Natural Health Care: Treatment and Policy Trends

Buckwheat Honey Better Choice For Children Than Dangerous Cough Medications

2007-12-06T14:20:00.000-05:00

I can practically hear the collective "no, duh" resonating throughout the natural health world. Regardless of how long (centuries?) this remedy has been circulating and showing solid reproducible success "in the field" I'm very happy to see that an alternative to the dangerous over-the-counter medications is now being reported in the mainstream media. I understand it took a legitimate peer reviewed study in this months Archives of Pediatric and Adolescent Medicine to get everyone's attention but this is an example of how a natural remedy can work better, faster and safer than a standard previously accepted treatment. This alternative probably involves less overall cost although that was not in the scope of the study. It seems that buckwheat honey can soothe coughs in toddlers and adolescents and can safely and effectively replace the dangerous over-the-counter remedies that are no longer recommended. It's remarkable that this alternative rose into the public eye right after the dangers of standard children's cough medicine was exposed, but, whatever.

The lesson here: never underestimate the power of nature....or your 2 year-old's instincts. My wife chuckled when she saw the latest report on buckwheat honey noting that my son asks for honey when he has a cough. Now we know why.

Plantar Fasciitis Easier to Treat Than Many People Think

2007-11-30T10:09:00.000-05:00

Most health care providers will tell you that certain conditions will show up in their office in clusters. Lately, I've been seeing a whole slew of plantar fasciitis cases. This usually presents as acute and severe heel pain that is particularly troublesome when walking or during the first few steps after getting out of bed in the morning. Sometimes a heel spur will appear on the x-ray. Many of my patients suffering with this condition are distance runners and tri-athletes who are currently entering their "off" season and are feeling the cumulative effects of their intense training. Other patients are comparatively less active but still suffer the same.

Plantar fasciitis is an acute inflammation, strain, or even partial tearing of the plantar fascia which is a ligamentous structure that supports the longitudinal arch of the foot. Repetitive stress such as running or prolonged standing are common causes. However, if there are biomechanical distortions in the lower extremity, such as foot pronation (flat feet), or misalignments of the spine and pelvis, physical stresses along the entire kinetic chain can manifest as a weak spot at the attachments of the fascia. This will develop into acute inflammation or partial tearing simply from normal daily activities. Once set in, though, plantar fasciitis can be very painful and disabling.

In a comprehensive review of the literature published in the Journal of the American Academy of Family Physicians in 2005, standard medical and podiatric treatments for plantar fasciitis showed pretty poor outcomes for the most part. In many cases full resolution of the problem is reported to take several years. Of course, this can vary depending on who the patient sees for treatment. In my office full resolution usually takes 4-6 weeks with most of the work being done by the patient at home. Orthopedists and podiatrists tend to rely on anti-inflammatories, plantar fasaciitis night splints and possibly some home stretches. Sometimes, unfortunately, surgery would be recommended.

The anti-inflammatories will often provide some immediate relief but it's usually temporary. The night splints can help stretch the fascia and help the cases where there is significant pain during the first few steps after getting out of bed in the morning. The home stretches really are not that effective unless the biomechanical distortions outlined above are addressed. Unfortunately, while these techniques can temporarily provide some comfort, they rarely eliminate the condition altogether and the patient often becomes discouraged. As a result the condition can linger for many years and patients will suffer needlessly. Surgery, however, is not at all indicated according to a review of the evidence. I could not find any studies that outline the vast amount of money spent (wasted?) on these standard treatments that are shown to be less than effective.

For years chiropractors have experienced significant success treating plantar fasciitis. Probably because they address the underlying biomechanical issues in the foot and pelvis I've talked about. This combined protocol is, unfortunately, not included in the literature review published in the Journal of the American Academy of Family Physicians. If it were, I figure we'd be at the top of their list of recommendations. It stands to reason that if the misalignment in the foot or pelvis remains untreated the problems will just keep coming back. This may be why standard orthopedic and podiatric treatments that focus merely on controlling the pain are only marginally effective.

Recently, I've re-formatted my approach when treating plantar fasciitis and I'm getting even better results. I still do all the wonderful chiropractic analysis and adjust whatever biomechanical issues in the spine, pelvis or foot that I find. However, I recently have added a deep, patient assisted, soft tissue treatment called Active Release Technique to my protocols for plantar fasciiitis. The concept is to lengthen the tissue while maintaining a light pressure or tension along the length of the fibers. This will break down adhesions in the fascia, ligaments, tendons or even nerve sheaths. Essentially the injured area will become more elastic, less pain sensitive and even stronger in just a few treatments. Sort of like a triage for the injured tissue itself. Once the patient is sub-acute, typically in 2-3 weeks, I will install a home stretching and strengthening program that will usually eliminate the need for extended numbers of visits or physical therapy.

