chronic neck pain in seniors and chiropractic

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As we age, those nagging aches and pains start to impact on your quality of life.  Chronic neck pain is high on the list.

Almost since the opening of my practice I have taught a variety of classes at a senior-oriented branch of a local community college called NAILS (New Adventures In Learning for Seniors).  That’s where I first met Marge.  Marge secretly wanted to come in to my office for treatment because she suffered from chronic neck pain.  However, she also had osteoporosis so her primary care doctor told her not to see a chiropractor because she had weak bones.

Good thing she followed his recommendations.  After all, I climb on my desk and, with a Tarzan-like roar, jump onto my unsuspecting patient in an attempt to adjust their spines.  When I’m really busy I just stack them on top of each other and adjust them all at once.  Very dangerous for weak bones.

For the next few years, Marge continued to see me occasionally at the NAILS events and continued to suffer with neck pain based on her primary care doctor’s recommendation.  At some point, however, her confidence in my ability to safely treat her overcame her primary care’s warning.

Good thing she did.  I treated Marge on and off over the next 10 years or so until she passed, even visiting her in hospice when her time was near.  She not only achieved wonderful relief from her neck pain, but her energy levels improved because she was no longe battling pain all day long.  She even took my advice to get into yoga, which turned out bad for business because she was seen less frequently in the office after she started yoga.

The sad part is that she still spent several extra years in pain because of biased and incorrect advice from her primary care.  We certainly did not treat her in the same manner we would treat a college football player or MMA fighter, but we were able to balance treatment and safety to give her wonderful results.

All of this leads up to the results of this particular study.  In it, researchers looked at 241 participants aged 65 years or older with neck pain, rated at a 3 or higher (on a scale from 0–10) of at least 12 weeks duration.  They were then put into three groups:

  1. A group who were only given home exercises (standard approach)
  2. The same home exercises along with a supervised exercise group (the basic physical therapy approach)
  3. The final group was given the home exercises but also received manipulation for 12 weeks.

After 12 weeks of treatment, the group that received manipulation had the best results (10% greater decrease in pain compared with the home exercises alone group and 5% better results over supervised exercise plus home exercise).

As an added bonus, none of the seniors treated with manipulation in this study died or ended up with multiple neck fractures as a result of any over-zealous neck manipulations.

Not that the results of this should come as any big surprise to anyone who has seen a chiropractor before for neck pain or to any of my colleagues, but sometimes it’s nice to see it in writing.  And hopefully, studies like these can keep future Marges from suffering unnecessary pain when safe and effective treatments are available.


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lumbar spine surgery outcomes

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In general, most patients think that the diagnosis of a lumbar disc bulge means that surgery is inevitable.  This couldn’t be further from the truth.

There are so many misconceptions that revolve around low back pain that it’s always hard to decide where to start.  I have covered many of these issues in the past such as:

The list is much longer, but these are probably the top two concerns when it comes to low back pain.  It is rare that a MRI actually finds anything useful that actually relates to your current symptoms.  It is clear, however, that a MRI sets in motion a serious of events leading to epidurals and surgery.

That’s not to say that surgery is not a viable option for disc problems.  As successful as our office usually is treating disc problems, there have definitely been patients who have not responded to care and ended up in surgery, but it’s been a handful.

When someone does have a bona fide disc bulge that is creating his or her current symptoms, a very common concern centers around permanent nerve damage.  And it’s a very real concern.  Nerves don’t like pressure on them and if the pressure is sustained for a period of time permanent damage can occur.  For this reason, many surgeons will urge patients with a disc bulge to undergo surgery before this nerve damage occurs.

While pain in the leg is usually the first sign of nerve involvement (not all leg pain comes from a disc injury–the patterns associated with disc injury are very specific), muscle weakness takes some time to show up.  When this muscle weakness progresses, surgeons are quick to recommend surgery.

