Reduction of Labor and Delivery Time Due to Chiropractic Care
The Journal of Pediatric, Maternal & Family Health published a case study on April 3, 2017, documenting the case of a woman who experienced a shorter and easier birth due to chiropractic care. This improvement was compared to her first pregnancy and delivery where she did not receive any chiropractic care.
The study begins by noting that chiropractic care has been involved in the care of pregnant women since the early days of the profession over a century ago. The authors note that over 76% of practicing chiropractors report that the care of pregnant women is a part of their practices. This care is rendered for both musculoskeletal issues related to pregnancy as well as care for overall wellness during pregnancy.
In this study, a 28-year-old woman went to the chiropractor for evaluation and possible care. She sought chiropractic for a pain in her tailbone area as well as for wellness care. The woman believed that her pelvis had shifted due to her first pregnancy. She reported that after the delivery of her firstborn, she experienced pain and discomfort at her tailbone any time she sat on a hard surface. The woman reported that her first pregnancy went well, but that her delivery was very long and difficult. This was one of the factors in her desire to receive chiropractic care in anticipation of her second pregnancy.
Her history revealed that between the ages of eight and sixteen, she was a competitive gymnast and was receiving chiropractic intermittently during that time. She also noted that she did not receive any chiropractic care during her first pregnancy. Prior to her first pregnancy, she did not have tailbone pain. She later attributed her long and difficult labor and delivery as being the cause of the tailbone pain.
A chiropractic examination was performed and it was determined that multiple vertebral subluxations were present. Care was started to address the subluxations through a series of adjustments to the areas involved. After a number of adjustments, the woman reported a 50% reduction in the tail bone pain. She then became pregnant for the second time. The chiropractic care was continued to, hopefully, facilitate an easier delivery process.
As with her first birth, the woman decided to have her second child at home. She was supervised by the same Certified Professional Midwife (CPM) that attended her first home birth. According to the midwife, the woman’s first labor and delivery time combined was 32 hours and 25 minutes. After chiropractic care, the midwife reported that the woman’s labor and delivery times for her second child was only two hours and 45 minutes combined.
In their conclusion, the study authors note that chiropractic care during pregnancy is far more valuable than just symptomatic relief of musculoskeletal pains, and should be considered for the overall wellness and process of pregnancy. They stated, "This case report provides supporting evidence that subluxation centered chiropractic care on pregnant patients can have beneficial effects on the birthing process."
Fibromyalgia Helped Following Chiropractic - A Case Study
On March 13, 2017, the Annals of Vertebral Subluxation Research published a case study documenting the improvement from chiropractic of a woman who had been suffering with fibromyalgia, widespread pain, fatigue, depression, and headaches.
Fibromyalgia is a chronic, widespread pain syndrome with an unknown medical cause. The word itself is actually a descriptive term that can be broken down into three words. "Fibro" is a Latin word meaning fibrous tissues such as tendons and ligaments. The middle part "my" is short for "myo" which is Latin for muscles. And the word "algia" is Latin meaning pain. The study authors note how common this problem is by stating that, "It is estimated to affect 2-3% of the American population and is the second most common diagnosis made in rheumatology clinics in the United States."
Fibromyalgia is about ten times more common in women than men, and commonly starts between the ages of 60 to 79 years. Due to many patients with fibromyalgia also suffering from depression, common medical treatment is low-dose antidepressants as well as pain medication.
In this case, a 40-year-old woman went to the chiropractor with an 8-year history of medically diagnosed fibromyalgia. Her symptoms included widespread pain, including neck pain, mid and upper-back pain, and arm and shoulder pain. She was also suffering from headaches, high blood pressure, and depression. The medical care she had been receiving for her condition included three non-steroidal anti-inflammatory drugs (NSAID) per day, seizure medication, and a series of three cortisone injections.
