minimally associated with education, spine expertise, or practice experience.  Arguably, chiropractors are the least fear avoidant of the providers, since our entire schooling and education is based on movement and function and these only occur with use.

However, I work in a clinic that is multi-disciplinary and have watched other providers and disability programs and had to deal with the consequences of their FABs.  Health care providers with strong fear avoidance beliefs leads to patients with higher fear avoidance beliefs and more disability.  Health providers with low fear avoidance beliefs leads to patients with lower fear avoidance beliefs and  lower disability.
Next week, I’ll show you how we spot how well people will do with their care.

CMCC Run/Walk for Chiropractic Education and Research

Dr. McCallum is again walking in the Annual CMCC Run/Walk for Chiropractic Education and Research in Toronto on April 29th.

Canadian Memorial Chiropractic College is considered the top chiropractic college in the world and is renowned for rigour and innovation.  It is a private institution and receives no government funding, but relies on membership, tuition and donations.  If you’ve been helped by Chiropractic, or know someone who has, please give generously. Just go to www.cmcc.ca/dorotheamccallum and follow the steps to donate online.

We are as close as the CanPages online. Please feel free to refer your family and friends using this link:

 www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

Dr. Dorothea McCallum is an Abbotsford back painrelief doctor who looks at so much more.  Your back is connected to every organ, cell and tissue in your body by the nervous system. Find out how chiropractic can help you live a longer, fuller life.

Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

Dr. McCallum is raising money for Chiropractic Education and Research on April 29th.  The 27th Backs in Motion, Run/Walk for Chiropractic Education and Research is taking place in Toronto and Dr. McCallum needs your help!

Canadian Memorial Chiropractic College is considered the top chiropractic colleges in the World and is renowned for rigour and innovation.  It is a private institution and receives no Government funding, but relies on membership, tuition and donations.  If you’ve been helped by Chiropractic, or know someone who has, please give generously.  Just go to:  www.cmcc.ca/dorotheamccallum and follow the steps to donate online.

MOVE YOUR WAY TO BETTER HEALTH

Staying active can stave off illness.  Actually this is a ridiculous thing to say because it sounds like we are predisposed to illness and only by really working at it can we ever hope to be healthy.  The truth is the exact opposite.  Our bodies are predisposed toward health, and it is only by neglect in not providing the best materials to build a good body and keeping its environment pure that we get sick.

That being said, one of the key requirements for excellent health is movement.  And now the scientists are proving what chiropractors have been saying for 117 years!!

Researchers at the University of Missouri recently persuaded a group of healthy, active young adults (I bet they were students) to stop moving around so much so they could see how inactivity affects disease risk.  Scientists have known for some time that sedentary people are at risk for developing heart disease and Type 2 diabetes.  But they haven’t fully understood why, in part because studying the effects of sedentary behavior isn’t easy.  People who are inactive may also be obese, eat poorly or face other lifestyle or metabolic issues that make it impossible to tease out the specific role that inactivity, on its own, plays in ill health.

In a recent study in Medicine & Science in Sports & Exercise, scientists created a fairly realistic version of inactivity by having volunteers cut the number of steps they took each day by at least half.

They wanted to determine whether this physical languor would affect the body’s ability to control blood sugar levels.  “It’s increasingly clear that blood sugar spikes, especially after a meal, are bad for you,” says John P. Thyfault, an associate professor of nutrition and exercise physiology at the University of Missouri, who conducted the study.  “Spikes and swings in blood sugar after meals have been linked to the development of heart disease and Type 2 diabetes.”

The scientists fitted their volunteers with sophisticated glucose monitoring devices, which checked their blood sugar levels continuously throughout the day.  They also gave the subjects pedometers and activity – measuring armbands, to track how many steps they took. Finally, they asked the volunteers to keep detailed food diaries.

Then they told them to just live normally for three days, walking and exercising as usual.

Exercise guidelines from the AHA and other groups recommend that people accumulate 10,000 steps or more a day, the equivalent of about 5 miles of walking (our genetic requirement is actually closer to 10 miles per day for optimum health, but the American Heart Association is only interested in preventing heart attacks, not optimum health.)  Few people get even close to 10,000 steps.  Repeated studies of American adults have shown that a majority take fewer than 5,000 steps per day.  The volunteers in the study were atypical in that on average they exercised 30 minutes or so most days and easily completed more than 10,000 daily steps during the first three days of the experiment.  The average was almost 13,000 steps.

During these three days, according to the data from their glucose monitors, the volunteers’ blood sugar did not spike after they ate.

