Realistic Goals for the New Year

I hear it every day during the holiday season..."I am starting my diet and exercising every day starting January 1st!". Yep, and for most people that really means I will start on the 3rd or 4th and continue for 1 day to 1 month before going right back to my old ways. Why? Because very few people change their whole life all at once and never go back. My advice is simple. Stop playing the "all or nothing" game.

A realistic plan that includes using sense during the holidays is a good way to start (all holidays, not just Christmas). The holiday season should not be an excuse to eat ALL DAY, everyday. This is true for a couple of really important reasons.

1. If you are like the average American, you will gain 7-10 pounds between Thanksgiving and New Years doing that. That is OVER 40 HOURS of exercise or over 24,500 calories that need to be cut! Statistically, most people don't even stick to their resolutions long enough to undo that damage. Now, if you were to use some sense and only splurge a bit and throw in some short exercise sessions and you might limit it to two pounds. That is less than 12 hours of exercise or 7,000 calories to cut. Combine diet and exercise and two pounds comes off in a week.

2. If you are used to eating every time you see food, how hard is it going to be to suddenly eat less than "normal?" It is hard enough to cut calories from your regular diet. It is much harder to go from excessive eating and constant snacking to trying to get by on 3 small meals a day.

OK, I know it is too late to go back and use sense over the holidays, so we need a realistic plan for getting going in 2011. Here are a few tips to help get you started to better and LASTING fitness and eating habits.

1. PUT DOWN THE COOKIE! (Just kidding, unless you are actually eating a cookie!).

2. Start drinking lots of water. Most holiday food is high in sodium and many of us drink too much alcohol or caffeine during the holidays. This can lead to water retention and dehydration. Dehydration makes you HUNGRY. VERY HUNGRY! Put the water back and save yourself a lot of pain.

3. Do a bit of planning for your meals and shop accordingly. It is easier to make good food choices when those are the ONLY choices in the house! Don't buy a bag of chips and expect not to eat it. You need to plan for snacks and meals and buy ENOUGH food. Don't pretend you aren't going to eat anything. You will end up making a trip to McDonalds or somewhere else for a snack! Almonds or low calorie popcorn or rice cakes can make good snacks to satisfy cravings for chips. If you are a coffee drinker, decaf flavored coffee with or without Stevia or Splenda and some low fat milk can help with a sweet tooth craving. Buy ingredients for specific healthy meals like stir fry (no fried rice and no take out), or fajitas with LOTS of peppers and onions and fresh tomatoes. One chicken breast is plenty to feed 2 people if you use a lot of veggies. Also, try making a bowl of fajita ingredients and skip the tortilla. Add extra veggies to pasta sauce to bulk it up. If you want meat, use one or two hot Italian turkey sausage. You will get a lot of flavor for a few calories.

4. Choose a reasonable exercise starting point. If you haven't worked out in years, do not start with running and do not make your first workout so intense that you cannot move for the next three days. Start with 20-30 minutes on the treadmill or elliptical machine and build. Nothing stalls an exercise plan like excessive post-workout soreness. You want to aim for 4-6 days per week and 30-60 minutes each time. To get there, start with 4-6 days per week, but keep the intensity down and see how you feel before adding more. 20-30 minutes on a bike is a great start! Ultimately, it cannot be where you end if you really want to get healthy, but it is a very good place to begin.

5. Think HEALTH more than weight loss. Aim for 6-8 servings of fruits and vegetables a day (and not the syrupy or cheesy kind). Try to go meatless several meals a week. Allow for some treats too. It is OK to have a cookie now and then, but that CANNOT mean every day. If you are in the habit of having dessert after meals, that is something that needs to go. Meals should not be REWARDED with more food!

There is so much to say on this topic, but this is a good start. Being healthy is a choice, but it is NOT and absolute. You can have the things you crave, but not all the time. There are a lot of yummy substitutes out there.
Exercise is its own reward once you get started. You will have more energy, sleep better, feel less stressed and weigh less. What's not to like? Seriously, it's not that bad...

Have a Happy and Healthy New Year!

Follow Through Makes All the Difference

I have heard it a million times..."I tried Chiropractic and it didn't work for me." My next question is always, "How many times did you go before you stopped?"

Generally, I will hear an answer of one or two times. While it is true that chiropractic care will not work for every person or every problem, one or two visits is not an adequate treatment for the majority of problems. So, why don't people follow through before declaring it a failure? I think that happens for several reasons:

1. The patient has a high copay and was not planning on having to do more than one or two visits. At that point, they start to worry that they are going to spend a lot of money and get no result.
2. The doctor did not make the treatment plan clear, and therefore the patient was expecting to feel better within a few visits.
3. A friend or family member has told them of the "miracle of chiropractic" and how after just one "crack" they had no more pain. This does happen, and it is great when it does, but most cases do not respond that quickly. This creates a disappointment that can be as damaging as someone telling them it won't work!
4. Outside influences start to create doubt. Sometimes when a patient starts treatment, they get negative feedback from family or friends and they suddenly doubt their choice and stop care.
5. Chiropractors oversell the care and scare patients away. I have heard a lot of patients and a lot of chiropractors talk about extremely lengthy treatment plans proposed on the second visit with a need for payment plans and long term commitments. This is, in my opinion, damaging to chiropractic. When I say lengthy, I mean a year or 6 months planned out right away. There is NO reason that you should need to commit to a year right away! NOW- you SHOULD expect to have about a month planned out if you have a significant problem. If you have an auto accident or herniated disc, you may be in for a few months of care. But I don't blame a patient for running for the door when they show up with a stiff neck and are told they will need care for a year. I would run too!