But, even at this stage of the game, is surgery for a lumbar disc bulge really needed?  This is the exact question asked by the authors of this particular study.  In it, researchers looked at  150 patients with sciatica due to a lumbar disc herniation and whose symptoms also included a moderate or severe muscle weakness to see how much of a difference having early surgery (versus more prolonged conservative care) had on the recovery of the muscle strength.  Here are the details:

  • In seven (10%) of the 70 patients who were assigned to early surgery the leg pain resolved even before surgery could be performed.
  • 32 patients (40%) of the 80 assigned to conservative care ended up having surgery because of severe pain.
  • While the muscle strength recovered faster in the surgery patients, by 26 weeks there was no difference in muscle recovery between the surgery and no-surgery group.
  • At the 1 year mark, complete recovery of muscle strength occurred in 81% of surgical patients and 80% of non-surgical patients.

The results from this study clearly indicate that muscle strength recovery is no different between those who have surgery and those who don’t.  Just like what I see in our office, some patients are in too much pain and decide for surgery, although the 40% number makes me wonder what “conservative care” really consisted of for the number to be that high.

Another very important tidbit that researchers discovered had to do with factors that led to a lower likelihood of having muscle strength actually return.  These were:

  • Those with a severe muscle weakness at the beginning were 540% more likely to still have weakness after a year.
  • Those with a lumbar disc herniation that took up more than 25% of the space in the spinal canal had a 640% higher chance of not experiencing any muscle strength recovery after a year.

The take home message is that, even with muscle weakness that occurs as the result of a lumbar disc bulge, your likelihood of recovery is just as good whether or not you have surgery.  The only two factors that would make your situation more dire would be a more severe muscle strength loss and a larger disc bulge.  Aside from that, if the pain is no unbearable, odds are that you are better off not going through the pain and risk of future problems that come from surgery for a lumbar disc bulge.


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expensive cancer treatments

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Cancer is one of the scariest things we can and will face in our lifetimes.  It’s a very emotional time and we become susceptible to hopes and infer things unsaid from our doctors.

Some cancers we do exceedingly well with treatment.  Others, not so much so.  And for those that we don’t have effective treatments for the immediate future continues to look bleak.  We just don’t have good options for treating cancers like pancreatic, colon, advanced breast and prostate cancer.  And do not mistake good outcomes promoted by various natural groups for cancers that were actually “pre-” cancerous and not likely to progress to full cancer (which happens commonly with breast and prostate cancers).

For those tougher cancers, this means that we hear hope when hope might not really be given by our cancer doctors.  (A recent study looking at 102 cancer center advertisements found that most ads used emotional appeals / hope instead of information about treatments–only 2% of the ads tried to “quantify” the potential benefits or mentioned risks)  Oncologists are human.  It takes a pretty detached physician to look a cancer patient in the eyes, family also present, and tell them that there really are no good options for treatment.

Maybe this is why it never seems to happen.  I have had patients, friends and family who have been recommended treatment for a cancer with a grim prognosis.  In these situations, it should have been explained that the treatments will likely not do much to improve survival and will likely destroy any quality of life the patient would otherwise have had.

Just to illustrate how true this is, theirs was a review article looking at this very topic and the costs associated with drugs for cancer care.  The results:

  • In the 71 drugs licensed by the FDA for the treatment of solid tumors since 2002, the average survival benefit is 2.1 months.
  • These few weeks usually come at a cost of tens of thousands of dollars and severe adverse effects.

I don’t mean to sound like the doom and gloom bringer, but society needs to take a more reality based approach to cancer treatment.  If society understood just how poorly we still deal with cancer maybe we would start giving prevention the spotlight that it so rightly deserves.  Further, maybe we should offer cancer patients options:  (1) Expensive cancer treatment loaded with side effects that will only marginally prolonged your life or (2) tens of thousands of dollars to live the life of your dreams for the next 2-4 or 6 months.  Take that cruise to the Mediterranean.  Take the 2 week Hawaii vacation and helicopter over the volcanoes.  And bring all your close family members.  Option 2 would save countless thousands of dollars.

As the cancer patient, which memories would you rather leave your loved ones with?


Categories : cancer
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CT scan side effects

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Statistically, the answer is probably yes because we are handing these out like candy.  Fill up at Quik Trip and you can have your windshield repaired and a CT scan ordered.

