Cholesterol Lowering Drugs & Exercise - A Prescription For Longer Lives

 The Lancet recently published a study which looked at mortality risk for a segment of the middle-aged population with dyslipidemia and the effect of statin-therapy and exercise. The cohort study found that "patients who took statins and were physically fit had as much as a 70% reduction in the risk of dying during the follow-up period as compared with the least physically fit patients who were taking statins." 

 Additionally, the singular use of either a stain-therapy (i.e. Lipitor) or cardiovascular exercise reduces the mortality risk for the population in question as well. 

 What does this mean? It means that exercising is an essential component of a healthy lifestyle and even 20 minutes daily of a brisk walk can have profound effects on health. We also have to remember that statin-therapy comes with some risks - and that consulting with a spectrum of physicians to find the right therapy for you is essential. 

http://www.medpagetoday.com/PrimaryCare/GeneralPrimaryCare/36134

Epidural Steroid Injections Do Not Help Chronic Sciatica

 As a chiropractor who works with other health providers including anesthesiologists, orthopedic surgeons and neurosurgeons it is essential to keep up on the latest news and research available. One recent MedpageToday article particularly caught my interest with respect to back pain and treatment options.

 Inflammation is a common problem, not only in society-at-large, but with back pain as well. One of the more invasive methods of dealing with back pain is through the administration of epidural cortisone injections into problematic regions of the spine. This can provide some relief for patients for varying lengths of time. For sciatica, or irritation of the sciatic nerve, this meta-analysis revealed that patients derive "minimal benefit from epidural corticosteroids."

 The data collected revealed that there was small, but statistically significant short-term pain improvement for patients with leg pain, but the long-term effects were modest and did not achieve statistical significance. Patients were either administered corticosteroid or placebo through injection.

 Again, speaking as a chiropractor who refers non-responsive patients for this form of treatment, it is worth noting that chronic sciatic sufferers may have limited options when all forms of conservative therapy have failed. It makes it all the more important to treat the cause of the problem, not mask it through a combination of pharmacological interventions and injections.

http://www.medpagetoday.com/Neurology/GeneralNeurology/35927

Meningitis Outbreak Update: Afflicted Toll Hits 500+

A recent update from MedpageToday.com notes that over 500 patients have become infected with various fungal forms of meningitis due to contamination of vials with a medical compound shipped from a Massachusetts company to places across the country. As of Monday of this week, 11/26, there are approximately 510 affected people with 36 deaths, the vast majority due to fungal meningitis, an infection of the tissue that lines the spinal cord within the spinal column.

Unfortunately, the vast majority of those affected suffer from chronic pain conditions, namely spinal and extras-pinal joint pain. These conditions, if unresponsive to first-line medical treatment, are often treated with methylprednisolone, a steroid that is injected to reduce inflammation. It is important to note that inflammation can be successfully, conservative and naturally managed through less invasive and obviously safer techniques.

With regard to joint and muscle pain, chiropractic and functional medicine can help to keep you out of the office of the medical doctor and put your health in your hands.

http://www.medpagetoday.com/Neurology/GeneralNeurology/36109

More Information On Epidural Steroid Injection & Meningitis Outbreak

As the number of Americans who have both acute and chronic back pain increases, the use of alternative therapies and traditional therapies have risen as well. In many instances, they are very closely aligned, much moreso than you would think. Many chiropractors today, including Dr. Donohue at Rehabilitation & Spinal Care of Rockford, work in network with other medical professionals including anesthesiologists and orthopedic- and neurosurgeons. The use of epidural steroid injections is a tool designed to "blunt" the inflammatory response in a certain area of pain within the spinal architecture.

With the use of epidural steroid injections to help stem pain, there are risks involved and Dr. Donohue would like his patients to know that before recommending such a procedure, he exhausts all other conservative options. Here is an informative article about the use of chiropractic in the wake of this outbreak.

http://www.baltimoresun.com/health/bs-hs-chiropractors-meningitis-20121104,0,5046512,full.story

Obesity & Pharmacology: Simplicity or Best Outcomes

Obesity is an epidemic in every sense of the word. As the waists of the people of the United States continue to grow, the Food & Drug Administration (FDA) has assessed two new weight loss drugs in the hopes to curb this disturbing weight trend. Obesity, for its seeming simplicity, is an extremely complex, multifactorial disorder that has a cultural, genetic and environmental basis and the purpose of this post is to respond to the perspective section of the New England Journal of Medicine's recent perspective article in the October 25, 2012, Volume 367, Number 17 edition (right next to Halloween and candy!)

The second paragraph of the narrative states, "However, numerous once-promising weight-loss drugs have been abandoned because of serious toxic effects: aminorex (pulmonary hypertension), fenfluramine and dexfenfluramine (valvulopathy), phenylpropanolamine (stroke), rimonabant (suicidal ideration and behavior) and most recently (sibutramine (myocardial infarction and stroke). The removal of sibutramine from the market left orlistat as the only prescription drug approved for the long-term treatment of obesity.

These drugs (tradenames: Belviq and Qsymia) as prescribed, are adjuncts to a reduced-calorie diet and increased physical activity lifestyle for patients who are defined as obese. They both act to inhibit or reduce appetite and in some people, produce a negative-energy balance. In reading the of the article, it is mentioned that there was a time in which an increased incidence of brain and mammary tumors were a possibility in Belqiv. Later in the article, it is stated that the administration of Belqiv can also possibly lead to increases in psychiatric, cognitive and serotonergic adverse effects.

The reason I bring this up is due in large part to posit the question: How do people feel about the prescription of drugs to combat any, and all health concerns? 

I ask this because as a practitioner who has counseled patients in weight loss, exercise and eating healthier I wonder if medication provides the best outcomes for obese patients who are seeking, or are mandated to lose weight. I fully understand that weight loss is a complicated endeavor combining emotional, psychological, physiological and biomechanical factors. Is prescribing a patient a weight loss drug like Orlistat just easier than counseling them? Or does pharmacological intervention simply provide better outcomes? It's a question that I struggle with often as the secret to weight loss is not a mystery, but the path can be so difficult for people.