So how do you decide what to do?
I would recommend asking yourself the following questions.

1. Have I had this problem for a long time? If so, chances are it is going to take a while to fix it.
2. Is there a structural defect or damage involved? Do you have a disc herniation or arthritis? Again, it may take a while to get your problem under control.
3. Did the doctor explain why the care is necessary and what to expect? Were there goals set, such as 50% improvement by 2 weeks? Treatment should be focused on REAL results.
4. What do I hope to gain from treatment? This is not always a simple question. Do you just want to get your pain to a manageable level? If so, you need to let the doctor know that. We are ALWAYS going to recommend the care that will eliminate or stabilize the problem. If you just want to get well enough to get through the week, then that is different. You need to share that information, and you should expect that your pain may return.

The obvious point I am making here is that there needs to be communication between the doctor and the patient and an establishment of realistic goals and expectations. A patient has a right to know WHY care is needed and approximately HOW LONG it is expected to take. However, you cannot fairly say that something doesn't work if you did not follow through with a reasonable plan. If a doctor tells you that something will take 2 weeks to heal and you give it 2 days, the blame does not fall with the doctor! We all wish that there was a magic pill or adjustment that will cure something instantly, but sadly, the body is limited by its own healing mechanisms, and we can only work within those parameters.

Be Well!

Chiropractic Care and Pregnancy

If someone asked me what the single most underused benefit of chiropractic care is, I would have to say pregnancy pain relief. The main reason for this is that patients and doctors don't know how safe and effective it truly is. Over the years I have heard many people tell me after delivery that they couldn't wait to have their baby so that they could come in and have their back adjusted. I have had many doctors tell their patients (and also my patients) that they should NOT get adjusted while they are pregnant. Clearly, we chiropractors need to better job educating those around us on what we do and how we do it! On the flip side, I do have several OB/Gyn's who send me patients on a regular basis. They understand how beneficial chiropractic can be to the over 60% of pregnant women suffering from back pain and sciatic pain associated with pregnancy.

Let's take this a question at a time.

What will a chiropractor do for a pregnant patient and how does it work?
Pregnancy affects the spine and pelvis a great deal and the effects start almost immediately. This means that pain can be present before the patient is even "showing." Treatment for low back pain, in my office, consists of flexion/distraction (a specialized form of traction), gentle chiropractic manipulation and home stretching. As the joints undergo the stress of pregnancy, chiropractic care can help to relieve reduce muscle fatigue, nerve irritation and joint inflammation that pregnancy can cause. My home programs focus on stretching and also keeping stabilizers (both abdominal and lumbar) active and strong.

Is it safe?
Chiropractic care is very safe during pregnancy. I make a few adjustments to my treatment that allow a pregnant patient to safely receive care throughout the pregnancy. The main modifications focus on limiting or eliminating lumbar rotation with the adjustment and refraining from the use of electrical muscle stimulation since it has not been tested on pregnant women. I also use a table with a "break away" middle, thereby creating an indentation for the baby to sit in. This allows a woman to lie on her stomach for treatment without any pressure on the baby. The adjustments are also a bit more gentle, as the ligaments are more lax during pregnancy.

How does it differ from a non pregnant patient's treatment?
As I stated above, we limit rotation, do not use muscle stimulation and use the break away to create space for the baby. I will most often use a pelvic drop on my pregnant patients. This eliminates rotation, which in very rare cases could be unsafe. If that position is not comfortable, I will use a non-rotational side position. I also may need to use a brace to help stabilize the patient. This is a last resort, as patients tend to hate them!

How long will it take?
As with any patient, the length of time needed to relieve pain will vary. Many women experience complete relief in a few visits. Others may need to be monitored throughout the pregnancy. In MOST cases, treatment will last 3-4 weeks.

More questions? Feel free to email me at DrWente@AllianceChiroCenter.com. You may also want to visit the American Chiropractic Association's website. Here is an article you may find interesting.

Understanding Your Insurance

INSURANCE! There are times when it can feel like a bad word, but we would all hate it more if we did not have it. Just ask someone who is living without. What I see most often when patients are angry about it is a basic misunderstanding of coverage. It saves you a lot of headaches if you learn a few basics about your policy prior to going to the doctor.

If you can answer the following questions, you are in pretty good shape:
1. Who is my insurance company? (you would be surprised...)
2. What is a deductible and how much is mine?
3. Do I have a copay, co-insurance or both?
4. What is my out of pocket max?
5. Do I need to see an in-network physician?
6. Do I need a referral to see a specialist?
7. Does my employer have a health reimbursement account attached to my policy?

If you do not know the answers to the above questions, you are not alone. However, there is also a good chance that you will get a nasty surprise after going to see the doctor. There is one thing that you need to know ABOVE ALL ELSE about your health insurance. YOU are responsible for knowing your benefits, and neither your doctor or your insurance company is liable for services that you received out of network or that needed a referral or pre-certification. I know, that seems ridiculous when they send you a 50 page book detailing your benefits. How can you possibly know it all? You can't, that is why you need to know the above information and how to get specific information when necessary.

Before we get into gathering the above information, it may be helpful to define a few of the above terms.

Deductible- This is the portion you are required to pay before the insurance starts to pay claims for you. For example, if you have a $500 deductible, you are responsible for the first $500 of your medical bills before the insurance company will pay anything. There are a few possible exceptions to this rule, and you will need to find out if these apply to you. Most preventive visits, such as an annual well visit or physical, will be covered without the deductible being applied. There are also a few plans that cover exams or office visits before the deductible is met. Your copay will still apply to these visits, though. AGAIN- you are responsible for knowing if this applies to your policy.