I recently had a patient with a headache that was not responding as expected.  Her PCP ordered a CT scan.  Not an MRI.  When I told her she needed to get him to order a MRI instead, his office noted that they do not order MRIs.  What????  For her situation, there was absolutely no reason for a CT scan over the MRI.  As a matter of fact, the only reason to order a CT over the MRI is when we need rapid information, such as an intracranial hemorrhage after head trauma.  Or maybe if some type of bone growth is suspected.  Also, you can’t do an MRI when any type of metal is in the body such as a pacemaker or spinal fusion.

Other than these limited situations, MRI preferable to CT scans.  Despite this, CT scans are now coming in cereal boxes and kid’s meals in the drive thru.  In an ER setting the argument is usually that CT scanning is much quicker (read = you can make more money off of it), which is why ERs only use CT scanners.  And some will say that the initial cost of purchasing the scanners is much cheaper for the CT scan over the MRI.  This may be a good argument for a hospital, but NOT for a physician ordering from an imaging center with access to both.

So why all the frustration on my part?

Because the radiation associated with CT scans has been estimated to contribute to some TWENTY NINE THOUSAND cancers per year in the US alone.

That makes this discussion incredibly relevant to your long-term health, since it’s highly likely you’ve had a CT scan done before.  The article noted above was published over 5 years ago, so this has been plenty of time for physicians to change their addiction to ordering CT scans.  Heck, you could practically hear the screeching of the brakes immediately after this study was published.

Turns out that the screeching sound was actually the tires squealing as the number of orders for CT scans took off at full speed.  Yup, according to this review article, there were just over one million CT scans order in England in 1996-97.  By 2012-13 this number had jumped to a whopping five million.  Even worse, for 2013-14, there was a 13% increase with no sign of “plateauing.”

How are these numbers even possible???

I know that I often complain that it seems like most physicians don’t keep up with medical literature, but geez-o-Pete.  We’re talking 5 years since the concerns started to rise that one of the CT scan side effects included a large increase in cancer risk.   Despite this, we still have physicians ordering these scans.  Even worse, they are ordering them for situations where an MRI would be an even better choice or (even worse, in my opinion) they are ordering them for situations where they should not be ordered.  This happens an awful lot for conditions like headaches, shoulder pain and back pain.

So what should you do?

  1. Avoid the ER if at all possible.  Try urgent care or find a good chiropractor.  If you do go, make sure they feel the CT scan is absolutely, positively needed and the benefits of obtaining the scan outweigh the increase in cancer risk from ionizing radiation.
  2. If your doctor is ordering a CT, have a discussion with him or her about ordering a MRI instead.  There is no radiation with a MRI.
  3. Just like in the ER, if your doctor is ordering a CT scan, make darn sure the imaging itself is actually needed.  All too often a CT scan is done as a shot in the dark.  Imaging should be done to help confirm a diagnosis, NOT to fish around for ideas.
  4. If you have an ultrasound done, it many cases it is NOT necessary to order a CT scan on top of this just to confirm what the ultrasound found.  It’s ridiculous.
  5. If a CT scan is absolutely determined to be the best option (if you have a pacemaker, for instance). then check with your doctor and the radiologist about ways to lower the radiation exposure for the test (such as imaging ONLY the area of concern).

For a full review of the Committee of Medical Aspects of Radiation’s 16th report you can click here to read more about it.


Categories : low back pain
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side effects of ranitidine

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Before we even start, I just need to go on record saying that I think that giving drugs that block stomach acid production is a very bad idea in adults.  In children, it borders on a travesty.

I think most of us, regardless of medical background, could easily agree that digestion is very important to long-term health.  And digestion centers around our body’s ability to make stomach acid.  Without stomach acid the entire process begins to unravel, opening up a Pandora’s box of epic proportions.

I further stand on the belief that ANY provider writing a prescription for a drug that blocks the production of stomach acid should be able to look you in the eye and give you at least 10 very important physiological processes that will be negatively impacted by this drug.  If they cannot do this, they have no business interfering with aspects of the body that they don’t fully understand.

This may be a strong statement, but it boils back down to just how massively important digestion is for long-term health.

Consistent with prior blog posts on this topic (which can be read by clicking here) I do have to note that this class of drugs for someone with a bleeding ulcer can be life-saving.  But every bit of paperwork that comes with this class of drugs makes it clear that it is for short-term use (usually 3 months or less).  Despite this, I frequently see patients who have been on them for YEARS (for those of you not good with math, years > months….).

