Health Update: Fibromyalgia

Fibromyalgia: The Challenges of Diagnosis

Fibromyalgia (FM) is a chronic condition where there is widespread / whole body pain that is often difficult to diagnose.  Some patients may spend years of going to different doctors, undergoing many tests (of which most, if not all, are “negative”), and they may be diagnosed with different conditions such as rheumatoid arthritis, hypothyroidism, or mononucleosis before a diagnosis of FM is finally given.  Needless to say, this process can be very frustrating!

The reason for this dilemma is that there is no single diagnostic test (blood test, x-ray/image finding, etc.) that verifies the diagnosis of FM, leaving doctors in a position to “rule out” all other possible “diagnose-able” conditions first, before considering FM as “the” diagnosis.  Another challenge is the fact that FM symptoms vary widely from one person to the next and even vary within the same person at different times of the year.  There are a few “guidelines” doctors can use to help secure the diagnosis of FM.

One such guideline is from The American College of Rheumatology (ACR) which requires that “widespread” pain be present throughout the body for at least 3 months (“widespread” is defined as pain on both sides of the body, above and below the waist).  The ACR also has identified 18 points on the body of which at least 11 of the 18 “tender points” must be present to secure the diagnosis of FM.  There is debate as to the accuracy of this rather stringent criteria as FM symptoms can come and go and vary, making the 11 of 18 tender point findings sometimes change between visits.  Hence, widespread pain above/below the waist on both left/right sides of the body for at 3 months has become a more accepted indicator for diagnosing FM.

Yet another challenge in pinning down the diagnosis is that the FM sufferer may experience signs and symptoms seemingly unrelated to FM, such as stomach ache/digestive problems or headaches. This can lead the doctor down other paths before considering FM as a diagnosis.

Fibromyalgia can be primary (no other condition caused it) or secondary (other condition(s) lead to the development of FM).  Hence, the diagnosis process focuses on identifying conditions which can be identified through standard diagnostic tests, often overshadowing the diagnosis of FM.  Testing for conditions such as lupus, multiple sclerosis, sleep apnea, diabetes, Crohn’s Disease, and/or others, often makes sense to both you and your doctor, but adds to the delay in diagnosing FM.  Here are some suggestions to help your doctor through this diagnostic maze:

Ask questions:  Ask about what each test is for and what the next plan is if the tests are negative.  By increasing your understanding, this will reduce your frustration in this process.

Keep records:  Obtain a copy of EVERY test you have and share the information with any new doctor or specialist.  This can save time and money!

Find the “right” doctor:  Find a doctor you can trust and “talk to.” Not all doctors “believe” FM exists and some are close minded to considering it.  Try to locate a doctor with a lot of experience with FM cases and is willing to “…work with you.”

Build a good relationship: Be open, honest and avoid anger, skepticism and don’t be confrontational.  Be upfront about what is frustrating you about your symptoms.

Take care of yourself: Ultimately, “success” of treating FM demands a “team” effort between you and your doctor.  Managing stress (eg., deep breathing exercises), obtain care that works (eg., chiropractic, massage), eat a healthy diet (eg., gluten-free), exercise regularly but don’t overdo it, and get plenty of sleep and rest.



If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.                            
                                    
YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR FIBROMYALGIA! FOR A FREE NO-OBLIGATION CONSULTATION CALL (732) 719-8148

Today's Health Issues

Mental Attitude: Brain Scans Of Healthy Women Reveal Fear Of Getting Fat. Using MRI technology on healthy women, researchers observed viewing images of overweight females activates an area in the female brain that processes identity and self-reflection. "These women have no history of eating disorders and project an attitude that they don't care about body image," said Mark Allen, a BYU neuroscientist. "Yet under the surface is an anxiety about getting fat and the centrality of body image to self."
Personality and Individual Differences, May 2010

Health Alert: Lawsuit Fears, Peer Pressure Drives Higher Costs, More Tests! 25% of heart doctors order more tests than necessary, driving up costs. However, most report the extra tests are not for their own financial gain or to meet patient's expectations. 24% said they recommended a test because they were worried about malpractice lawsuits. 27% said they did it because they thought their colleagues would.
Circulation: Cardiovascular Quality and Outcomes, April 2010