Copay- A copay is a set amount that you pay for each visit. These may vary by the type of doctor or facility. It is common to have a lower copay for your primary care physician and a higher one for a specialist or the emergency room.

Coinsurance- This is a percentage of the total amount the insurance company covers. It is generally 10-20% of the covered charges.

Out of Pocket Max- This is the maximum amount you will have to pay before the insurance company assumes 100% of the cost. This may or may not include your deductible. For example, if you have a $2,500 out of pocket max and a $500 deductible and a 20% coinsurance, you will need to pay your deductible and then pay 20% of all covered charges until that amount has reached $2,000. At that point, you will no longer need to pay the 20%. Obviously, you hope that you do not have that many medical bills in a year, but for a family of 5 or for someone with a serious illness, it isn't hard to get there.

Health Reimbursement Account (HRA or HSA)- This is a bank account designated to cover health payments only. A lot of employers are using these to lower the cost of insurance for their employees. They will purchase a high deductible plan and then fund an account to help meet the deductible. You will generally get a card to go with the account. This card is then used to pay your medical bills. Other companies will issue the money for you until it runs out. In this case, it is VERY important to know how much they will issue, because if it runs out, it may be 4-6 weeks before you know it, due to the time lag associated with insurance company processing. If you purchase your own insurance or if your employer does not provide the account and you have a high deductible plan, you can set up your own account (an HSA). You may then add money to it, pre-tax, to pay your medical bills.

Confused yet? Hopefully not. The final pieces of the puzzle pertain to networks and referrals. Most insurance companies have a network of providers that they have contacted with that agree to take a set reduction in their fees in exchange for access to that group of patients. You are generally required or at the very least urged to see one of these providers. There are different benefit structures that exist with most companies for in and out of network providers. You need to make sure that you ask the doctor or facility if they are IN NETWORK. I, sadly, hear a lot of stories of how the office said they "took their insurance" and then sent a large bill because they were out of network. The office didn't lie, they filed the insurance. However, they also failed to disclose that your benefits would be better at a different facility. As I stated earlier, YOU are responsible for the bill EVEN IF they failed to tell you that. That is why it is so important to understand your benefits. The same goes for referrals. If you need a referral to see a specialist, it is your responsibility to know it and to get the referral.

So how do you learn what you need to know? It's simple. Call your insurance company and ask them the questions above. Then, write it down and stick it in your wallet or purse with your card. You can also ask the doctor's office to verify your benefits for you. Most will if you ask, but they may not if you don't. When you are having a specific procedure done that you are unsure about, call them again and ask about it.

You may be wondering why your doctor doesn't know your benefits when you tell them who your insurance carrier is. Well, that's because each company sells a large variety of plans. United Healthcare offers hundreds of different benefit structures. There is no way that your doctor can know them all.

Bottom Line: Take a few minutes to ask questions and understand your plan. It will save you from a big headache and a big bill!

Chiropractic Care for Headaches

Suffer from frequent headaches? Chiropractic care may be able to help. There are many reasons why headaches occur. They can be migraines, tension, trauma induced, sinus, cluster or multiple other types, each having its own causation. Headaches are a very complex topic and are not well understood by a large portion of the population. On health intake sheets at my office, I very often see migraine circled, only to discover that the patient simply thought that denoted a severe headache. While migraines are severe headaches, not all severe headaches are migraines. Getting to the root cause of the headache will help determine if the headache is likely to respond to chiropractic care. But, as with most things in the body, there are no perfect rules and there is a lot of overlap of headache causes. For example, a migraine sufferer may also get a tension headache. If he or she gets enough of those headaches, it can cause a "ramping effect" and trigger a migraine.

As a chiropractor and a tension headache sufferer, I am well aware of the benefit of chiropractic care for tension headaches. I have also had great success with helping migraine sufferers decrease the frequency of their headaches or control headache pain during times when taking their medication is not possible, such as pregnancy. Trauma induced headaches that linger beyond a few days also respond well to chiropractic care. Cluster headaches are more difficult to control with chiropractic, and sinus headaches only respond if you can manage to relieve the sinus pressure, which can sometimes be achieved with chiropractic care.

You may be wondering what chiropractic care for a headache consists of. Generally, I will use 3 or 4 different elements. The chiropractic adjustment is number one. Headaches almost always have a link to the cervical spine, or neck. This link may be direct or indirect. Secondly, I use trigger point therapy to relieve muscle tension. I will also frequently incorporate passive modalities like electrical muscle stimulation or ultrasound. Lastly, home stretching and/or exercises are added to relieve muscle tension and re-establish proper muscle balance.

The amount of time that it will take to get your headaches under control will vary person to person, but if you are going to see a change, it should start within 2 weeks. Many people experience dramatic improvement after just one treatment. BUT, like everything with headaches, it varies. However, it is generally a relatively small time and money investment to see if chiropractic care can help.

