Terry A. Rondberg, DC | Wellness for Mind and Body

One of the staff members of the newspaper I founded and publish, The Chiropractic Journal, gave birth to a healthy son last month. We all cheered the occasion, knowing that this child will grow up in a world that has discovered the true meaning of health and wellness.

It’s incredible to think that the work we do now, educating the public about the dangers and risks of drugs and invasive medical procedures, will improve the lives of generations to come. In that infant’s lifetime, we’ll make astounding advancements in what is now being called the “new biology,” and in the field of energy healing.

Most wellness practitioners, including chiropractors, fully understand that stress is the key factor in most — if not all — chronic illnesses, since it effectively shuts down the immune system. In a study appearing in the current online edition of the journal Proceedings of the National Academy of Sciences, researchers concluded (not for the first time) that stress increases the inflammatory activity that is part of our immune system’s natural response to potentially harmful situations. “Frequent or chronic activation of the system may increase risk for a variety of disorders, including asthma, rheumatoid arthritis, cardiovascular disease, and even depression,” stated lead researcher George Slavich, a postdoctoral fellow in the UCLA Cousins Center for Psychoneuroimmunology. Also included in the list of diseases that could be triggered by stress were certain types of cancer. (Abstract available online

What many people don’t know — including some doctors — is that the stress levels of pregnant women can affect the health of their unborn babies. In 2007, a study published in the journal Clinical Endocrinology, Stress revealed that high stress levels during pregnancy may affect the unborn baby as early as 17 weeks after conception, with potentially harmful effects on brain and development. Another research study linked stress during pregnancy to premature and low-weight births.

Obviously, stress reduction is critical for all people wanting to maintain a high level of health — but it’s even more important for pregnant women. After all, they’re pumping stress hormones for two!

On a lighter note, several research studies have found that eating some types of chocolate (dark and raw chocolate particularly) during pregnancy can be beneficial to the child, partially because it tends to alleviate some of the woman’s stress.

A Yale study published in Epidemiology, May 2008, claimed chocolate during pregnancy reduces the risk of preeclampsia, a major pregnancy complication. Another study — this one published in Early Human Development back in 2004 — found that babies born to women who ate chocolate every day while they were pregnant were more active and “positively reactive” (meaning they smiled and laughed more). They also showed less fear of new situations than babies of stressed women who didn’t indulge their sweet tooth in chocolate!

So, forget the meds … pass the chocolate!

By Terry A. Rondberg, DC

A commentary published in the July 28 issue of the Journal of the American Medical Association (JAMA) revealed that diagnostic errors are the single largest contributor to medical malpractice claims, accounting for about about 40% of all claims and costing approximately $300,000 per claim.

The authors — Mark Graber, MD, of Stony Brook University Medical Center; and Hardeep Singh, MD, MPH, of Baylor College of Medicine — pointed their fingers at everything BUT the practitioners themselves.

“The great majority of diagnostic errors have root causes that derive from the properties of the healthcare setting, organization and practice,” Dr. Graber said. “By working together, cognitive scientists, informaticians, clinicians, and human factors engineers have a unique opportunity to decrease the likelihood of diagnostic error to the extent that the five principles we outline in JAMA can be incorporated into every new medical home.”

The authors discussed a new model of primary care, called the patient-centered medical home, developed and endorsed by the American Academy of Family Physicians, the American Academy of Pediatrics, American College of Physicians, and the American Osteopathic Association.

The model facilitates partnerships between individual patients, their personal physician, and, when appropriate, the patient’s family. Care is assisted by physician “extenders,” nurse empowerment, information technology, and other means to assure that patients get care when and where they need and want it in a culturally and linguistically appropriate manner.

The medical home model places emphasis on team-based care, and primary care teams could include not only physicians but also nurses, allied health professionals and personnel, the authors explained.

In this model, the medical doctor would be the gatekeeper and decide what role the “allied” health professions would have. “The physician could take a leadership role, while the entire group collectively takes care of the patient,” explained Dr. Singh.

It’s always heartening to see the medical profession recognize and admit the problems inherent in the current disease-oriented system, such as misdiagnoses, prescription errors, unnecessary surgeries, etc.