Diet: Diet Alone Unlikely To Lead To Significant Weight Loss. Reducing caloric intake is not enough to promote significant weight loss. This is due to a natural compensatory mechanism that reduces a person's metabolism in response to a reduction in calories. Diet and exercise must be combined to achieve this goal. American Journal of Physiology, April 2010

Exercise: Back Stretching Exercises at Your Desk. Stretch your back with a "big hug". Hug your body, placing the right hand on your left shoulder and the left hand on your right shoulder. Breathe in and out, releasing the area between your shoulder blades. Do this several times during your day. Angela Smith, MD

Chiropractic: It is about your nervous system? There are more nerve cells in the human brain than there are stars in the Milky Way Galaxy. Chiropractic adjustments have been shown to increase nerve flow to vital organs.

Wellness/Prevention: Smoking Bans Reduce Heart Attacks. According to the World Health Organization, tobacco smoke is responsible for one in ten adult deaths. Many countries have introduced policies restricting where people can smoke, leading to fewer hospital admissions for cardiac events.
The Cochrane Library, April 2010

Quote: "It is true that I am carrying out various methods of treatment recommended by doctors and dentists in the hope of dying in the remote future in perfect health." ~ George Santayana

Childhood Obesity and Healthy Eating

Eat your vegetables, don’t drink too much soda, get some exercise.  We all know what we should be doing, but few of us actually stick to what we know.  In fact, it is rare that you will find a family that sticks to a healthy diet, limits the amount of time in front of the computer or TV and encourages regular exercise.  Childhood obesity is becoming an epidemic in the Unites States.

According to data from CDC and NHANES surveys from 1976-1980 and 2003-2006, obesity rates in children from 2-5 years old has risen from 5.0% to 12.4%, 6-11 years old from 6.5%-17.0% and in children from 12-19 years old from 5.0%-17.6%!  This drastic raise in obesity rates is increasing the risk of cardiovascular disease (such as high blood pressure and high cholesterol) and Type 2 (Adult onset) Diabetes in children. 

Several factors are contributing to the increase in these obesity rates.  First of all, there is a drastic imbalance between the amount of calories consumed and calories burned on a daily basis.  High caloric foods such as fast foods and those which are processed have little nutritional value and are unable to be broken down easily by the body.  Foods and drinks with high sugar content are easily converted to fat.  Also, most children lead a sedentary lifestyle.  One study found that children between the ages of 8-18 years old spend a little over 3 hours per day watching T.V., DVD’s, playing video games or spending time on the computer.

Environmental and behavioral factors are also contributing to the obesity rates in children.  Young children are easily influenced at home, in school and their community.  It is essential that as parents, you give your children the proper guidance and healthy eating habits.  Family meals are a comforting ritual for both parents and kids.  Children like the predictability of a family meal and parents like the time spent with their children.  This is also a great way to introduce health eating habits.  Children who are raised in families that have regular meals together have been shown to be more likely to eat more fruits, vegetables and grains, are less likely to snack on unhealthy foods and are even less likely to use alcohol and smoke.

Whether you have a toddler or a teen, here are five of the best strategies to improve nutrition and encourage healthy eating habits:
1)Have regular family meals.
2)Serve a variety of healthy foods and snacks
3)Be a role model by eating healthy yourself.
4)Avoid battles over food.
5)Involve the kids in the process

By making some simple changes in your family eating habits, you are greatly reducing the risk of poor health for your children, now and in the future.

Should my children see a Chiropractor?

It is all too often that I am adjusting a child and another nearby patient says to me “I had no idea that you can adjust children, why do they need chiropractic care?”. Well, in my opinion, all children should be adjusted! Many spinal problems that affect adults began as early as birth. Even “natural” child birth places significant stress on the spinal column and developing nervous system. Theses stresses on the nervous system have often been traced to be directly related to common infantile disorders such as colic, nursing difficulties, chronic ear infections, sleep disturbances and allergic reactions. As the infant grows, learning to hold their head upright, sitting, crawling and walking, all pose an opportunity in spinal development where minor trauma may adversely affect spinal alignment and the nervous system.