That certainly changed during the second portion of the experiment, when the volunteers were told to cut back on activity so that their step counts would fall below 5,000 a day for the next three days.  The volunteers stopped exercising and at every opportunity, took the elevator, not the stairs, or had lunch delivered instead of strolling to a café.  They became, essentially, typical American adults.

Their average step counts fell to barely 4,300 during the three days and the volunteers reported that they now “exercised” on average, about three minutes per day.

Meanwhile, they ate exactly the same meals and snacks as they had in the preceding three days, so that any changes in blood sugar levels would not be a result of eating fattier or sweeter meals than before.

The changes were profound.  During the three days of inactivity, volunteers’ blood sugar levels spiked significantly after meals, with the peaks increasing by about 26 percent compared with when the volunteers were exercising and moving more.  What’s more, the peaks grew slightly with each successive day.

This change in blood sugar control after meals “occurred well before we could see any changes in fitness or adiposity,” (fat buildup), due to the reduced activity, Dr. Thyfault says.  So the blood sugar swings would seem to be a result, directly, of the volunteers not moving much.

This is both distressing and encouraging news.  “People immediately think, ‘So what happens if I get hurt or really busy, or for some other reason just can’t work out for awhile?”  Dr. Thyfault says.  “The answer seems to be that it shouldn’t be a big problem.” Studies in both humans and animals have found that blood sugar regulation quickly returns to normal once activity resumes.

The spikes during inactivity are natural after all, even inevitable, given that unused muscles need less fuel and so draw less sugar from the blood.

The condition becomes a serious concern, Dr. Thyfault says, only when inactivity is lingering, when it becomes the body’s default condition.  “We hypothesize that, over time, inactivity creates the physiological conditions that produce chronic disease,” like Type 2 diabetes and heart disease, regardless of a person’s weight or diet.

To avoid that fate, he says, keep moving, even if in small doses.  “When I’m really busy, I make sure to get up and walk around the office or jog in place every hour or so,” he says wear a pedometer if it will nudge you to move more.

Then, when you’re not so busy, get back into your routine and keep moving!  Remember, activities that use the large muscles of our legs use the most blood sugar and burn the most calories, so even taking the steps instead of the elevator has a HUGE benefit.

From this study, you can see how adaptable your body is, and how easy it is to go wrong in our modern society where we sit all the time.  So, get up and move around.  If your job requires you to sit a lot, stand up every time the phone rings and walk around your chair.  Your body will thank you!

CMCC Run/Walk for Chiropractic Education and Research

Dr. McCallum is again walking in the Annual CMCC Run/Walk for Chiropractic Education and Research in Toronto on April 29th.

Canadian Memorial Chiropractic College is considered the top chiropractic college in the world and is renowned for rigour and innovation.  It is a private institution and receives no government funding, but relies on membership, tuition and donations.  If you’ve been helped by Chiropractic, or know someone who has, please give generously. Just go to www.cmcc.ca/dorotheamccallum and follow the steps to donate online.

We are as close as the CanPages online. Please feel free to refer your family and friends using this link:

 www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

Dr. Dorothea McCallum is an Abbotsford back painrelief doctor who looks at so much more.  Your back is connected to every organ, cell and tissue in your body by the nervous system. Find out how chiropractic can help you live a longer, fuller life.

Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

If any of

The Number of People with Diabetes Worldwide is Larger Than the US and Canadian Population Combined

The Non-Communicable Diseases Alliance which is comprised of many international health councils reported to the United Nations in September 2011 that more than 366 million people in the world have diabetes.  That’s more than the population of the United States and Canada combined.

The problems that diabetic patients face are enormous – heart disease, stroke, kidney disease and eye damage are just a few.  Diabetes also can have severe effects on the feet, including:

• Diabetic neuropathy, which damages nerves in the feet, will cause patients to not feel heat, cold or pain.  If a foot suffers a cut, it could become infected.
• Peripheral vascular disease, which slows blood flow to the feet, will delay healing in a sore or cut.  That, too, can lead to infections.
• Common foot problems – such as athlete’s foot, calluses, bunions and blisters – are only made worse by diabetes.

Infections can lead to gangrene, which is death of tissue due to a lack of blood flow.  This may lead to the removal of a toe, foot or even part of a leg.  The Cleveland Clinic reports that diabetes is the most common, non-traumatic cause of leg amputations.