Still, I’ll continue to work toward the time when we supplant the old paradigm of labeling and treating conditions and symptoms with the new holistic view of the human body as a complex system of energy patterns that responds to non-invasive care such as chiropractic and other “energy medicine” approaches. And I especially look forward to the time when we don’t label all wellness and healing modalities as “medicine!”

By Terry A. Rondberg

In recent years, researchers have piled up the proof that many of the prescription and OTC pills sold to “treat” colds and flu in kids are ineffective. Even worse, they all have potentially negative side effects. One study, conducted by researchers at Penn State, found that placebos were just as effective as OTC drugs in suppressing coughs due to colds.

“Consumers spend billions of dollars each year on over-the-counter medications for cough,” said Ian Paul, assistant professor of pediatrics, Penn State Children’s Hospital, Penn State Milton S. Hershey Medical Center. “Our study showed that the two ingredients used in most over-the-counter medications were no better than a placebo, non-medicated syrup, in providing nighttime relief for children with cough and sleep difficulty as a result of upper respiratory infection… The desire to ease symptoms is strong for both parents and clinicians. This study, however, questions whether over-the-counter medications have a place in the treatment of these illnesses for children.” (“Effect of Dextromethorphan, Diphenhydramine and Placebo on Nocturnal Cough and Sleep Quality for Coughing Children and Their Parents,” July 2004 issue of Pediatrics.

Another study showed a significant percentage of children with attention-deficit-hyperactivity disorder improved when placebos replaced some of their daily meds.

“In ADHD, you can reduce the dose of the real medicine, substitute placebo pills and get the same effect on ADHD,” Walter Brown, MD, Clinical Professor of Psychiatry at Brown University and Tufts University School of Medicine, stated.

One theory is that the caring and hopeful attitude of the parents or caregivers has a powerful effect on the child. If the parent and child have a strong belief in the efficacy of the remedy, it will work. In the tests, participants had no more “faith” in one pill over another, so they all worked about the same. That’s the very definition of placebo effect.

You’d think that, given this evidence, parents — and their medical doctors — would be convinced that grabbing the pill bottle isn’t the best response to sniffles and sneezes.

But that’s not the way some people see it. Now, there’s a new pill being marketed to parents for use on their kids: a chewable, cherry-flavored tablet called Obecalp. You guessed it: that’s placebo spelled backwards, and the pill is nothing but sugar.

Giving a child a sugar pill is definitely an improvement to giving them chemical medications. But this still teaches the child that health can be delivered in pill form from outside. Why not skip the pill altogether and try activities such as yoga or meditation, both of which can be presented as a game or healing action? Health comes from INSIDE and the sooner we truly understand that, and share that understanding with our kids, the sooner they’ll take control of their health and wellness.

Allopathic medicine has a long history of “inventing” diseases and giving them fancy Latin names — all in order to come up with a pill or treatment to “cure” it.

But this one gets the absurdus maximus award — a Californian doctor, Steven Bratman, has “medicalized” a strong conscious desire to eat healthy, nutritional foods as a mental disorder! And, of course, he’s given it a name: orthorexia nervosa.

These poor demented souls are, as reported in The Guardian, “solely concerned with the quality of the food they put in their bodies, refining and restricting their diets according to their personal understanding of which foods are truly ‘pure’.”

They follow crazy behavior, like trying to eliminate refined sugar, salt, caffeine, alcohol, or other food groups from their diet. And they rebuff foods that have been in contact with pesticides, herbicides or contain artificial additives.

Granted, there are people who get a bit neurotic about food safety and base their dietary choices on fear rather than good sense. But the idea of turning food concerns into a mental health disease is just one more instance of medical manipulation.

While an anti-orthorexia drug hasn’t been developed — yet — Bratman quickly cashed in on his “disease” by writing a book called, “Health Food Junkies.”  I’m gratified to see it didn’t make much of a blip on the sales lists and got a dismal review score on Amazon.com (just 3 stars out of 5, with one person echoing my own feelings, saying, “So it is now a fixation to ‘obsess’ about healthy food? This is the most stupid, irresponsible drivel I have ever heard of. Ok, let’s NOT obsess about food, let’s keep eating meat, and dairy, and preservatives, and chemicals, let’s eat genetically modified food, let’s NOT read labels, let’s NOT think about what’s in our food, let’s keep getting diabetes, cancer and heart disease which NO DOCTOR has ANY CURE FOR!!! Just treatment, NO CURE. Let’s do that. Because doctors are so good at curing diseases. That’s why we are such a healthy nation! Mind-numbingly irresponsible, for a physician to write this.” I swear, I didn’t write that (but wish I had!). Here’s the Amazon page, just so you can read some of the other scathing reviews!