As your children grow up, they learn new skills such as riding a bike, playing sports and interactive video games, all of which carry the possibility of causing mild spinal misalignments (subluxations). If neglected, the injuries during this period of rapid growth may lead to more serious problems later in life. Subtle trauma throughout childhood will affect the future development of the spine leading to impaired nervous system function. Because the nervous system controls and coordinates the function of all systems: circulatory, respiratory, digestive, hormonal and immune system; any aspect of health may be impaired by nerve interference.

Through a thorough case history and examination, chiropractors are able to determine if subluxations are present. Chiropractic adjusting techniques are modified to fit your child’s size and weight. They are both gentle and specific to the child’s developing spinal structures. In fact, most parents tell me that their children look forward to their next visit and really enjoy the treatment! They also report that their children experience a greater level of health while under regular chiropractic care.

So, like I said at the beginning of this article, it is imperative to have all children checked for spinal misalignment. Many of you reading this article have experienced the power of chiropractic care, not just for pain relief, but for when you have been sick or run down, suffering from allergies or asthma. Give your children every advantage that you can to allow them to grow up as health and happy as possible.

Pediatric Chiropractics

As the weather warms up, it comes time to dust off that catcher’s mitt, clean those soccer cleats and get out the bathing suits. There is a sense of excitement in the air. One that can only be described as Spring and Summer. During this time of year, many families will spend countless hours at the baseball diamond, soccer field, swimming pool and even the playground. But, did you know that this is also a time of the year when many new injuries can occur in your children?

In the United States, about 30 million children and teens participate in some form of organized sports, and about 3 million injuries occur each year, which cause some loss of time and participation. Almost one-third of all injuries incurred in childhood are sports-related injuries. By far, the most common injuries are sprains and strains. Obviously, some sports are more dangerous than others. For example, contact sports such as football can be expected to result in a higher number of injuries than a non-contact sport such as swimming. However, all types of sports have a potential for injury, whether from the trauma of contact with other players or from overuse or misuse of a body part. Did you know that most organized sports-related injuries (about 60 percent) occur during practice and not the actual game? Also, children who are less developed than a more mature child of the same age and weight are more at risk for injury. Hormones even have an affect of injury rate in children. Before puberty, boys and girls carry approximately the risk of sports related injuries. However, during and after puberty, boys are at a greater risk.

In preparation for this exciting time of year, parents must take precautions to reduce the risk of traumatic and overuse injuries in their children. Everyone knows that proper warm ups, stretching and cool downs are essential. But, did you know that dehydration is a major cause of muscle injury. Sports and other vigorous activities can cause excessive fluid loss from perspiration. Sodium depletion has also been associated with muscle injury. Loss of sodium, the most abundant chemical constituent of body fluids outside the cell, is usually a function of dehydration. To reduce the risk of injury due to dehydration, follow these simple rules.

1)No soda! Sugar will increase the rate of dehydration.
2)Drink 4-6 8oz glasses of water per day minimum.
3)Mix your favorite sports drink 50/50 with water to replace electrolytes including sodium.

Another simple step that you can take to help reduce the risk of injury is to have your child check by a qualified pediatric chiropractor. Probably more than any other health profession, chiropractic’s approach to health closely relates to the needs of the athlete. Most sports involve body contact, fast starts and stops and positioning that places an unusual amount of strain on the structural system. Pediatric chiropractors give special attention to the spine, joints, muscles, tendons, ligaments and nerves. Chiropractic is a natural health care method that stresses the importance of keeping all the systems of the body functioning efficiently so the player enjoys peak performance, minimum risk of injury and fast recovery. Many world class and Olympic athletes, as well as most professional sports teams, have retained sports chiropractors to provide care to enhance their performance.

Call our office today to set up a consultation with Dr. Beck to assess and correct the possible risk of injuries that your children may face this sports season. Dr. Beck is a board certified diplomat in clinical chiropractic pediatrics.

Health Update: Whiplash Part 2

Whiplash – What Is It?