This particular study looks at just one of the serious side effects of ranitidine and other acid-blocking drugs when used in children (although studies have shown the same concerns with adults).  Here’s what they found:

  • 46% of kids taking acid-suppression medication had bacterial growing his or her stomach (compared with 18% of the controls).  This is a 255% increase in bacteria present in the stomach of kids on these drugs.

On the surface, this sounds really bad.

Bacteria growing in the stomach where it is not supposed to grow.  (Also seems ironic in light of the use of acid-blocking drugs for H. pylori infections in the stomach)  But the news gets far worse.  Researchers looked at what types of bacteria were growing in the stomach and here’s what they discovered:

  • Staphylococcus 1,275% more likely to be present.
  • Streptococcus 691% more likely.
  • Veillonella 956% higher risk.
  • Dermabacter 478% higher risk.
  • Rothia 638%.
  • To top it all off, the number of bacterium found were higher in treated patients.
  • For those kids who had  proximal nonacid reflux, there were higher concentrations of certain bacteria in his or her lungs.

While they did not find a difference in the bacteria or number of bacteria in the lungs of those on acid-blocking medications who did not have proximal nonacid reflux, it does raise some serious concerns about having bacteria known to cause respiratory infections growing in the stomach.  The esophagus is just way too close to the trachea for comfort.

The take home message is that using acid-blocking drugs carries significant risk to long-term health.  While it may or may not contribute to upper respiratory infections (and there is good evidence that it does) the long list of additional side effects remains scary.  There are many ways to help manage your symptoms, from DGL (a special form of licorice that does not affect blood pressure), vitamin U (a compound that is present in cabbage and can be very good for the mucosa of the gut), dietary changes and stress management.  While some of these may require considerable upheaval of where you are at health-wise, it’s certainly much safer in the long run.


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infertility in women and vitamin D

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As a father, I can tell you that, despite the days I want to kill them, having children was a very important decision my life.   But this isn’t always an option when infertility in women and men is an issue.

Fertility problems can create stress and disappointment in a relationship and can lead to sexual problems, anxiety and divorce.  Heartbreak on top of heartbreak.

I have certainly covered the topic of infertility (both infertility in women AND in men) many times in the past, always looking at it from a natural standpoint (these prior blog posts can be read by clicking here).  “Fertility specialists” have an agenda and really don’t seem to care why you can’t get pregnant.  They are going to do what they do and to heck with what your underlying problem might be.  They are going to used Clomid first and IVF second, moving on to more expensive procedures if that fails.

The expression, “when all you have is a hammer everything looks like a nail,” fits here.  Few “fertility specialists” will have the important discussion with you on thyroid function, achieving an optimal weight, chemical exposures (BPA, phthaltes, flame retardants, etc…), exercise, pulling back from being on a diabetic pathway, exercise and stress management.  All of these are very real factors in a successful pregnancy, but they will require a sincere commitment from you and your partner (YES–both partners need to get on board).

Some of these changes, like managing stress, may involve a complete overhaul of the way you view life.  It’s a major factor in infertility and then feeds back into the problem when stress levels rise from the fertility issue itself.  This is probably one of the reasons why there are always stories about couples who adopt a child and then get pregnant shortly afterwards.  In these cases stress was probably the major player.

While this sounds overwhelming and “not important” in getting pregnant when you could just run down to the nearest “fertility specialist” for a prescription, the stakes are far higher than most couples realize.  If your stress levels are high enough to affect your ability to get pregnant, if you do get pregnant (regardless of how), your stress levels are absolutely going to pre-program your little one for a lifetime of stress-related issues.  THIS is what is at stake.

Of course, some of the changes do not require life-altering approaches.  A simple, good quality prenatal is one of them.  Do NOT do any of the pharmaceutical / prescription ones.  They are all junk and I have yet to see one that is worth more money than a Centrum from Walmart.  A good quality prenatal is going to cost you at least $20 per month and will not be covered by your insurance.