Not surprisingly, Bratman’s ideas have been picked up by the British medical community, which seems intent on destroying everything that isn’t totally aligned with the allopathic paradigm, be it homeopathy or, now, healthy eating!

Ursula Philpot, chair of the British Dietetic Association’s mental health group, told The Guardian: “The issues underlying orthorexia are often the same as anorexia and the two conditions can overlap but orthorexia is very definitely a distinct disorder. Those most susceptible are middle-class, well-educated people who read about food scares in the papers, research them on the internet, and have the time and money to source what they believe to be purer alternatives.”

(Interestingly, the main goal of the association appears to be acceptance by the medical profession, and, in the group’s words to “act as a specialist within a multi-disciplinary team … (and) act as a consultant to other health professionals advising on nutritional aspects of care.” Sounds much like those chiropractors and other alternative health providers who used to be willing to medicalize their professions in order to gain the approval of MDs. By now, most of them realize that’s not going to happen!)

Getting back to the dread “orthorexia nervosa” disease, Wikipedia further explains: “The subject may avoid certain unhealthy foods, such as those containing fats, preservatives, man-made food-additives, animal products, or other ingredients considered by the subject to be unhealthy; if the sufferer does not eat appropriately, malnutrition can ensue. Orthorexia sufferers have specific preferences about the foods they are eating and avoiding. Products that are preserved with additives can be considered dangerous. Industrial products can be seen as artificial, whereas biological fruits and vegetables can be seen as healthy.”

So, unless you relish an apple with a thick coating of pesticide residue, a fast food burger with 80 grams of saturated fat, or a TV dinner with a list of unpronounceable (and unidentifiable) ingredients, you may want to make an appointment with the nearest shrink. You could be a very sick mind (although chances are, you’ll have a heck of a lot healthier body than most!).

The friend who sent me this information — a guy who has a PhD in molecular biology and is finishing his last year interning as a psychiatrist — had a novel suggestion: “How about we come up with a term for a syndrome where certain sciences over-classify and are slaves of the pharmaceutical industry? Maybe inservio supervacuus (superfluous slave).”

When DD Palmer called our profession “chiropractic” — combining the Greek words cheir (hand) and praxis (action) — he couldn’t have chosen a better name. While there are a few doctors who substitute mechanical devices for their hands, even those practitioners have some hands-on work with patients — palpation, adjusting or just placing the hands on affected areas.

We, and our patients, have always known that the success of chiropractic has a great deal to do with the “personal touch” we provide (metaphorically as well as literally). Surveys on patient satisfaction almost always emphasize the influence of our personal involvement with those under our care, particularly when compared to the cold, impersonal treatment received from many medical providers.

A recent research study, sponsored by the National Cancer Institute and presented at the 6th International Conference of the Society for Integrative Oncology, reinforces our understanding of the importance of true “by hand” practice, whether it’s provided by a health care practitioner or a caretaker.

Researchers found that touch — particularly massage — administered by care partners significantly reduces the effects of cancer and the side-effects from its treatment while providing comfort and improvement in the quality of life.

In the study, 97 family caregivers learned touch and massage techniques from a 78-minute instructional DVD, called “Touch, Caring, and Cancer: Simple Instruction for Family and Friends.” They then used these touch techniques to safely care for people living with cancer. “The magnitude of the impact of family members was unexpected. Our research found significant reductions of pain, anxiety, fatigue, depression and nausea when massage was routinely administered at home by family and caregivers,” lead researcher William Collinge, PhD, revealed.

The study found massage by family members reduced stress/anxiety (44% reduction), pain (34%), fatigue (32%), depression (31%), and nausea (29%).

“The discovery that family members can learn and administer simple massage techniques that can consistently reduce stress is significant. Stress is a constant that negatively impacts the lives and wellbeing of cancer patients,” Collinge wrote. “Both cancer patients and caregivers benefit because massage appears to strengthen the relationship bond. Massage provides the caregiver a way to make a difference.”