A chiropractic examination was performed to access the woman’s spine and nervous system. This consisted of postural evaluation, x-rays of the spine, paraspinal surface electromyography (sEMG), paraspinal thermography, range of motion (ROM), and motion and static palpation. Additionally, a 36-question short-form (SF-36) questionnaire was given. This questionnaire is a standard and verifiable measurement of quality of life as stated by the patient. It is often used to gauge the overall improvement of a patient in their abilities to have a normal and function life. The scores that the patient can give themselves in each of the areas range from 0 for the worst possible, to 100 representing the highest level of functioning possible.
The woman received a total of 44 chiropractic visits over a 5 month period after which a re-examination was performed and all tests were compared to the original findings. The study records that all objective findings showed improvement including the patient's range of motion, the sEMG tests, as well as x-ray findings.
The SF-36 patient questionnaire showed considerable improvement in most all the areas as reported by the woman. Her emotional well-being improved 10 points from 39.6 to 49.6. Her reported energy/fatigue improved 37.5 points from a 16.6 to 54.1. She reported that her general health improved 35.0 points from a 3.0 to 38.0. As for pain, her original rating was a complete 0, which improved 36.7 points. Likewise she rated her physical functioning at 0 before her care which improved to 39.4 after chiropractic. Her limitations due to emotional problems improved 8.3 points from 50.9 to 59.2. The woman reported that her social functioning improved 37.5 points from an original 21.2 to 58.7 after chiropractic.
In their conclusion the authors wrote, "Reduction in radiographic vertebral subluxations and improvements in spinal alignment and posture, ranges of motion, musculoskeletal pain, headaches, and health-related quality of life were achieved using [chiropractic] on a patient diagnosed with fibromyalgia."
Study Finds 21 Percent of Patients are Misdiagnosed
A study published in the Journal of Evaluation in Clinical Practice on April 4, 2017, found that more than 20 percent of patients are misdiagnosed. The study titled "Extent of Diagnostic Agreement Among Medical Referrals" looked at the diagnosis originally given to patients and compared that to the diagnosis later given upon the patient seeking a second opinion.
The study reviewed the records of 286 patients who were referred by their primary care doctor to the Mayo Clinic's General Internal Medicine Division in Rochester, Minn., over a two-year period from Jan. 1, 2009 to Dec. 31, 2010.
Overall, the results showed only 12 percent of those seeking a second opinion at the Mayo Clinic had their diagnoses confirmed. However, 21 percent of the patients had their diagnosis completely changed, while 66 percent of those patients received a refined or redefined diagnosis. Overall, the study showed that almost 88 percent of patients seeking a second opinion at the Mayo Clinic receive a new or refined diagnosis.
Previous research cited in the new study showed that errors in diagnosis "...contribute to approximately 10 percent of patient deaths." Additionally they "…account for 6 to 17 percent of adverse events in hospitals."
"Effective and efficient treatment depends on the right diagnosis," said study co-author James Naessens, a health care policy researcher at the Mayo Clinic, in an April 4th press release in Science Daily. "Knowing that more than 1 out of every 5 referral patients may be completely [and] incorrectly diagnosed is troubling -- not only because of the safety risks for these patients prior to correct diagnosis, but also because of the patients we assume are not being referred at all."
In a Washington Post article, Mark L. Graber, a senior fellow at the research institute RTI International and founder of the Society to Improve Diagnosis in Medicine, who was not involved with the study noted, "Diagnosis is extremely hard. There are 10,000 diseases and only 200 to 300 symptoms." He added, "Doctors are humans, and they make the same cognitive mistakes we all make. If you are given a serious diagnosis, or you’re not responding the way you should [to medication], a second opinion is a very good idea. Fresh eyes catch mistakes."
Second opinions are still encouraged, but the concern is that they may be limited due to in-network insurance issues preventing patients from seeking second opinions. In response to the problem of diagnosis error, the National Academy of Medicine has called for dedicated federal funding for improved diagnostic processes and error reduction.
It is obvious that there is an increase in cost both in diagnosis and medical treatment if the first diagnosis is not confirmed by the second opinion. However, Naessens sums up the concerns if a second opinion is not sought saying, "Total diagnostic costs for cases resulting in a different final diagnosis were significantly higher than those for confirmed or refined diagnoses, but the alternative could be deadly."