Whiplash is a slang term for an injury to the neck that occurs as a result of a sudden jolt, classically occurring in a car accident though a slip and fall injury can sometimes result in a similar condition.  In a classic rear-end collision, the car is struck from behind and accelerated forward at speed that even if the person knew the impending collision was about to take place, bracing the body prior to impact would not prevent injury.  In fact, muscles can only be voluntarily contracted at around 800-1000 msec. and in a rear end collision, the head is “whipped” within a 300-400 msec. time frame.  Add to that, the muscles in the front of neck are initially stretched with the car is propelled forward leaving the head in a relatively extended backwards position.  Most of the headrests in cars are not properly positioned so the head often goes back much farther than the limits of our muscles, ligaments and joints may allow resulting in stretching and tearing of these tissues.  When the tissues in the front of the neck are over stretched, the “rubber band” effect propels the head forward - overstretching the muscles, ligaments, and joints in the back of the spine.  This “crack the whip” phenomenon occurs within 400-500 msec., far quicker than what we are capable of when voluntarily contracting our muscles. Here is a breakdown of what happens in a 5 mph rear-end collision:

0 msec.: At the moment of impact, the car seat just begins to move and the occupant has not yet been accelerated forward.
50 msec.:  As the back of the car seat pushes the torso forward, the spine moves forward, resulting in a straightening of the thoracic and cervical spine. About 2-3 G’s of force are exerted on the torso.
75 msec.:  This difference in motion between the neck and torso results in an S-shaped curve, where nearly all of the bending in the cervical spine takes place in the lower cervical spine.  This rapid bending in just a few joints can result in ligament damage in the lower spine.
150 msec.: Here, the torso has pulled so far forward on the lower neck that the head is forced backwards often over the head restraint.  Depending on the position of the headrest, the angle of the seat back, and “spring” effect of the seatback, the ligaments in the front portion of the spine are often injured during this phase of the collision.  About 3-4 G’s are exerted on the shoulders.
200 msec.:  Finally, the force of the car seat throws the head and torso forward. Here, 5 G’s are exerted on the head and neck as it whips forwards.  All of this is completed in less than 500 msec.

One of the reasons this occurs has to do with the ability of the car – particularly the back bumper to not deform so that the force of impact is transferred directly to the contents within the vehicle (ie., the passengers).  At higher speeds, the crushing metal absorbs some of the impact and the contents are actually less jostled and thrown about.  This helps explain how a no damage rear end collision can result in greater injury than a higher speed collision.

If you, a loved one, or a friend is struggling with whiplash residuals from a motor vehicle collision, you can depend on receiving a multi-dimensional chiropractic assessment and therapeutic approach at this Advanced Wellness in Marlboro.

Dr. Cilea is president of Advanced Wellness, an integrated practice that offers chiropractic care, physical therapy, pain management, acupuncture and massage therapy.  To find out if you are a candidate for their customized treatment approach call 732-719-8148 or visit www.advanced-wellness.net.

What is Kinesio Tape?

By Dr. Jeff Gontarski
“Few who watched the 2008 Beijing Olympics will forget the Gold Medal beach volleyball performance of Kerri Walsh and Misty May-Treanor. The black Kinesio tape atop Walsh’s 6-foot, 3-inch frame, in stark contrast to her white bathing suit, also sparked a good deal of speculation.”
“Internet message boards made wild guesses. Was it a political statement or a sponsor’s logo? Perhaps a memorial to a deceased relative? Countless therapists knew the answer, but viewers were mystified. According to several reports, Walsh’s therapists used the tape to stabilize the superstar’s surgically repaired shoulder and boost blood circulation.” A quote from the article, “Kinesio Tape Comes of Age.” by Greg Thompson.
At Advanced Wellness of Marlboro, Kinesiotaping techniques are used for multiple ailments such as low back pain, plantar fascitis, knee alignment, pain issues and numerous others. “ Taping techniques are quick, easy, comfortable and allow the patient to get back to there activities of daily living faster” say Dr. Jeff Gontarski PT, CEAS, physical therapist at Advanced Wellness. “Our taping methods also help patients with posture and everyone is amazed with the results.”
The specialized tape works in different ways depending on its’ intended use. For patients with pain and inflammation, tape is applied to relax the skin and underlying tissues to allow for increased blood flow. Patients with instability problems can easily have their problems corrected by aligning the joint properly and securing with kinesiotape. “ The tape is a specialized tool and should be applied by a trained professional according to your problem” says Dr. Jeff.
If you have any questions about Kinesiotape and are wondering if it could help your problem, please contact one of our clinicians at Advanced Wellness.