It is important for diabetic patients to take care of their feet before serious complications develop.  Measures that can be taken include:

• Wash feet in warm water, but do not soak them.  Dry well, especially between toes.
• Check feet every day for sores, blisters, redness or calluses.
• Wear socks that are comfortable along with properly fitted shoes.
• Wear orthotics, which can be designed to reduce the peak pressure areas on the foot, reducing the chances of ulcerations or tissue damage.  Orthotics also correct biomechanical problems in the gait.

While the number of cases of diabetes continues to soar, non-insulin dependent (Type II Diabetes) is an almost completely preventable disease, and if you develop it can be reversed with easy life-style changes in diet and exercise.  Dr. McCallum is a Certified Chiropractic Wellness Practitioner who can help you make these easy changes.  As well, with over 15 years experience fitting Footmaxx Orthotics, she can help you with finding the right fit for you.

It’s Almost Run Time Again!

April 29th and the CMCC Run for Chiropractic Research and Education is nearly here.  Please visit my donation website to contribute to this great cause and support me as I support Chiropractic!

CMCC is a Not for Profit Educational Institue and receives no Government Funding, so we rely on people like you who have been helped by Chiropractic to help us continue to educate excellent Chiropractors.

To Donate:  www.cmcc.ca/dorotheamccallum and just follow the instructions.  Tax Receipts wil be issued by CMCC for next year.

Dr. Dorothea McCallum, Abbotsford orthotics custom provider uses the advanced Footmaxx computer system to analyze your gait.  Custom orthotics are manufactured to correct your particular walking patterns.  Not based solely on the shape of your dysfunctional foot, Footmaxx orthotics actually correct over-pronation and other gait irregularities. Wearing Footmaxx orthotics and can lead to healthier, functional feet.  Plus, no more foot pain!  Visit McCallum Chiropractic for a gait analysis.

Visit our office on-line by seeing our video on CanPages!  New Patients always welcome www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

Is it OK to exercise if I have a cold?

Mild to moderate physical activity is usually OK if you have a garden variety cold and no fever.  Exercise may even help you feel better by opening your nasal passages and temporarily relieving nasal congestion.

As a general guide for exercise and illness, consider this:

• Exercise is usually OK if your signs and symptoms are all “above the neck” – symptoms you may have with a common cold, such as runny nose, nasal congestion, sneezing or minor sore throat.  Consider reducing the intensity and length of your workout though, or you may feel worse.  Instead of going for a run, take a walk, for example.

• Don’t exercise if your signs and symptoms are “below the neck” – such as chest congestion, hacking cough or upset stomach.

• Don’t exercise if you have a fever, fatigue or widespread muscle aches.

Exercising with a fever or flu symptoms stresses your immune system even more.  Intense exercise can put you into an anaerobic exercise state and you will use the proteins in your blood for energy. Many of these proteins are part of the immune system, so you will have less ammunition to fight your illness. 

Sometimes it’s okay to rest.  Go to bed, drink plenty of fluids and sleep.  Also, if you have the flu, make sure you stay warm – take a hot bath and climb into a nice warm bed.  Viruses hate heat and this is one of the reasons your immune system and metabolism increase your temperature when you have an illness.  Don’t impair this process by taking fever lowering medications.  If you have joint aches and pains, a warm bath will ease your discomfort.

When you need chiropractic adjustments Abbotsford is the place to be.  Dr. Dorothea McCallum provides General Chiropractic Care for people of all ages, Pre and Perinatal care for Moms and babies – Webster Technique Certified, Wellness Care and Coaching – Certified Chiropractic Wellness Practitioner (CCWP), Custom Corrective Orthotics.

If any of your friends have questions about chiropractic or our office, refer them to our CanPages (Yellow pages online) site for more information about us. www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

This is a reminder that the schedule for this blog has changed. I will be publishing on the 1st and 3rd Thursday of every month.

Daily Aspirin Is Not For Everyone

As a Certified Chiropractic Wellness Practitioner I believe that all medicines are toxins with one or two good side effects.  There are NO medicines that are preventative.  All medicines work in the body to either enhance or block one of the body’s normal mechanisms for establishing and maintaining homeostasis.  Anything that disrupts homeostasis causes stress in the body and has consequences. So… I always go a little nuts when one of my patients comes in and tells me that they take baby aspirin every day to prevent a cardiovascular event or stroke or lower their cancer risk.  I just think there are better ways to stay healthy and now the medical research is catching up to me!

Nearly a third of middle-aged Americans regularly take a baby aspirin.  New research shows that aspirin is not for everyone, and that in some patients this so-called wonder drug is doing more harm than good.