Another simple approach to helping infertility in women is making sure you are getting enough vitamin D.  Yup.  The simple, seems-to-help-with-everything vitamin D.  Same stuff.  Usually not more than $20 per year for the high quality stuff we offer our patients here in the office.  But just how much can it help?

This particular study looked at just this question.  In it, researchers looked at a group of 335 women undergoing IVF treatment to see how much vitamin D levels had an impact on a successful outcome.  The cutoff was 20 ng/ml as deficient.  Here’s what they found:

  • 20% of the women with low vitamin D got pregnant while a much higher 31% achieved pregnancy with higher vitamin D levels.
  • Overall, women with vitamin D levels above 20 ng/mL were 215% more likely to become pregnant.
  • Even better, the women who had higher vitamin D levels (30 ng/mL) had the highest chances of pregnancy.

These are pretty good odds for just a simple, safe and inexpensive intervention.  Keep in mind that most vitamin D experts (myself included) still consider 30 ng/dl too low and that more optimal levels should be closer to 60-100 ng/dl.  So how much better would pregnancy rates be if we looked at the highest levels?

It is also important to note that this was not an intervention trial.  These women were not given vitamin D to see if it could improve pregnancy success, but clearly there is an association between vitamin D levels and fertility.  It’s a strong enough argument for me to recommend at least 2,000-4,000 IU of vitamin D daily to couples (yes–both partners!) who are considering getting pregnant.


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high fat diets and magnesium

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Not everyone is on a constant struggle to lose weight. Even fewer have deliberately goals to achieve a weight worthy of donning a Mawashi.

But you may be unwittingly doing just that.  There are many things that we do in our daily lives that you may think are healthy, but actually contribute to weight gain.  The quick list can include doing things such as drinking out of plastic water bottles and drinking orange juice with your breakfast.  Many of the items on this list, however, you could probably nod your head in understanding when things like BPA in plastics and excess calories from drinks are pointed out.

Sometimes, however, the things you do that contribute to weight gain aren’t so obvious.  Or rather, it’s the wrong combination of things that send the dial of your scale to the right.

This concept is outlined quite nicely in this particular study.  In it researchers looked at what happened when a high fat diet was combined with a magnesium deficiency in rats.  A high fat diet is not inherently bad for you, despite what the USDA food guide pyramid led you to believe in the 90′s.  The right choices of fats makes all the difference.  When was the last time you ran into someone who became morbidly obese eating avocados?  It just doesn’t happen.

These good fats come in things like nuts and seeds, wild caught fish, avocados and olive oil.  These food items are not entirely guilt-free, but you shouldn’t lose any sleep when you indulge in foods with healthy fats.  Many of these food items (most notably the nuts, seeds and avocados) are a very good source of magnesium.  Maybe Mother Nature knew what she was doing.

Other good sources of magnesium are dark chocolate, green leafies, beans and whole grains.  Keep in mind that magnesium is an incredibly important mineral that is used in hundreds of ways in the human body.  Unfortunately, it is also a very commonly deficient mineral.

Back to the study.  Researchers put rats into 4 separate diet groups and compared:

  1. A normal, control diet to;
  2. A high-fat diet to;
  3. A magnesium-deficient high-fat diet group

When the dust settled, it was clear that both high fat groups had the most prediabetic profiles (as measured by protein phosphorylation in the insulin-signaling pathway).  Between the two high fat diets, the group that was magnesium deficient had the worst profile and greatest risk of developing diabetes.

The take-home message is that there is not a single aspect of your lifestyle that is going to make or break your health and long-term weight goals.  In this instance, make sure that your higher fat choices include foods that are also higher in magnesium such as nuts, seeds and avocados.


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nuts and heart attack

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Sure–you know that avoiding smoking, exercising regularly and eating lots of veggies and fruits will help you live longer.  But can one simple snack extend your life?

Turns out that if the snack consists of different types of nuts the answer is probably a solid yes.  The benefits of nuts on our long-term health is well-documented.  They protect your brain, they protect against diabetes and they strongly protect your heart.  And the benefits are not isolated to a single type of nut–it seems like every time researchers look at a particular type of nut it shows a protective effect on whatever chronic disease that happens to be in the study.

However, there are a few very important factoids to take into account.