This research not only reminds us of the significance of personal touch between doctor and patient, but might be a good incentive to bring a massage therapist into your practice. The synergistic effect of the two disciplines would no doubt benefit many patients and might increase patient volume.

You may even want to provide certain patients with the video used to train the participants in the study (it’s available from Amazon.com). I believe strongly that the “hands on” approach works for all people, regardless of the state of their health. Since it reduces stress — the primary cause of most health issues — it would be effective on most people, not just those with cancer.

By Terry A. Rondberg

A new study published by JAMA shows that among patients age 65 years and older, rosiglitazone (a medication for treating Type 2 diabetes) is associated with an increased risk of stroke, heart failure, and all-cause mortality (death) when compared with pioglitazone (another medication for diabetes).

In their conclusion, the authors wrote: “…in a population of more than 227,000 patients 65 years or older who initiated treatment with a thiazolidinedione, we found that, compared with pioglitazone, rosiglitazone was associated with an increased risk of stroke, heart failure, and death and the composite of AMI (heart attack), stroke, heart failure or death.” (JAMA.doi:10.1001/jama.2010.954)

Despite trying to put rosiglitazone in the most “favorable” light possible, researchers had to admit that “analysis showed no differences in the risk for heart attack between rosiglitazone and pioglitazone,” even though the study found that rosiglitazone was associated with a 1.25-fold increase in risk of heart failure compared with pioglitazone.

Obviously, BOTH medications have serious negative side effects, but the report’s wording seems somewhat biased to me so I delved a little deeper. Within the past five years, the study’s head researcher, Steven E. Nissen, MD, has received research support from numerous drug companies, including AstraZeneca, Atherogenics, Novartis, Pfizer, Resverlogix, Daiichi-Sankyo, Sanofi-Aventis and — most importantly — Eli Lilly and Takeda.

The drug that fared better in this study (branded name Actos) is manufactured by Eli Lilly and Takeda. Avandia, the branded version of rosiglitazone, is made by GlaxoSmithKline, a name curiously absent from the list of Nissen’s financial benefactors.

Probably just a coincidence, right? Yet, only this month, the BMJ (which used to be called British Medical Journal) published a report that explored a possible link between authors’ financial conflicts of interest and their position on the association of rosiglitazone with increased risk of myocardial infarction in patients with diabetes.

The research abstract noted: “Of the 202 included articles, 108 (53%) had a conflict of interest statement. Ninety authors (45%) had financial conflicts of interest. Authors who had a favourable view of the risk of myocardial infarction with rosiglitazone were more likely to have financial conflicts of interest with manufacturers of antihyperglycaemic agents in general, and with rosiglitazone manufacturers in particular, than authors who had an unfavourable view (rate ratio 3.38, 95% CI 2.26 to 5.06 and 4.29, 2.63 to 7.02, respectively). There was likewise a strong association between favourable recommendations on the use of rosiglitazone and financial conflicts of interest (3.36, 1.94 to 5.83)” (BMJ 2010;340:c1344)

In another, even more chilling report (also published in BMJ), the author writes: “Casually following the fortunes of the blockbuster diabetes drug rosiglitazone (Avandia), you can’t help but imagine a Hollywood thriller. There is the scene where a leading scientist secretly records a meeting with drug company executives, a high powered congressional investigation, and a bitter legal battle waiting in the wings. Yet when you look more closely, the facts are even stranger than fiction. An expensive new drug shown to raise the risk of heart failure and suspected of increasing the chance of heart attacks has been taken by millions of people around the world and is being kept on the market by an industry funded regulatory system, despite calls from senior safety experts to withdraw it.” (BMJ 2010;340:c1848)

I took a look at one other factor as well: pricing. The most common price I could find for Avandia — the drug touted as “safer” by the research paper — was $3.32 per pill (for 30 pills of 8mg, which is considered the normal dose). For Actos, the price was $1.34 per pill (for 30 pills of 30mg, again, considered the normal dose).

When it comes to this type of medical drug research, the saying “follow the money” seems to apply. Perhaps it’s also time to follow the advice of “X-Files” character Fox Mulder: TRUST NO ONE.