Swine Flu, Fact and Fiction

By Scott Beck

With the 2009-2010 flu season in full force, many Americans are searching for protection for them and their families. This year is particularly scary since we are faced with the first pandemic (global outbreak) in over 40 years because of the H1N1 influenza virus. As growing controversy over the safety and effectiveness of the seasonal and H1N1 flu vaccines spread, the question “what am I to do” often arises. To make an informative decision on your families health care options, we must first take a look at the facts.

Each day the media reports additional cases of H1N1 infections and rising death tolls attributed to the pandemic disease. In July of 2009, the World Health Organization issued a press release stating that it will no longer release the global table of H1N1 infections because it is “extremely difficult, if not impossible” to determine swine flu cases in laboratory testing. The Centers for Disease Control issued a similar statement on October 2, 2009. “Influenza diagnosis will not distinguish between infection with seasonal influenza vs. infection with A-H1N1.” However, we are told by our doctors and the media that it is imperative to have the flu and “swine” flu vaccine this season. Here are a few facts on that:
The nasal spray vaccine by MedImmune has demonstrated evidence in clinical trials of shedding the live virus for 3-21 days post-vaccination. This means that vaccinating large populations, especially school children, with the live nasal-spray vaccine may actually cause a rise in the number of those infected! Also, pregnant woman have been identified as a targeted risk group for H1N1 and seasonal influenza, therefore, they are urged to get the vaccines. However, Influenza vaccines are Category C pharmaceuticals, which means that no animal or human studies have been conducted for safety. Influenza vaccines have not been tested on pregnant women.
As a concerned and informed parent, you are now wondering what you can do to protect your family with a safe and natural approach. The simple answer: CHIROPRACTIC. One of the most important studies on chiropractic and the immune system was performed by Ronald Pero, Ph.D., chief of cancer prevention research at New York's Preventive Medicine Institute and professor of medicine at New York University. Dr. Pero measured the immune systems of people under chiropractic care as compared to those in the general population and those with cancer and other serious diseases. His initial three-year study was of 107 individuals who had been under chiropractic care for five years or more. The chiropractic patients were found to have a 200% greater immune competence than those people who had not received chiropractic care, and they had 400% greater immune competence than those people with cancer and other serious diseases. The immune system superiority of those under chiropractic care did not appear to diminish with age. Dr. Pero stated “When applied in a clinical framework, I have never seen a group other than this chiropractic group to experience a 200% increase over the normal patients. This is why it is so dramatically important. We have never seen such a positive improvement in a group.”
The immune system is affected by the nervous system through the connections with the endocrine and the autonomic nervous system. And chiropractic care improves the function of the nervous system through improving the movement of the spinal bones that encase and protect the spinal cord. Stressful conditions lead to altered measures of immune function, and altered susceptibility to a variety of diseases. Chiropractic care is a safe, gentle and effective way to enhance your immune system this flu season. Call today for a FREE consultation to discuss how our health care team can help your family!

How to Practice Gratitude.

Study after study shows that people who give time, donate money or simply help others are healthier and live more fulfilled lives. Here are some things you can do.

1.) Volunteer. Volunteer your time, skills and expertise. Volunteering helps, you build and sustain your community, which in turn will give back to you. It's a win-win situation. People volunteer to contribute their skills and knowledge however it's practically guaranteed that you'll walk away with more knowledge and skills than you had beforehand. There is little else in life that offers the same level of satisfaction like watching your hard earned efforts benefit someone in need. Volunteering also offers you new interests, new experiences, new people, and authenticity and credibility in your industry.

2.) Donate funds. What's your favorite cause or charity - something that's important to you, your family or your friends? Perhaps it is the American Cancer Society, the Humane Society, or the Nature Conservancy. These organizations thrive on two things: Volunteers and Donations. If you have causes, passions and charities which are near and dear to your heart, it's important to do what you can to keep them in the black, financially solvent, and able to continue to provide their services.