First, raw nuts are the best option.  Absolutely, positively NO added oils.  That means cottonseed oil, peanut oil and any other oil manufacturers try to stuff into the nut container.  These added oils will completely counteract the benefits of the nuts.  Personally, I buy bulk bags of almonds, pecans and walnuts from Costco because their prices on these 3 types of nuts is the lowest you can find.  Then, when Sprouts has other types of nuts on sale, like cashews or hazelnuts, I add them to the mix.  If I’m feeling really rich, I’ll splurge on a pound of macadamia nuts.

Next, I really don’t concern myself over added salt.  The research linking low salt diets and chronic disease is very weak and likely is more due to the presence of high levels of sodium (and low potassium) in processed foods.  Personally, however, I prefer to match my nuts with dark chocolate drops instead of salt to spruce up the experience.

Either way, the addition of nuts to your daily routine is a powerful one.  But just how powerful?  This particular study asked this very question.  It looked at 17,184 residents of Spain over the course of 5 years to see if nut consumption had any effect on the participants risk of dying from any cause (all-cause mortality).  Here’s what they found:

  • Those participants who ate nuts at least twice per week had a 56% lower risk of dying when compared to non-nut consumers.

These are some pretty serious numbers.

This powerful effect of nuts is likely due to several factors present within nuts.  First, they help you avoid snacking on other, less healthy, snacks.  The fat present in nuts (polyunsaturated and monunsaturated) has consistently shown to protect your heart from damage.  Lastly, they are an excellent source of gamma tocopherol–the powerhouse form of vitamin E that has been shown again and again to protect the brain and the heart.

Either way, if you are not already snacking on nuts during a typical week, it’s definitely time to start.


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pneumococcal vaccine dangers

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Sometime, somewhere medicine decided it could best Mother Nature and vaccinations for kids were born.

Originally, diseases like polio and smallpox were commendable diseases to eradicate.  But the god complex kicked in from there.  Hepatitis A, hepatitis B, “cervical cancer,” the flu, rotavirus, pertussis…the list is now quite long.  On the list is the vaccination for Streptococcus  pneumoniae, a bacteria that causes nasty things like pneumonia, ear infections and meningitis and is responsible for tens of thousands of childhood deaths in the developed world (the vast majority of the deaths occur in undeveloped countries and in children with compromised immune systems).

This is a serious disease and not something to sneer at.  Personally, in my family, I would make choices to strengthen our immune systems so that we can fight off infections the way Mother Nature designed us to.  The details of this are beyond the scope of this post but you can bet they involve dietary choices, exercise and supplementation.

For mainstream medicine, however, we have the Prevnar vaccination.  To heck with all that “healthy lifestyles” junk.

In 2000, Prevnar was introduced by Wyeth and rapidly rose to one of the company’s top revenue sources.  Here’s the problem:  S. pneumoniae actually contains upwards of 90 different serotypes.  I describe serotypes as cousins in the same family.  The original Prevnar vaccination only protected against 7 of the cousins, although these were the cousins that were present in some 90% of infections.

In walks Mother Nature.

Much like a giant Wac-a-Mole game, when you smack down some of the cousins, the others rise up.  What have we seen since the introduction of the Prevnar vaccine?

  1. Serious lung infections (empyema) caused by this bacteria are on the rise.
  2. Other cousins (serotypes) of the bacteria have risen up.  These cause more severe infections and are resistant to antibiotics.
  3. The rates of disease in adults has climbed.  Adults are now getting infected in new, unknown ways (not just from their kids).

You get the point.  Mother Nature is winning AND she’s pissed off that we even tried.

But don’t worry, because in 2010 Wyeth came riding in on a white horse called Prevnar 13.  This one now contained vaccinations for 13 of the cousins (instead of just 7).  Everyone was now told they needed new vaccinations with Prevnar 13 (can you say, “financial boon?”).

We are slow learners.