About Terry A. Rondberg, DC
Terry A. Rondberg is founder and CEO of the World Chiropractic Alliance. He is an ardent advocate for drug-free chiropractic care not just for back pain, but total body wellness. He has spoken globally on the issue of alternative care and the abuses of our current “health care” system.

In a study published in the Journal of Patient Safety, non-medical therapies were shown to relieve pain among a wide range of hospitalized patients as much as 50 percent. However, chiropractic was not among the approaches tested. Instead, researchers focused only on acupuncture, acupressure, massage therapy, healing touch, music therapy, aromatherapy, and reflexology.

The study showed that allowing patients to have access to drug-free care that reduces stress can have a significant impact on pain major challenge and eliminate the risk of negative side effects associated with the drugs normally given to patients.

“Roughly 80 percent of patients report moderate to severe pain levels after surgery,” said Gregory Plotnikoff, MD, one of the study’s authors and medical director of the Penny George Institute for Health and Healing at Abbott Northwestern Hospital.

“We struggle to provide effective pain control while trying to avoid the adverse effects of opioid medications, such as respiratory depression, nausea, constipation, dizziness, and falls.”

The study included 1,837 cardiovascular, medical, surgical, orthopedic, spine, rehabilitation, oncology, and women’s health patients between January 1, 2008, and June 30, 2009. They scored their pain verbally on a zero-to-ten scale before and after treatments.

“Earlier studies narrowly focused on whether specific integrative therapies manage pain in either cancer or surgical patients,” said Jeffery A. Dusek, PhD, research director for the George Institute. “Our real-world study broadly shows that these therapies effectively reduce pain by over 50 percent across numerous patient populations. Furthermore, they can be clinically implemented in real time, across, and under the operational and financial constraints within an acute care hospital.”

Lori Knutson, RN, BSN, HN-BC, executive director of the George Institute stated: “I think we will find that integrative approaches to pain management during the hospital stay will improve patient satisfaction and outcomes, and we will see cost savings from patients using fewer drugs and experiencing fewer adverse events.”

SOURCE: “The Impact of Integrative Medicine on Pain Management in a Tertiary Care Hospital,” March 5, 2010. Journal of Patient Safety.

While pharmaceutical companies have boasted for decades that their pills and potions are “approved by the FDA,” does that really mean anything? Apparently, very little, if the story of how one drug — Multaq (dronedarone) — “earned” its approval is any indication.

Drug maker Sanofi-Aventis touts Multaq on its website as “a prescription medicine used to lower the chance you would need to go into the hospital for heart problems.” The FDA’s decision to approve the drug was based primarily on a study conducted last year by Richard Page, chairman of the department of medicine at the University of Wisconsin School of Medicine and Public Health. The paper was published in The New England Journal of Medicine.

However, it turns out that Page was pretty much “bought and paid for” by Sanofi-Aventis. The drug company PAID for the research, collected data, and performed the analysis without an external audit. Page put his name on the paper, never having seen the raw data. He simply trusted the company to be honest and ignored the fact that the major financial experts, including Morgan Stanley, estimated the drug could reach nearly $3 billion in revenues.

In addition, Page and four co-authors were Sanofi-Aventis paid consultants and/or speakers, and two co-authors worked directly for Sanofi-Aventis, and owned stock in the company.

Despite all that, Page shrugged it off with a glib, “There is a sense of trust that they won’t falsify data.” Either he’s incredibly naïve, or he thinks the rest of us are.

To add injury to insult, the Multaq branded pill was selling for 47 times as much as its generic equivalent — in Britain Sanofi was selling the drug for £2.25 pounds per day, compared to 5 pence a day for a generic competitor, amiodarone. That equates to $3.30 compared to 7¢!

But wait … it gets better. Another research study (this one, by researchers at the Cedars-Sinai Heart Institute — Journal of the American College of Cardiology, 2010; 55: 1569-76) has concluded that the branded drug is far less effective than the current standard drug, Cordarone (amiodarone) for atrial fibrillation, and has no safety benefits.

That’s pretty much what was known back in 2003, when a drug trial was actually stopped because patients receiving Multaq were dying in greater numbers than those getting a placebo.

Still, the drug was “approved” by the FDA. You have to ask yourself — what would it take for a drug to be rejected?