Researchers in London reported in the Archives of Internal Medicine that they had analyzed nine randomized studies of aspirin use in the US, Europe and Japan that included more than 100,000 participants.  The study subjects had never had a heart attack or stroke; all regularly took aspirin or a placebo to determine whether aspirin benefits people who have no established heart disease.

In the combined analysis, the researchers found that regular aspirin users were 10 percent less likely than the others to have any type of heart event and 20 percent less likely to have a nonfatal heart attack.  While that sounds like good news, the study showed that the risks of regular aspirin use outweighed the benefits.

Aspirin users were about 3o percent more likely to have a serious gastrointestinal bleeding event, a side effect of frequent aspirin use.  The overall risk of dying during the study was the same for the aspirin users and the others who did not take it.  And although some previous studies suggested that regular aspirin use could prevent cancer, the new analysis showed no such benefit.

Over all, for every 162 people who took aspirin, the drug prevented one nonfatal heart attack, but caused about two serious bleeding episodes.

“We have been able to show quite convincingly that for people without a previous heart attack or stroke, regular use of aspirin may be more harmful than it is beneficial,’ said Dr. Sreenivasa Seshaisai of the Cardiovascular Sciences Research Center at St. George’s University of London.

These findings are likely to add to the confusion about who should regularly take aspirin and who should not.

Research shows that among men who have had a heart attack, regular aspirin use can be lifesaving, lowering the risk of a second heart event by 20- 30 percent.  It also reduces the risk of a recurrence among women who have had a stroke caused by a blood clot.

Aspirin works by interfering with the blood’s clotting action.  In blood vessels narrowed by heart disease, fatty deposits can burst, leading to the quick formation of a clot that blocks the flow of blood to the heart or brain.  Regularly taking an aspirin helps prevent the clot from forming. (As an aside – regular exercise helps the body grow new peripheral blood vessels around blocked and narrowed areas.  So, even if you have narrowing of your arteries you can improve your circulation and prevent  catastrophic events. Plus, when you need your normal clotting mechanism, such as when you knock yourself and get a bruise, or cut yourself, it will work.)

Nearly half of current aspirin users , however, don’t have established cardiovascular disease and have never had a heart attack or stroke, and take aspirin in the hope of preventing one.   Many of these people do this on their own without medical supervision.

So basically what this research is saying is that whether you take aspirin or not, the chance that you will die is the same.  People who take aspirin are less likely to die from heart disease or stroke, if they have cardiovascular disease, but are more likely to die by bleeding to death.  People who do not have cardiovascular disease will not die from heart attacks or strokes, but if they take aspirin, they are more likely to die from bleeding to death.

Hmmm.  What do you choose?  There is good research to show that life-style changes in diet and especially exercise have a profound effect on preventing cardiovascular disease and even repairing and preventing a second event.  Wouldn’t it be worth it to eat better food, take a regular walk and pump a little iron to live a little longer?  These changes might not be as easy as popping a little orange pill once a day, but you won’t have to worry about bleeding to death!  And you’ll just feel a whole lot better.

If any of your friends have questions about chiropractic or our office, refer them to our CanPages (Yellow pages online) site for more information about us. www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

If you’re looking for a holistic chiropractor Abbotsford is the place to look!  Dr. Dorothea McCallum has been practicing drug free, surgery free, hands on chiropractic for over 20 years. Dr. Dorothea McCallum provides General Chiropractic Care for people of all ages, Pre and Perinatal care for Moms and babies – Webster Technique Certified, Wellness Care and Coaching – Certified Chiropractic Wellness Practitioner (CCWP) and Custom Corrective Orthotics.

Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

Panel Recommends Pap Smear Tests Every Three Years, Not Yearly

I found an article about this in the New York Times.  I don’t actually get all my research and scientific reading from The New York Times – I belong to a Research Review Service and have access to the Canadian Memorial Chiropractic College Library online (and in person when I go there), but it is interesting to see what gets published in vehicles that the public reads.  It’s interesting seeing how long it takes the research to hit the streets – it’s often a pretty long time!!!

This article is interesting for a number of reasons, but because I’m in an “alternate” health field, I always get a chuckle from how medicine defines prevention.

The article I’ve quoted in the title starts out by saying that the Pap smear test is still the best way to prevent cervical cancer.  Well, actually, the Pap smear test is the best way to detect if cervical cancer is developing.  So, it’s not actually a prevention – which would mean that you are such a healthy organism that you’re not even at risk for developing such a disease – but a method of early detection.  That being said, it is a good test for detecting early cancerous changes in cervix cells.