3.) Mentor. Mentoring is an exceptional way to share your knowledge and experience with others and give back to the world. Mentoring is when you meet with someone one-on-one and help them learn and grow. A mentee can be a child or young adult struggling with choices, a professional who is interested in growing their career, or a person interested in starting a business similar to yours. A mentor/mentee relationship is essentially, however you define it.

If history and experience have taught us anything it's that the more you give, the more you receive. When you take the time to give back to the world with the intention of improving the lives of others, the essential result is that you end up receiving so much more than you can possibly imagine. Give it a try. You'll be amazed what happens in your life.

I Feel Better. Why Continue?

The biggest mistake patients often make is quitting care too soon. Once symptoms resolve many patients feel they are fixed. This cannot be further from the truth. My years of observing relapses proves this.

It is impossible to correct mechanical flaws in joints, break up scar tissue and adhesion and strengthen the weakened supporting structures in a few visits. Your body is very intelligent and will avoid pain at all costs. Even at the expense of proper biomehanics. Ultimately the body will compensate which will only lead to a problem elsewhere in the body.

The goal needs to be correction of the joint problems and prevention of future problems. This takes time and effort. It is common to think you are fixed when the pain is gone but this is rarely the case.

Make your own rules to lose weight.

When is comes to nutrition you need to create rules and stick to them. Far too many times people consume an abundance of food on a Saturday night only to wake up Sunday morning and have another huge breakfast...and no gym in sight. If you want to play you must pay. How about this approach. I am going to indulge on Sat night but I will be at the gym first thing in the morning and I will eat a moderate breakfast. I personally make rules such as no alcohol during the week or no dessert during the week. Once again it all boils down to discipline. However, at least this way there is some accountability and you will feel the remorse when you break your "rules". They are your rules so make it fun. The bottom line is you must expend more energy than you consume.

This one nutrition tip can change your life!

I recently participated in Tom Phillip's Ultimate Body Transformation. Tom is my trainer and a group of his clients followed Tom's program as he trained for a natural bodybuilding show. Always looking for a challenge I jumped in. Although I have always been a good eater I was amazed at the power these 2 P's had in getting me the leanest I have been in years! The first P is preparation or better yet planning. As the saying goes, "If you fail to plan you are planning to fail. " This cannot be more true than when it comes to eating. You must take the time to prepare the meals in advance for your ENTIRE day. The next P is Portion control. You can eat the best, organic and healthy food choices, however, if you eat too much you will gain weight. It is simple math. You must burn more than you consume! I have heard it time and time again. "I eat healthy" or "I don't like sweets." Without preparation and portion control you will never get to your goals no matter how healthy you think you eat.

Did you make a health deposit or withdrawal today?

Huh? Each day we either move in the direction of health and wellness or towards sickness and disease. We rarely are staying in a neutral state. So how did you begin your day. Did you make a deposit or a withdrawal? Let me give some examples. Did you choose to get up early and exercise or did you hit the snooze button. Did you have the quality high protein breakfast or the sugary cereal? You have choices each day, all day. These choices are either depleting your health potential or enhancing it. Take a piece of paper. Make 2 columns. The left column is the deposits. The right column is the withdrawals. Take inventory. It may be a surprise you are as healthy as you are! This is only a testament to the amazing resilience of the human body. Take heed. Disease is not about bad luck. It is about your choices throughout your life.


http://www.advanced-wellness.net

What is wellness?

I am often confused by the term wellness. What is it? Is it going to a spa for a massage? Is it eating a plate of veggies? The reality is there is no perfect definition. I think the best way to explain wellness is "any activity or habit you do to better help one acheive a higher state of health." For example going to the gym regularly is a wellness habit. Doing this on a regular basis will certainly help you maintain an active life. The point is wellness is an action word. One must actively participate if they are looking to acheive a higher state of wellness. My top 3 wellness acts.
1. Exercise regularly. It can simply be a 20 minute walk but make sure you move your body daily!
2. Eliminate ALL refined carbs including white flour and white sugar.
3. Reduce your stress by emptying your plate. Learn to say no. Much of our stress is self inflicted. Don't commit to so much.

That's it for now. See you next time.

Dr. Cilea

www.advanced-wellness.net