The home program is pretty simple and starts with a frozen bottle of water to roll the foot on when it's very sore. Once the patient is walking comfortably (usually within 2-3 weeks) I have them, while seated, roll the foot over a golf ball to break up trigger points along the fascia as it's healing. You want to constantly remodel the tissue as it heals.Also, trying to control the golf ball without letting it slip away is a great way to begin a balancing exercise to strengthen the injured area and entire underneath of the foot. There are additional exercises that really need to be reviewed one on one with a chiropractor or physical therapist that can maximize the healing. In some cases where the foot is woefully pronated customized orthotic shoe inserts are needed to reduce the frequency and severity of future episodes. In my opinion both Footlevers and Ortho-Rite make superior products that really are not very expensive.

Using these combined methods seems to provide a faster, easier, safer and more effective way to deal with plantar fasciitis. In the long run it's also quite a bit less expensive than the standard orthopedic, podiatric and physical therapy modalities.

High-Deductible Plans and HSA's Not Gaining Traction

2007-11-21T07:59:00.000-05:00

The post below is from one of my favorite places to peruse, The Health Care Blog. Really a quality site for wonks (or those of us who try to be). This particular post piqued my interest because it touches a nerve for all providers, like myself, who deal with both patients and policy.

My feelings about HSA's and high-deductible plans are mixed. Yes, they can allow for easier access to health insurance among the uninsured, especially small business owners. They do fill a niche but that might be all. If I did not have good benefits through my wife's job this is actually the type of plan I would have to consider. However, this again reflects a policy trend that allows HMO's to provide a lot less coverage for only slightly less premium cost. Which means...you got it...much more profit for the HMO. After you're done paying the high deductible and higher co-pays you pretty much lose the advantage of slightly lower premiums. If you do the math that can be a bad deal and I think that's why people are not taking to them. Also, people simply do not trust HMO products anymore. Especially the new ones that are promoted as "consumer oriented." It's not consumer oriented if the consumer pays just a little less but gets A LOT less in return. That is a sham. Then again, it might be the better sham for you and your family. You decide.

If you can deal with my typo's (typing while dealing with a 2yr old can be a test) you can read the comments myself and few others exchanged by going to the site and clicking on "comments" at the end of the post.

From http://www.thehealthcareblog.com/

POLICY: Low prices ain't cheap enough

Mercer says that the number of small businesses offering health insurance to workers went down last year despite the greater and easier availability of high-deductible and HSA plans.
Fewer small employers offered health insurance this year, despite the widespread availability of new, lower-cost high-deductible insurance plans, a survey released today by benefit firm Mercer shows. Advocates of the high-deductible plans touted them as one solution to the growing number of uninsured, expecting the plans to appeal to small employers, who would continue to offer health insurance as a result. "That's not happening," says Blaine Bos, a Mercer partner and one of the study authors. "In fact, the reverse is happening."The study of nearly 3,000 employers found that the percentage of employers with 200 workers or fewer offering any kind of health insurance fell to 61% this year from 63% in 2006.That drop came even as the cost of high-deductible plans with tax-free savings accounts averaged $5,970 per worker per year. That was $700 less than a comparable plan without a savings account and far lower than the $7,120 for the average HMO, the study says. HSA/HRA type plans are growing in the market, but not as fast as employers are dropping coverage.
Continue reading "POLICY: Low prices ain't cheap enough"

Parents Might Be Jailed For Not Vaccinating Their Children

2007-11-18T12:47:00.000-05:00

This is a little over the top and sensational but since it's true and was reported on MSNBC I am willing to put it here. I'm not looking to stir up the whole vaccination debate but this seems a bit extreme. For the record my kid has all the standard mandated vaccinations (not the flu) but I'm not all that comfortable with it especially after reading David Kirby's Evidence of Harm. We do give my little guy a healthy dose of anti-oxidants before each shot, though.

Recently there has been a trend of forcing immunizations among certain demographics in an effort to prevent conditions that really are not imminently life threatening. Many times the efficacy of the immunization itself is still in question but state and federal officials force the mandate through anyway. Unfortunately, this is done without allowing for ANY balanced and informed decision making by the citizens. I think if the people knew what the science shows they'd be the ones forcing a more moderate application. I sniff an upcoming battle between citizen groups, government agencies and the pharmaceutical companies that will probably make it to the Supreme Court if this trend continues. At that point we may have the open national conversation about the safety and efficacy of vaccinations we desperately need.

For a solid evidenced based review of this issue please click on DocAltMed and read what Dr. Avery Jenkins has to say. He's a natural health care provider (also without the wacky stuff) who relies on the evidence to make his clinical decisions. He wrote a well referenced post on this very topic just a few weeks ago. In the end you'll have to follow the law but become your own informed advocate. The whole vaccination issue needs to be cracked open and re-evaluated. What should be forced? What should be dropped because the literature shows it's a failure? What should be left as optional? But now it's just getting silly when you jail parents for not providing vaccinations that in some cases are essentially unneeded in healthy populations of school aged children, have potential serious side effects, and might not even work in the first place. Really now.