The standard testing protocol, since as long as I can remember is for the test to be done yearly starting at puberty.  The new recommendation is that women should not get tested every year.  This is according to the United States Preventive Services Task Force (and has been endorsed by an equivalent Canadian body.)  Instead, every three years is the new recommendation.  The group named above is the same group that recently recommended against routine prostate cancer tests for healthy men (which is a topic for a whole other newsletter!)  Proposed changes are in response to insufficient evidence to weigh harms and benefits of separate tests screening for human papillomavirus, the virus that causes cervical cancer.

In a rare show of unity, groups including the American Cancer Society sided with the panel on the new recommendations on Pap smears and proposed new screening guidelines, bluntly recommending against the common practice of annual tests.  “If you test every year you find a lot of benign infections that would go away on their own,” said Philip Castle of the American Society for Clinical Pathology. “You end up overscreening, over managing and over treating women who are not actually at risk of getting cervical cancer.”  The task force, composed of primary care doctors who are experts at evidence-based research, is highly influential in setting the tone for primary care practice.  Echoing the panels’ recommendations, the cancer groups also said women younger than 21 did not need to be tested.  Side effects of over testing could include vaginal bleeding, pain, infections, risks of pre-term delivery and psychological impacts of facing a possible cancer diagnosis, experts say.

As a regular person, you’re probably wondering what all this is about; after all, wouldn’t early detection always be a good thing?  Isn’t more testing going to lead to a healthier population?  It turns out that it actually doesn’t – at least, not always.  What the public doesn’t understand about medical testing is that it isn’t as accurate and clear cut as you believe.  It isn’t like on TV with Dr. House – order more tests and come up with a more accurate diagnosis with each test.  The tests have certain parameters they measure and, given a whole bunch of variables, can indicate something – but they might also be indicating something else, entirely not related.  Tests nearly never prove anything, they more often disprove. The tests have to be given and studied in context.  A good history (which is what you tell your practitioner about what you are experiencing, your symptoms, what seems wrong, how long you’ve had it,  etc) is still the most accurate and valuable diagnostic tool. Tests should be given to prove or disprove a differential diagnosis (that is one or two or three good possibilities) based on your history.

Basically, what they are saying in this study is that Pap tests, because they are sensitive, but not very specific, show up a lot of things that are not necessarily important, but if you look at them too soon, they can get your doctor excited and he will treat you for something that you probably won’t get, and even if you did, it wouldn’t be important anyway.  But if you get tested every three years, it is easier to distinguish what we should be getting excited about.  Being treated for anything is not without side-effects and dangers – it is often better to leave well enough along and be sure of what you have before you risk the treatment.

I don’t know if this helps make this subject clearer for you, but I hope it does because medical over treating is dangerous and not health inducing.  I’m all about getting and staying healthy.

Now for the real clincher.  Want to know how to prevent cervical cancer? (That is, not get it at all?)  This isn’t a very popular strategy in our current society, but it is the most effective.  Practice abstinence before marriage.  Have only one sexual partner in your life who also has only one sexual partner in their life (you). What can I say?  Effective, not popular.  Instead we invent a vaccine for a couple of the more than several papillomaviruses and give it to little girls. 

Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

If you’re looking for a holistic chiropractor Abbotsford is the place to look!  Dr. Dorothea McCallum has been practicing drug free, surgery free, hands on chiropractic for over 20 years. Dr. Dorothea McCallum provides General Chiropractic Care for people of all ages, Pre and Perinatal care for Moms and babies – Webster Technique Certified, Wellness Care and Coaching – Certified Chiropractic Wellness Practitioner (CCWP) and Custom Corrective Orthotics.

 Referring your friends and family is easy.  From our CanPages listing, they can visit our site, and link up to our website and blog, get directions or email us with questions. www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html

When Doing Nothing is the Best Treatment

“Don’t just do something; stand there!”

Sound clever?  It’s the kind of thing that teaching clinicians of every discipline spout off at their students. A good clinician does their best to do their best for their patient and sometimes – that’s nothing.

Here are some medical examples:

Sore throat?  Get an antibiotic.

New headache?  Get a CT scan.

Backache?  Get an X-ray.

Still got a backache?  Get an MRI.

PSA at the upper limit of “normal”?  Get a biopsy.

Blood pressure still high?  Add another medication.

Doctors tend to want to ”do something” whenever they note something amiss.  And patients, by and large, want something done when they have a symptom.  Few people like being told just to watch and wait.