The Cost of Not Paying Attention

The holidays are rapidly approaching and with that comes weight gain for most people. It’s hard not to gain weight with all of the additional parties and goodies that seem to be everywhere you look. However, you can minimize the damage if you pay a bit of attention to what you are taking in. The problem for most people is that they take on an all-or-nothing attitude when it comes to diet. So, naturally, when the holidays come, they stop trying to control their food intake and simply plan to take care of it after the New Year. This is a huge mistake, because after a month of partying, most people are worn out and tired and never take off all of the weight they gained, leading to that yearly creep of weight that so many experience. A pound of fat is equal to 3,500 calories. The average exercise will burn 200-500 calories per hour. So even at 500 per hour, that is 7 hours of exercise! The average person eats 1600-2200 calories per day (or should) so that is a 1 1/2 to 2 days of food! Now, multiply that by the SEVEN pounds that the average American gains each holiday season. Scary.
Now, if you can minimize the gain to 1 or 2 extra pounds, that might seem a little more doable. The key is paying attention to what you are taking in, not denying yourself all of the goodies the holidays have to offer. Here are a few tips:
Avoid standing next to bowls of food. It is way too easy to just reach out and grab another cookie when they are right next to you. Stand a little further away, so that you have to think about it before you grab one.
Think about what you drink. Stay away from the pop. With all of the other things you are taking in, you don’t need the extra 220 calories a can of soda has to add! A light beer has about 100 calories. Think of drinks like deserts, because that is essentially what they are. Hot chocolate, egg nog, punch and many others are full of calories.
Watch your portions. Try to take a little of everything not a lot of everything!
Try to eat healthy when you are at home. If you know you have a bunch of parties coming up, plan low fat, healthy meals for the time when you are at home. Every little bit counts!
Sneak in some exercise, even if it is only 15 minutes. It’s 15 less you’ll have to do after the holidays, AND it makes you think about fitness, which may encourage you to “behave” at the next party. I will try to get on the treadmill for 20 minutes a day during the holidays. It gives me some “me time” and helps keep my energy up while traveling. It also burns 100 or more calories, which is always worth while!
While no one wants to diet through the holidays, using a little restraint can go a long way to minimizing the damage in January.

Winter Exercise Ideas

A lot of people get their exercise outside in the spring, summer and fall, but then get out of the routine in the winter because it is too cold to go outside. Here are a few things to try during the winter to keep you going.

Buy a Workout Video (or 3)
There are a lot of great exercise DVDs out there. You can choose from just about any type of activity you can imagine. The great thing about an exercise video is that they are designed to use little or no equipment and to be done in relatively small spaces. I recommend a small collection to avoid boredom and to vary your activities. A good collection would include a few levels of cardio, a good upper and lower body toner with an ab section, preferably one that can be split up so that you don't have to work the whole body at once if you don't want to, and a good stretching or yoga video. Most video cost between $10-$20, so they are affordable. If you get a new one every 3 or 4 months, it is much cheaper than a gym membership and you can avoid being bored to death by the same routine.

Invest in a "Mini Gym" for your Home
With just a few pieces of equipment, you can develop your own home workout routine at home. A great start would be a workout mat, an exercise ball, and 2 sets of hand weights, one that you consider light and one that you consider medium. There is not a part of the body you might like to exercise that cannot be worked with that equipment. The best part...you can get it all for less than $100. By using intervals of toning and cardio such as jumping jacks, running or walking in place, you can create a great routine and set it to your favorite music to keep you motivated. Make sure to warm-up with some light full body activity and cool down with the same and finish with static stretching. Never stretch before, rather start with moves like walking in place, arm circles and a few other light intensity moves.

Turn Bad Weather into a Workout
Shoveling snow can be GREAT cardio. Make sure to warm-up and cool-down after and use good form. If you think of it as exercise, it may be more fun than thinking of it as work.

Try a Winter Hike
Hocking Hills and other parks provide wonderful settings for winter hikes. Just make sure that you wear good shoes and layer against the cold.

Look for Open Gyms or Join a League
Like to play a sport? There are always multiple sites for open gym for basketball and volleyball and many other sports available in the winter. Not only will you get a good workout, but it is a great way to get together with friends in the winter.

Don't Forget the Old Standbys
Winter is a good time to take the clothes off the old exercise bike or treadmill! These machines can be a little boring, but there are ways to liven up your workout while using them. Get a good sound track going to start. Pick your favorite music and get moving. If you are on the bike, you can read a book. It's true that this isn't the BEST workout in the world, but it is certainly better than nothing and time flies when you are reading a good book. You can also put the bike or treadmill by your TV and watch your favorite show while you are working out. Another idea, try playing games with yourself on the treadmill. I will set the speed and then turn the incline up 1 degree every minute until I am at the max and then head back down. Two cycles of that and you are done! Intervals are good too. Walk for 5 minutes then run 2 walk 3 for 3-4 cycles and then walk 5 to cool down. It will go fast and give you a good workout.

It may be easier and sound more fun to workout in the sun of summer, spring and fall, but winter is the WORST time to neglect your workouts. We are generally less active in the winter and eat more, so you need to keep a regular workout schedule to avoid winter weight gain. Regular exercise will also boost your immune system and energy levels, which we could all use in the winter time. There is always something you can do, so stop making excuses and get moving!

Healthy Eating With the Help of Your Freezer

One of the easiest and fastest ways to have home cooked meals, even when you have no time, is to keep meals frozen for easy preparation. Fall is a great time to do that, because you can make your garden vegetables or farmer's market purchases last all winter. The best thing about it, though, is that with a little planning it takes you almost no extra time to get a freezer full of goodies.

Getting good things to eat into your freezer can happen several ways.
1. Have a day at home with a bit of free time? You can easily make chili, vegetable soup or homemade pasta sauce while doing other chores around the house. These types of meals require some prep, but the majority of the cooking time will allow you to do other planned activities such as laundry, dishes, computer work or just relaxing.
2. Make twice as much for dinner. Making something that freezes well (pasta sauce, chicken noodle soup, shredded chicken)? Make twice as much and freeze half. It takes very little time to double a recipe. You will be grateful the next time you want something good to eat and don't feel like cooking!
3. Freeze individual serving portions of ingredients. You don't always have to have something completely done to save time freezing it. For example, green peppers are much cheaper in the summer than the winter. Therefore, I will freeze them for use in stuffed peppers all winter long. It saves prep time too, as you don't have to wash, core and slice them. You just pull them out and use them. You can also save extra zucchini by shredding and freezing it for baking casseroles or zucchini bread. This works well with corn too. Nothing is quite as good as summer corn on the cob. You can buy several dozen and freeze the whole ear or cook and cut it for great tasting corn all winter. It's much healthier than grabbing the bag of french fries in the bottom of the freezer and takes no more time!