This particular study takes a look at what has happened in the few years since the introduction of the Prevnar 13 and the story isn’t good.  Here’s the details from a study down in Massachusetts on reports to the state public health system:

  • There were 168 cases before Prevnar 13 was introduced (looking at 2007-2009) and 85 after in children 5 years of age or younger.
  • After more kids were hospitalized (57.6% vs 50.6%).
  • After more kids who got the infections had other conditions (23.5% vs 19.6%).  In other words, it may be that, after the introduction of the Prevnar 13, kids with other conditions (like asthma), were now more likely to get infected.
  • Children with other conditions had higher rates of infections caused by a nonvaccine type (27.6% vs 17.2%).
  • These same children were also far more likely to be hospitalized (80.4% vs 50%) and have a much longer hospital stay (3 days vs 0.5).
  • There was no difference in mortality rates before versus after.

Just to sum it up, the addition of the new vaccine is not saving lives, but it IS putting more kids into the hospital with infections that are harder to control.  Unfortunately, this is the type of information that your pediatrician is not likely to hear about, much less share with you in an effort to fully educate you on your decision to vaccinate your child.

Buyer beware.


Categories : vaccination
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antibiotics and vaccination

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I will admit that most doctors don’t actually read medical journals.  They may subscribe, but that doesn’t mean that they actually read them.

There are some specialists I tend to be more critical of when it comes to staying current with the medical research, but pediatricians usually top the list.  Not only do they (I am using the term “they” here in a general sense–certainly there are top-notch pediatricians out there who have actually cracked a medical journal in the past 5 years…) not do things that are supported in the medical literature (like using vitamin D and probiotics to fight off infections), but they continue to recommend damaging treatments for infants IN THE FACE of medical literature that shows these interventions are therapeutically worthless and potentially very harmful.

Two perfect examples are:

  1. The use of acid-blocking drugs in infants.  A recent study found that, out of a group of 567 pediatricians surveyed, only 1.8% followed guidelines.  A full 82% were overprescribing this class of drugs in infants.  All of this in light of research that is at least 6 years old finding that these prescriptions are used inappropriately.
  2. Antibiotic use in infants for conditions that are self-limiting.  The most notorious of these being ear infections.  Despite over THIRTY years of research screaming not to use antibiotics for this condition, pediatricians still aren’t getting the message.

Quite frankly, this is atrocious and inexcusable.  Worse, these two treatments can produce irreparable harm to the little infant’s immune system.  And yet, despite this, there was a recent article online about the treatment of bed wetting in children by chiropractors (based on several websites, NOT any type of study), slamming the treatment as being unscientific.

Talk about glass houses.

So what does all of this have to do with this particular article?

In it, researchers looked at the makeup of the bacteria in the gut of a group of 48 Bangladeshi infants at 6, 11, and 15 weeks of age and evaluated how the blend of bacteria in the gut affected the response to four different vaccinations:  Oral polio virus (OPV), Bacille Calmette-Guérin (BCG-for tuberculosis), Tetanus toxoid (TT) and Hepatitis B virus.

The vaccines were then checked for effectiveness (using specific T-cell proliferation for all four, the delayed-type hypersensitivity skin-test response for BCG, and IgG response for OPV, TT, and hepatitis B virus).  Here’s what they found:

  • The presence of the bacteria Actinobacteria and B longum subspecies infantis led to a stronger immune response with vaccination.
  • However, the presence of  EnterobacterialesPseudomonadales and Clostridiales led to a weaker vaccine response.

Here’s the kicker.  Antibiotic use has a tendency to increase the presence of the Clostridiales family of bacteria and throw off the balance of an infant’s gut.  Herein lies to ultimate conundrum:  Most pediatricians are militant about giving infants and children every vaccination recommended by the CDC and refuse to even consider that this might not be the best course of action for your little one’s health.  At the same time, pediatricians have been very slow to adopt a policy that limits antibiotic use in all but the most serious of conditions.

It seems likely that these two practices negatively affect one another.  The pediatrician who is staying current with all the research in his or her field (arguably, given that our knowledge of health is constantly changing, this is the ONLY acceptable type of pediatrician to take your child to) will understand that the unnecessary antibiotic may actually affect how well a vaccination works and avoid them as much as possible.

And NOT avoid antibiotics because he or she has a concern about “antibiotic resistance” but because antibiotics completely disrupt the delicate balance of the developing immune system of your little one.  When you find THIS pediatrician, stick with him or her.


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