Of course, every “thing” a medical doctor does also has side effects – rampant bacterial resistance from antibiotic overuse; major increases in radiation exposure from unnecessary CT scans; incontinence or impotence from prostate cancer treatments that may do nothing to prolong life; toxic drug interactions from multiple medications, particularly in the elderly.

The admonishment “don’t just do something; stand there!” reminds us that we should stop and think before we act, that there are many instances in which doing nothing is greatly preferable to doing something.

In fact, there are some doctors for whom “doing nothing” is the dominant way of thinking, who are not reflex “do-ers.”  They tend to lean to toward the status quo:  If the patient is doing fine right now, why rock the boat?

There’s a term for this in the medical literature – clinical inertia – a term with a distinctly negative connotation.  It describes the doctor who, for instance, sees a patient with cholesterol levels that are not optimum but who does not prescribe a statin.  Or the doctor who notices that a diabetic patient’s blood sugar levels are still not normal but refrains from increasing the patient’s medication.  Of course, this is not black and white:  there is a continuum of practice styles, just as there is a continuum of personalities in general.  At one end are doctors who jump on the merest hint of a borderline lab value; at the other are doctors who avoid making changes unless absolutely necessary.

An essay in the Journal of the American Medical Association called “Clinical Inertia as a Clinical Safeguard” postulated that doctors who tend toward inertia might actually benefit their patients by protecting them from overzealous medical intervention.  Keep in mind that what follows is based on U.S. information.  Here in Canada, because of our more socialized medical approach, we are often inadvertently protected from overzealousness.

The study focused on three common medical conditions – diabetes, elevated cholesterol and hypertension (high blood pressure) – for which there are established clinical guidelines for doctors to follow and “quality measures” that evaluate medical care.  For all three illnesses, “lower is better” is the dominant mantra.

Yet, while “lower is better” is probably true for large populations, that is not always the case for individual patients.  In fact, there are some clinical trials in which aggressively lowered blood sugar or blood pressure have been association with higher rates of dying. (This doesn’t surprise me because the condition is stressful on the body and the treatment just increases the stress.)

The authors weren’t saying that medical conditions shouldn’t be actively treated, but they did caution that standard clinical guidelines tend to favor overaggressive treatment in pursuit of “good numbers.”  In the stampede toward good numbers, individual patients can be harmed by the side effects of these treatments.  Clinical inertia might actually act as a safeguard for such patients.

No one wants doctors who fail to act when action is necessary. Medical emergencies are a different story altogether.  Most chronic illnesses are not emergencies, so there is room for deliberation before action.  I think many people could be saved by inertia.

As a chiropractor I’ve seen so many people, especially older people coming in with lists that exceed two or three and can reach up to 14 and 15 different medications.  Often patients don’t know what each one is for and can’t keep straight when they are supposed to take each one.  I just remember the Doctor from Sunnybrook who taught us pharmacology saying that taking more than 3 medications at one time meant that the doctors were treating the side-effects of medications with other medications and that the patient would become so toxic that it was dangerous.  And the more medications a person was on, the more confusing the symptoms would become.

I feel fortunate to be a chiropractor.  Even if I for some reason decided to overtreat somebody for a period of time (and they went along with it) the worst that could happen is some joint hypermobility that can be resolved with rest and muscular strengthening exercises. Chiropractic is not inherently dangerous or toxic.  Since most people who go to chiropractors are undertreated because of scheduling, monetary, and other considerations, they never actually attain optimum spinal function and over treatment is almost never a danger.

As a Certified Chiropractic Wellness Practitioner I still think that the best treatment for chronic conditions like diabetes, high cholesterol and high blood pressure is prevention and life style modification.  If you already have these conditions, it’s not too late to change some of your behaviours and help your body heal and function better.  Talk to me about alternatives.

Start the New Year out right and get a check up.

Dr. McCallum’s office is located upstairs in the Bay SevenOaks, 32900 South Fraser Way, Abbotsford, BC.  Call 604-864-8232 to book an appointment.  We love helping people regain and maintain their good health.

When you need chiropractic adjustments Abbotsford is the place to be.  Dr. Dorothea McCallum provides General Chiropractic Care for people of all ages, Pre and Perinatal care for Moms and babies – Webster Technique Certified, Wellness Care and Coaching – Certified Chiropractic Wellness Practitioner (CCWP), Custom Corrective Orthotics.

Our office (inside the Bay) can be viewed on our CanPages site: www.canpages.ca/page/BC/abbotsford/mccallum-chiropractic-at-the-bay/4270514.html