I could go on and on, but you get the idea. Instead, I will just share my favorite freezer recipe:

Cabbage Soup
Add together in a large pot:
1 head of cabbage, cut up into bite size pieces
1 lb of hamburger
1 onion, chopped
3 T sugar or Splenda
2-3 T Worcestershire Sauce
6-10 cups water
1-2 bay leaf
salt and pepper to taste
a dash or 2 of cayenne pepper
Cover and cook until the cabbage is soft and the hamburger is cooked
Then add:
1-2 cans of diced tomatoes
1 12 oz can of tomato paste
Cook for an additional 15-20 minutes, remove the bay leaf and serve.

This soup makes A TON and freezes VERY well. Enjoy!

Working to Give Patients What They Want AND What They Need

Chiropractic care comes in many forms. Most people consider it a form of pain relief, something more natural than pills and less invasive than surgery. Others think of it as a way to keep things working properly, and they schedule appointments or check-ups at regular intervals to prevent problems. Both are good approaches.

Chiropractic care helps to keep the joints of the body moving properly and helps maintain proper alignment. It also helps to keep your muscles working optimally. It also optimizes the flow of information to and from your brain through the spinal cord and nerves.

As a chiropractor, I use a variety of methods to help get patients well and keep them that way. It is more than just "bone cracking." A lot more. The adjustment is the main method that I use. That is a quick push applied to a joint or joints to restore proper motion. An adjustment usually results in a popping sound, which is actually air in the joint, not a bone popping. This treatment is what most people think of when they think of chiropractic care. In addition to that, I use passive care such as muscle stimulation, traction and therapeutic ultrasound. Other treatments used include trigger point therapy, muscle massage, active and passive stretching and active exercise. At times I will use taping, bracing or orthotics to aid in care.

No two people are exactly the same and, therefore, neither are their needs when it comes to getting well. That is why there are so many different tools to use to get them where they want to be. Many people who come to my office just want to get out of pain. I will give them a much different plan than someone who comes to the office with chronic migraines. A patient with severe arthritis will need much different care than an injured teenage athlete. The key to being a good chiropractor is taking the time to find out what each person WANTS from care and then designing a plan to give them that result if at all possible. I hear a lot of people say that they don't like chiropractic because you have to keep going forever. To me, that is a clear case of the doctor not finding out what a patient wants and only trying to give them what they think a patient needs.

If you ask any chiropractor, they can tell you why it is a good idea to get regular chiropractic check-ups. However, I think that it is a mistake to assume that every patient is looking for a lifestyle change or a maintenance plan. Some docs would say that I am not being true to my profession by not recommending a maintenance plan to all of my patients. I prefer to see it as trying to give them what they want so that they will hopefully return if they need care in the future. Many people, after a few episodes of the same pain, will ask how they might prevent future episodes. That is a perfect example of someone who would benefit from a maintenance plan! Bottom line- pushing people into something they do not want or are not ready for will only drive them away. It is much better to take a minute to find out what they are looking for and try to give it to them. After all, health care is a SERVICE profession. That means we should be looking to please our customers, not change every one's way of thinking!

Learning From Experience

I have had quite a summer, and not a good one! I was tested in March using BRAC analysis and determined to have a BRCA-1 genetic mutation specific to my family. At that time, my sister was battling stage IV breast cancer, a battle she later succumbed to. I was given a 40% chance of ovarian cancer and a 50-85% chance of getting breast cancer! Given my age, the tenacity of my sister's cancer and many other factors, I decided to act quickly. In June I had a robotic hysterectomy at OSU. This procedure had the shortest recovery time and I was only away from work for 2 1/2 weeks. However, I continued to be very limited in certain activities.

Six weeks later and just as I was beginning to feel "normal", I headed into my second surgery. This one was a double mastectomy with immediate reconstruction. This surgery was also performed at OSU, in the James. Amazingly, I was hospitalized less than a day! However, I required help at home for simple things like taking a shower, going to appointments and even making lunch. I was not allowed to lift more than 5 pounds per arm! As a chiropractor, this created a big hole to crawl out of to get back to work. I knew that I would need to work very hard to make it back within the 6 weeks the doctors estimated.

My main goal in the beginning was to remain active. Within a week, I began taking walks. I started very slowly and listened to my body to know when to stop. My first walk lasted about 20 minutes and I went slowly upward from there. After my drains (tubes to allow the escape of fluid placed under the arms) were removed and I was given the OK to reach above my head, I started very gentle stretching of my chest muscles and my abdominals. I began standing using doorways and moved to lying on my back on an exercise ball. After surgery, I had a lot of bruising on my right side and a lot of swelling. I was also very surprised at how sore and tight my abdominal muscles were. I could literally SEE the fibers of the muscles pull up when I straightened up or leaned to the side! It felt as though they would tear if I moved too quickly or went too far. Obviously, this was an instance where I had to go very slowly and listen very closely to my body to avoid injury. I stuck with the gentle stretching and the walking for 2 weeks. Walking was a great way to loosen my chest muscles (arm swing) and to relieve the back pain that results from being hunched forward due to muscle tightness. I felt straighter and looser after each walk.