Pregnant Woman with Surgical Spinal Rods Helped with Chiropractic
The Journal of Pediatric, Maternal & Family Health published a unusual study on March 23, 2017, documenting the case of a pregnant woman with lower back pain being helped by chiropractic. What makes this case unusual is that the woman had previous spinal surgery and had Harrington rods inserted into her spine.
According to Wikipedia, the Harrington rod is a stainless steel surgical device that was implanted along the spinal column to treat curvatures of the spine, or scoliosis. Up to one million people had Harrington rods implanted for scoliosis between the early 1960s and the late 1990s.
The study begins by noting that chiropractic care for pregnant women has been a popular occurrence for much of the chiropractic profession’s history. Commonly, women seek chiropractic care to address physical complaints such as pregnancy-related musculoskeletal complaints. However, many pregnant women seek chiropractic for wellness care and to improve the birth experience.
In this case, a 28-year-old woman who was in her 21st week of pregnancy, sought chiropractic care with a chief complaint of shoulder and neck pain, which she attributed to her scoliosis. She had surgery seven years prior for a moderate scoliosis. Harrington rods were inserted into her spine from her second thoracic to her second lumbar vertebrae.
She rated her constant pain as 6 out of 10, with 10 being the worst. She recalled that this episode started when she was lying on her left side and she felt a muscle tightened so tightly that it was pulling on the rods from her scoliosis surgery. Her pain was worse at night and was too painful for her to get a massage. Her left shoulder was restricted and she claimed that she could not lift anything with her left arm. Additionally, she reported that she occasionally suffered with headaches and sinus congestion.
A chiropractic examination was performed, and it was determined that subluxations were present. A series of specific chiropractic adjustments were begun to address the woman’s subluxations. After each adjustment the patient reported a decrease in her pain.
After 13 weeks of chiropractic care, it was reported that the woman’s pain had significantly decreased and was now only a 2 out of 10. Additionally, her posture had improved as had her spinal range of motion. A week later, the patient suffered a fall which caused a minimal increase in her symptoms. Care was continued and she continued to improve in most areas. She delivered a seven pound girl vaginally with minimal assistance.
The complexity of this case, due to the patient’s spinal surgery history, contributed to variations in her symptoms as care was given. Overall, the quality of her life was improved and she was able to deliver a healthy baby. In their conclusion, the study authors summed up this unusual case by stating, "This case report provides supporting evidence on the effectiveness of chiropractic care throughout pregnancy and in particular, pregnant women with surgical rods to address scoliosis."
Study: Smoking Kills 1 in 10 Worldwide
The headline above comes from a story published on April 6, 2017, by United Press International reporting on an April 5th study published in The Lancet showing that 11% of all deaths world-wide were due to smoking. This translates into 6.4 million deaths due to smoking each year.
The study also showed that half of those deaths occur in only four countries. Those countries are the United States, Russia, China and India. These numbers are in spite of the fact that most all smokers know the risks and health hazards associated with smoking.
In spite of the facts and figures about the health risks, the study showed that almost 1 billion people worldwide are daily smokers. The numbers are much higher for men that woman. The actual percentage of smokers has actually gone down over the past few decades, but due to the rise in population, the number of smokers has increased.
In the U.S., the Centers for Disease Control and Prevention estimates that 15 of every 100 U.S. adults age 18 and older smoke cigarettes. Worldwide, India has 11.2% of the world’s total smokers. More men than women smoke but the study showed that USA, China and India, which were the leading three countries in total number of female smokers, accounted for 27.3% of the world’s female smokers. The countries with the most male daily smokers in 2015 were China with 254 million, India with 91 million, and Indonesia with 50 million. The countries with the most female smokers were the Unites States with 17 million, followed by China with 14 million, and India with 13.5 million.