Cigna Unfazed by '08 Election (and the need to pitch in?)

2007-11-17T09:36:00.000-05:00

Cigna's just kinda laying it out there, huh? See the article below captured from the Hartford Courant website. I love how they tell us it's a good thing that patients will pay more out of pocket. In this article they help answer the question "where's all the money in health care?" 10% growth no matter how desperate the country is to lower costs? They do recognize that funnelling patients to doctors that do a good job clinically and help lower costs is part of their plan. I give them that much credit. The chiropractors have been suggesting that for 15 years. However, will they share their "savings" with employers and patients? Um, well, they're more likely to keep it all and then report it to Wall Street as 10% growth...which is pretty much what they are telling us here. Please correct me if I am wrong.

"LITTLE ROCK, Ark. —NEW YORK — - CIGNA Corp., the U.S. insurer specializing in employer-sponsored health plans, expects net income to grow an average 10 percent a year regardless of who wins the 2008 elections, the company's chief executive said.The Philadelphia-based company will gain under any of the health care plans being offered by candidates for president, CEO Edward Hanway said Friday at an analysts meeting in New York. CIGNA will emphasize high-deductible health plans that give policyholders incentives to control costs, guide them to preferred doctors and offer preventive advice, he said.Voters have put health care reform high in polls for the presidential campaign agenda, and candidates are outlining plans to provide benefits to some or all of the 47 million uninsured Americans. CIGNA will capitalize on that, expanding sales of plans to individuals and families and to the elderly through the U.S. Medicare program, Hanway said.
The 10 percent gain in net income forecast for the next three to five years will translate into earnings per share of 12 percent to 15 percent, according to the forecast."

Omega-3 Fatty Acids Can help You Live Longer and Perform Better

2007-11-14T08:48:00.000-05:00

A comprehensive review of the research has shown the high value of a family of polyunsaturated fats called Omega-3 fatty acids. They are found naturally in fatty fish, some nuts and certain vegetable oils. According to MayoClinic.com the evidence is very strong that having Omega-3 in your diet is a natural way to lower triglyceride levels, provide strong secondary cardiovascular disease prevention, can help reduce high blood pressure, and is a potent natural anti-inflammatory. The evidence also shows Omega-3 can possibly provide some help with Rheumatoid Arthritis, lowering cholesterol, stroke prevention, reducing atherosclerosis, cancer prevention, angina pectoris, and even infant/brain development. More work needs to be done in those areas.

In my practice I use Omega-3 primarily as a natural anti-inflammatory. Because of the soft tissue techniques I employ I seem to have a large population of marathoners and tri-athletes who are always in a state of breakdown and repair. This leads to a lot of inflammation and discomfort that slows their recovery time between events and can even limit their training. The ones who take the Omega 3-6-9 (Fish, Flax, and Borage oils) tell me they feel better, train at a higher level and recover faster because of the reduced inflammation.

Of course, like with anything else that is really good for you, there are rare potential problems with some people who have bleeding disorders or who are pregnant or lactating. You really should consult with your health care provider before taking Omega-3 supplements and never take more than the recommended amount.

http://www.mayoclinic.com/health/fish-oil/NS_patient-fishoil

Introduction

2007-11-12T07:50:00.000-05:00

Hi, I'm Dr Michael Kane. I am a chiropractic physician who primarily treats musculoskeletal conditions. I do, however, believe strongly that the structure of the body can and often will affect it's overall function. I also have a special interest in policy trends relating to natural health treatment options...what others have commonly referred to as "alternative health care."

As I am sure everyone knows we are entering into an era of great cultural shift in the American health care landscape. With the '08 Presidential elections around the corner we can expect health care reform to be a major topic among all candidates. The winner of this election gets to run their plan through a Congress that is completely controlled and choked off by health care lobbying groups regardless of which party holds the power. That part will be interesting.

So as I listen to what people are saying I'm really not sure why they're calling it health "care" reform? My experience is that Americans really are asking for health "insurance" reform. People don't seem to be having as much difficulty with the care being provided as they do with ever-increasing treatment restrictions coupled with rising insurance premiums, deductibles, and co-pays. Considering doctors fees are dropping steadily one must ask "where's the money?" At the same time doctors across all disciplines must face reality and carve out the unnecessary waste. Those that perform with better outcomes by getting people well faster and for less overall cost should be promoted and rewarded.

So I figure we need to talk about these things. There are natural treatment options out there for common conditions that work faster, better and safer. Most of the time they are also less expensive. Natural health care can be a bigger part of the solution than we've been given credit. Alternative treatments that withstand evidence based scrutiny and years of "in the field" success should be part of the upcoming national conversation. We are about to engage in a captivating public dialogue about how care is delivered and paid for in this country. I hope this space allows myself, my colleagues, people in the industry, and most importantly the general public an opportunity to share some wisdom in both of these areas. Your comments are not only welcome but strongly encouraged.