Once I was given the OK by my surgeon, I started training with light weights and a ball. It is amazing how heavy 5 lbs can feel when you are attempting to bench press with expanders under your chest muscles! It is also a VERY odd sensation that takes some getting used to. I also started by simply supporting my weight on my hands in a push up position. I have yet to manage even a girl push up, but I know I will get there. At 5 weeks post surgery, I feel I have regained my stamina and most of my strength, with the exception of my chest muscles. I will continue working on those for many months to come. As a chiropractor, I use my chest and stomach muscles all day, every day. I will have to modify things for a bit, but I cannot wait to get back to work! I will be returning at just under 6 weeks, and I am very proud to have met my goal.

Here are the main things I feel were instrumental in my recovery:
1. Early return to activity. As soon as you are SAFELY able, you need to get moving. Clearly, this will be a modified and easy activity, but you need to do something.
2. Listen to your body. Pushing too hard will result in a set back. I had one during my recovery. I went to work after 2 weeks to manage paperwork and stayed too long. I could feel the pain in my back and chest, but I felt I needed to finish what I was working on. For the next 2 days, I had trouble getting up without assistance, especially toward the end of the day. Start small and build! If you don't you will have to start over again.
3. When the doctor tells you that you can safely perform an activity, get to it. It is a false line of thinking to try to rest to get back to normal faster. If you do not move your body, it becomes accustomed to that. It is OK for things to be hard or uncomfortable in the beginning. Just start small and see how you feel the next day. Chances are, you will feel fine. It was very hard for me to attempt a bench press activity because it felt so weird with a foreign body (the expander) under the muscle. However, if I waited until it didn't feel weird or uncomfortable, I would NEVER get back to it.
4. Get enough rest. It sounds like I have been telling you not to rest, but that is not the case. After surgery, it takes up to 6 weeks to get your stamina back. That means that you may require a longer night's sleep or a nap. I napped daily for about 2 weeks after my second surgery. Having had 2 so close together, I felt pretty wiped out. I also frequently slept 9-10 hours per night if I didn't nap. Your body needs extra time to rebuild, and a longer night of sleep is an important tool in that process.

My recovery was far from perfect and is not over yet, but I have learned a lot about my body's abilities. I have also learned that pain medicine and muscle relaxers can be an essential part of an early recovery. Don't attempt to "take the pain". This will slow your recovery! When you are able, you need to leave those pills behind, but for the first few weeks, they were an important part of my recovery. After I stopped with the prescription pills, I still took over the counter ibuprofen to help with minor pain and with inflammation. I still have swelling and bruising due to a hematoma (pocket of blood) on one side, and I still occasionally take ibuprofen when needed. Many people fear addiction to pain killers and therefore try to do without. Unless you have a history of trouble in that department, those medicines will help you recover more quickly by keeping you comfortable and allowing you to REST. Getting comfortable to sleep is extremely important, and often this cannot be achieved in the beginning without pain medicine.

There is much to be learned as a health care provider from being the patient for a while. It reminds you how hard it can be and how many questions arise during the recovery period. There is fear with recovery, especially recovery from a major injury or surgery. It is important to know that all people go through it. Ask questions. Follow ALL of the doctors orders, and get back to being you!

Why It Doesn't Always Matter What You Call It

One of the things that doctors of all varieties will notice is that a patient has an overwhelming need to have a name for their problem, even if the naming of it gets them no closer to feeling better. As a chiropractor, I have struggled a bit with this over the years, and not because I don't know what is causing a particular problem. The problem is that the explanation doesn't always have a nice "official sounding" name to put with the pain. When you tell a patient that a muscle imbalance from left to right is causing uneven forces on the spine and creating inflammation and pain, they may understand you, but they have trouble taking that home and explaining it to their family. This can lead to confusion, distortion of the problem and patient's coming up with their own names for a problem. That is harmless until they try to tell their primary care physician what is wrong and the doctor suddenly thinks the chiropractor is crazy or just has no idea what they are talking about! Conversely, it can be very hard to sort through a patient's story to figure out what may be the truth of the matter when they are discussing past history of a problem.

I propose this...when it comes to many conditions, it makes no difference what you call it, only how you treat it. Labels don't relieve pain! For example, fibromyalgia is a very popular diagnosis right now. I hear a fibromyalgia diagnosis during my health history at least once a week. However, if you ask most fibromyalgia patients what makes them feel better, they will all tell you different things or they will tell you that nothing helps. That means that the diagnosis has not helped them one bit. They still had to try all kinds of things and most of them still don't feel better. The same thing is true with a pinched nerve. People are often told that they have a pinched nerve or ask if a pinched nerve could be causing their pain. Here is the problem with a pinched nerve diagnosis- it doesn't tell you anything about the where or what of the pinching. Most times, it isn't even a true "pinching" of a nerve. It is inflammation of the nerve root sleeve. A true nerve pinch could be a result of a disc herniation, a bone spur, a muscle spasm or, rarely, even a tumor. These are all very different conditions!