In recent years, chiropractors have once more turned their attention to the neurological component of the subluxation. After decades of concentrating on musculoskeletal aspects, it’s a move that is as timely as it is important. In the years to come, our understanding of how we impact the brain will be the key to becoming the leader in the wellness revolution.

It’s a trend we’re seeing in other non-medical fields as well. In fact, a British research study published earlier this year in the journal Brain Research revealed that acupuncture has a significant effect on specific neural structures.

The researchers explained that when a patient receives acupuncture, it triggers a sensation called deqi (literally, the arrival of chi, pronounced duh-chi). Scientific analysis shows that this energy impulse deactivates areas within the brain that are associated with the processing of pain.

Dr. Hugh MacPherson, of the Complementary Medicine Research Group in the University of York’s Department of Health Sciences, noted: “These results provide objective scientific evidence that acupuncture has specific effects within the brain which hopefully will lead to a better understanding of how acupuncture works.”

Neuroscientist Dr. Aziz Asghar, of the York Neuroimaging Centre and the Hull York Medical School, added: “The results are fascinating. Whether such brain deactivations constitute a mechanism which underlies or contributes to the therapeutic effect of acupuncture is an intriguing possibility which requires further research.”

Last summer, following research conducted in York, acupuncture was recommended for the first time by the National Institute for Health and Clinical Excellence (NICE) as a treatment option for NHS patients with lower back pain. NICE guidelines now state that GPs should “consider offering a course of acupuncture comprising a maximum of 10 sessions over a period of up to 12 weeks” for patients with this common condition.

Current clinical trials at the University of York are investigating the effectiveness and cost-effectiveness of acupuncture for Irritable Bowel Syndrome (IBS) and for depression. Recent studies in the US have also shown that acupuncture can be an effective treatment for migraines and osteoarthritis of the knee.

The York team believes that the new research could help to clear the way for acupuncture to be more broadly accepted as a treatment option on the NHS for a number of medical conditions. “Our results show the importance of collecting and accounting for needle sensation data in neuroimaging studies of acupuncture,” researchers concluded.

There’s an equally important need to collect information on the neurological impact of chiropractic adjustments, such as that being collected by doctors who use the NeuroInfiniti equipment.

ABSTRACT:  “Acupuncture needling sensation: The neural correlates of deqi using fMRI.” Brain Research, Vol. 1315, 22 February 2010, Pages 111-118.

AUDIO: Dr. Hugh Macpherson, from the University of York, discusses new research into the effects of acupuncture on the brain published in Brain Research.

By Terry A. Rondberg, DC

For years, chiropractors and other non-medical wellness professionals have advocated taking nutritional supplements to make up for the deficiencies in our modern diets. Vitamin A has always been among the most recommended, since it’s critical to maternal health and child survival.

Recently, researchers at The Johns Hopkins Bloomberg School of Public Health have found a link between a newborn’s lung function and the vitamin A supplementation the mother has taken. The results were published in the May 13, 2010, issue of the New England Journal of Medicine.

“Children of mothers who received vitamin A supplementation before, during and after pregnancy had significantly improved lung function when compared to those whose mothers received beta-carotene supplementation or placebo,” said lead author of the study, William Checkley, MD, PhD, assistant professor in the Division of Pulmonary and Critical Care of the Johns Hopkins School of Medicine with a joint appointment in the Bloomberg School’s Department of International Health. “Lung function of offspring in mothers who received maternal vitamin A supplementation improved by about 40 ml versus those whose mothers received a placebo. This represents an approximately 3 percent increase in lung function. Furthermore, the magnitude of effect observed in this study is slightly greater than that associated with preventing exposure to parental smoking in school-age children.”

Vitamin A deficiency isn’t as widespread in the US as it is in some developing countries, where nearly 190 million pre-school age children worldwide don’t get enough vitamin A — the underlying cause of night blindness among children, as well as 650,000 early childhood deaths annually. But since the main sources of natural vitamin A are raw vegetables like carrots, sweet potatoes, winter squash, spinach, and cantaloupe, many people in America and Europe are not getting enough A either.

The new study emphasizes the need to eat nutritional, wholesome meals including plenty of vegetables, or to take supplementation as a safeguard. Since medical doctors receive little or no training in nutrition, this is where chiropractors and other wellness professionals can really make a difference. By educating patients and even providing access to nutritional supplements, we can make profound differences in the lives of all the people we serve.