"Despite more than half a century of unequivocal evidence of the harmful effects of tobacco on health, today, 1 in every 4 men in the world is a daily smoker," said study author Dr. Emmanuela Gakidou, in a press release. "Smoking remains the second-largest risk factor for early death and disability, and so to further reduce its impact we must intensify tobacco control to further reduce smoking prevalence and attributable burden."
A similar study published in JAMA Internal Medicine late last year showed that 28.6% of all cancer deaths in the US in 2015 were attributable to cigarette smoking. In the conclusion of that study, the authors wrote, "The proportion of cancer deaths attributable to cigarette smoking varies substantially across states and is highest in the South, where up to 40% of cancer deaths in men are caused by smoking. Increasing tobacco control funding, implementing innovative new strategies, and strengthening tobacco control policies and programs, federally and in all states and localities, might further increase smoking cessation, decrease initiation, and reduce the future burden of morbidity and mortality associated with smoking-related cancers."
In an ongoing attempt to reduce the number of smokers worldwide, in 2003 the World Health Organization created the Framework Convention for Tobacco Control (WHO FCTC). The WHO FCTC created guidelines to provide the foundation for countries to implement and manage tobacco control programs. In 2008, the WHO FCTC created the MPOWER measures to help implement the tobacco control measures.
Dr. Douglas Bettcher, Director of the Department of Prevention of Noncommunicable Diseases at WHO headquarters in Geneva stated, "The WHO FCTC and its guidelines provide the foundation for countries to implement and manage tobacco control. The MPOWER measures help make this a reality and have changed the landscape of global tobacco control." Dr. Bettsher continued, "Along with national and local governments and other partner organizations in high-burden countries, we are making positive change happen in some of the toughest tobacco industry strongholds. Together, we have protected nearly 1.8 billion people with at least one new MPOWER measure at the highest level of achievement since 2007."
Medication Errors Cause One Death Every Day and 1.3 million Injuries annually in the US
A News Release by the World Health Organization (WHO) on March 17, 2017, states the fact that, "Medication errors cause at least one death every day and injure approximately 1.3 million people annually in the United States of America alone." Their press release announces an initiative to reduce that number by half within the next five years.
Although the release notes that many countries do not keep good records on drug errors, the WHO estimates that worldwide the cost of medication errors is $4.2 billion, equal to about one percent of the world's total expenditures on healthcare. According to the WHO release, "The Global Patient Safety Challenge on Medication Safety aims to address the weaknesses in health systems that lead to medication errors and the severe harm that results."
Dr. Margaret Chan, WHO Director-General stated, "Apart from the human cost, medication errors place an enormous and unnecessary strain on health budgets. Preventing errors saves money and saves lives." Dr. Chan continued, "Most harm arises from systems failures in the way care is organized and coordinated, especially when multiple health providers are involved in a patient’s care. Any one of these, or a combination, can affect the prescribing, dispensing, consumption, and monitoring of medications, which can result in severe harm, disability and even death."
In the WHO release, Liam Donaldson, WHO’s envoy for Patient Safety, stated, "Over the years, I have spoken to many people who have lost loved ones to medication-related errors and their stories, their quiet dignity and their acceptance of situations that should never have arisen have moved me deeply." He continued, "It is to the memories of all those who have died due to incidents of unsafe care that this Challenge should be dedicated. There is a need for an organizational culture that routinely implements best practices and that avoids blame when mistakes are made."
Dr George Curry, president of the International Chiropractor Association commented on this issue by saying, "While every healthcare professional should applaud the effort to reduce medication errors that lead to harm, the discussion should also address ways to reduce the over utilization of medications in the population." Curry continued, "One sure way to reduce the incidence of medical errors is to look to other forms of care that do not involve medications. Chiropractic has always represented an alternative to the medication approach for many millions of people."
Dr. Robert Braile, chiropractor and author makes the point, "I guess a half reduction in the number of deaths and injuries would be considered by some as progress. But even if the WHO initiative is successful, that would mean that the WHO has a goal of only one death every other day and 650,000 injuries each year. Why is this level of carnage acceptable from a healthcare delivery systems that touts the mantra, 'First do no harm?'"