Diagnosis is OBVIOUSLY important when treating patients, but there are a lot of cases where your doctor is taking a guess. And I mean ALL of your doctors. The key is to rule out the dangerous stuff (heart attack, stroke, cancer, fracture) and then take your best guess based on the details of the examination and the history. I will give you a medical example. You come to the office with a headache. Your doctor will ask you where it hurts, what triggers it, how long it lasts, what makes it better, etc. Based on your answers, he or she chooses a category that is most likely the cause. He or she will then prescribe therapy based on that information. If the prescribed therapy does nothing to help the headache, then a different therapy will be tried until something is found that is effective. It is THE BEST method for dealing with the headache, but it is still guessing. The same happens with low back pain. There are multiple conditions that will present with very similar appearances. They will also most likely respond to the same treatment. So, I will make my best determination based on the history and examination and will work from there. If the pain goes away, does it matter if it was a facet syndrome or a sacroiliac pain? A mild disc injury will look and act pretty much the same. To complicate the picture, you may have a herniated disc that shows up on MRI, but that may have nothing to do with the current pain you are having. Just because it is there doesn't mean it hurts! A third of the population has a disc herniation and doesn't even know it!

I am not at all saying that doctors should stop diagnosing conditions. I just think that we need to stop focusing on the label so much. A diagnosis can become a crutch. It can become a part of how someone views him or herself. This can do a lot of damage to some people. You see people stop doing all of the things they like because someone told them they have a disc herniation, even if they have no pain. Pain behavior is a real thing and can be more debilitating than the condition that caused it. There are no rules that govern all people based on their health conditions. I have seen horrible spinal or knee arthritis in people who claim to have NO PAIN. And these folks are out there running and playing sports and having fun! Don't let the label change you just by its existence. Most things can be overcome with therapy and exercise. Just a thought...

Quit Babying It!

To many people, it seems contradictory to exercise something that is injured. This is especially true in the older range of the population. That is mostly because doctors used to recommend rest for injuries and pain of all sorts. Low back pain? Try a week of bed rest! Sounds lovely, but it will not help your back. In fact, it will probably make it worse.

Science has come a long way in the field of musculoskeletal injuries. Data shows that for most injuries, the closer someone can stay to normal activities, the faster they will get better. Obviously, this does not apply to all injuries or activities. If something is fully or significantly torn, such as a ligament, you may need to immobilize it to allow the fibers to heal together again just like you would a broken bone. But for most injuries, the best thing you can do is use it, you just need to use a little common sense too!

There are many reasons why this is true of healing.
1. Movement increases blood flow to all areas of the body and will bring nutrients and materials needed for healing to the injured site at a faster rate if it is moving.
2. Moving an injured area directs proper fiber growth when healing muscles, tendons and ligaments. If something is not moving, the tissue does not know which direction to place the new fibers and when the fibers are not aligned properly, you end up with scar tissue.
3. Decreased motion will lead to deconditioning and can lead to illnesses or blood clots. When you stay in the same position too long, you are more prone to develop blood clots, which can lead to severe problems. You can also get pneumonia. It doesn't take weeks or months for the likelihood of these to increase. It happens in a day or two.
4. Muscle tone lost is muscle tone that has to be rebuilt. If you do not get things back to where they were before the injury, you can be left with a weak spot, allowing the same injury (like an ankle sprain) to occur again and again.

With all of that said, you do need to be careful with an injury. Avoid heavy strain. If you work out, you will have to modify things for a little while. But MODIFY is the key word. Walk or ride a bike instead of running. Switch to little or no weight for your toning. Focus on stretching more than you used to. But don't stop moving! If you aren't sure what is safe, ask your chiropractor, trainer or medical doctor for advice.

What Can Chiropractic Do For You?

Most people think of back pain when they think of chiropractic care, and it is true that it is one of the major problems that chiropractors treat. However, I thought it might be more interesting to focus on what chiropractic care does for the body.
You have probably seen a list of all of the things that chiropractic care can treat. You may have wondered how one specialty can know so much about so many different things. The answer is simple. Understanding how the body works and applying principles that promote healing can have the same effect on multiple areas.


Chiropractic Care does the following things.

1. Increases blood flow to an area which helps to decrease inflammation, remove waste build-up and supply nutrients to allow rebuilding of damaged tissue.
Improves joint alignment and function. In other words, it makes the joint work the way that it should or as close as possible. If something is working properly, it rarely hurts!

2. Stimulates proper fiber alignment in damaged muscles, preventing scar tissue and speeding recovery.
Increases nerve flow to an area. This can have an effect on everything that the nerve root at that particular spinal level supplies.

3. Gives your immune system a boost. This is a product of the stimulation the adjustment sends to your brain.

4. Nourishes your discs. Unlocking tight or restricted joints will re-establish good blood flow to the disc at that level. Discs are nourished through movement. Restricted movement starves the disc at that level.

5. Causes the release of endorphins. This is temporary, but it results in that immediate good feeling that so many people feel afterward.


Looking at the effects of chiropractic manipulation, it becomes easy to see how it could help so many different conditions. When you add in the electrical muscle stimulation, trigger point therapy and exercise and stretching protocols, you get a program that can benefit every person, without exceptions. Chiropractic is most often used to help with pain or injury, but it is also great at PREVENTING problems, and now you can certainly see why.

Stop and Rethink Your Meal Ideas

Do you ever stop and give any thought to why people find it so hard to get healthy? It's simple. It is because they have practiced unhealthy habits for most of their lives, which makes any change seem like hard work. How many adults do you know who don't eat vegetables? That is going to make getting healthy pretty difficult! The recommendation for fruits and vegetables is 8 or more servings per day, and as I tell my husband, french fries don't count! Sadly, for most people, cleaning up your diet and getting all of the nutrients that you need will require some serious changes. However, if you give it a little thought, it can be very delicious and not as hard as you might think.

We waste so much of our daily caloric intake on things we don't need, that it seems like you would need to eat too much to get that many servings in. Obviously, we need to rethink our whole food structure. Boxed cereal is not a great breakfast, even with milk on it. Orange juice is OK, but you would be better off eating the orange. At less than $.50 per pound, bananas are a great breakfast food. I am also a big fan of egg dishes prepared with 1 egg and 3-4 whites. You can make omelets with tomatoes, spinach, onions, green peppers or just top the eggs with salsa. That gives you a bigger bang for your buck in the nutrition department and it will keep you full longer. You can buy presliced/diced onions and green peppers and deli ham with one slice of 2% cheese and have a "Denver" omelet in about 5 minutes. If you skip the traditional toast that you would normally eat with eggs, you are OK to have the cheese and meat, and you get the benefit of protein and dairy. The egg recipes also make for a quick and easy dinner on nights when you get home late. While I am on the egg idea- turkey, sliced tomatoes and diced onions with a piece of Swiss is another great choice, as is chopped spinach, garlic, diced onion and feta cheese. You can add a small amount of bagged bacon pieces if you like. SO good!

Now, how about lunch? Sandwich anyone? The main issue I have with sandwiches are that the bread is really a waste of time. Looking for fiber? Eat a salad or some celery. Bread, in reasonable amounts, is not the evil that it is often made out to be, but it is a non essential food. You are going to be a lot better off with soup and a salad or a low fat stir fry.

If you normally eat out for lunch, I can almost guarantee that you will be healthier and thinner if you start packing your lunch. Once again, it helps to think outside of the box with this one. Don't fall into the typical "brown bag lunch" routine or you will get sick of packing within a week. Try intentionally making too much dinner and then taking left-overs. You can even change them up a bit for variety. For example, if you make tacos or fajitas for dinner, use the extra meat for a salad topping the following day. You can rev up your dressing's nutritional content and cut fat by mixing salsa with light ranch. In the winter, try making soup on a Sunday and freezing it in small portions to pull out on those days when you don't have something else to eat. Lunch is easy if you keep the right items around. I am also a big fan of making 2 meals at once. Last night, while I was making pork chops and salad for dinner, I threw together a stir fry for today's lunch. I used tofu and prepackaged stir fry veggies that came with their own sauce. I had both meals ready in less than 30 minutes. Baked potatoes also make a quick and easy lunch starter. Top one with broccoli and cheese and have a side of raw almonds for a very easy and filling lunch.

Afternoon snacks can also help keep you satisfied until dinner time, but they also need to be GOOD snacks. I don't get home until almost 8 pm most nights, so an afternoon snack is essential or I will spoil my dinner with half a bag of chips while I am cooking (no body's perfect!). Raw almonds are a great snack. I get big bags at Sam's Club and use a 1/2 cup container to pack them in. It is amazing how filling a few handfuls of almonds are. I am also a big fan of applesauce as a snack. I will put about 1-1 1/2 cups in a bowl to snack on. You can use a piece of fruit and a string cheese too. Yogurt is also good. Make sure it has nutritional value and is REAL food.

I will save dinner thoughts for a later date. There is just so much that can be said on this topic.
Key points to leave with:
1. Eat real food that you need. Focus on fruits and vegetables first and go from there.
2. Pack your lunch.
3. Stay away from prepackaged foods whenever possible.
4. Plan ahead and use left-overs to your advantage. Cooking doesn't have to take a long time, you just have to put a little thought into it ahead of time!

A Healthy Lifestyle will Save You MONEY

With all of the debate on health care raging, I would like to address one of the topics that I feel is under emphasized. Americans are taking too many medications. The average patient in my office over the age of 40 is taking at least one but often 3-4 prescriptions. The average person over 60 is generally taking more than 5. The majority of these medications are for cholesterol, hypertension and Type II Diabetes. These are all preventable diseases that are generally caused by living an unhealthy lifestyle.

Don't get me wrong, when these conditions exist, the medication is necessary and it saves lives. However, I think that the focus needs to constantly be on prevention and healthy living. Think how much money could be saved if the prescriptions were cut in half. Even if you have great insurance, premiums reflect the cost of insuring the general population. I truly believe that prescription medication costs are responsible for a large portion of the constantly increasing cost of insurance. Did you know that erectile dysfunction is directly related to high blood pressure and diabetes? We wouldn't need all of those corny commercials if we were a bit healthier. VIVA Healthy Living!

Staying on the topic of healthy lifestyles reducing prescription costs, let's talk about osteoarthritis. Obesity is not the only cause of osteoarthritis. However, there are a greater number of people with hip, knee and spine arthritis that can be directly linked to obesity. Putting too much strain on your joints will lead to arthritis. The easiest way to do that is to be overweight. Not only are your joints overloaded, they are often forced out of proper alignment by the extra weight. An over sized belly forces the low back to be over extended at all times. This pushes the weight from the vertebral bodies backward to the facet joints. Vertebral bodies are large and thick and designed to carry weight. Facet joints are about the size of your finger tip and are NOT designed to carry weight. A few years of that and they start to hypertrophy, or add bone mass. This causes spurring and reduction in the space for the nerves. Hips, knees and feet are all pushed out their proper alignment with excess weight, causing pain, inflammation and eventual permanent change to the joints.

The sad thing is that most people understand that being overweight or eating junk instead of healthy food is harmful. However, it is so easy and so ingrained in our existence, that all you get are excuses as to why each particular person cannot change. Even more tragic is the fact that this is what we are teaching our children! We are creating a generation of obese children or children who with their current habits will undoubtedly become obese adults. It has got to stop for the health of our country and the health of our insurance system. I don't care who is running it, there is no way that it will be affordable if every person is taking 10 medications! There is no doubt that things need to change, and we need to start NOW.