I recently read an article linking a popular "osteoporosis medication" with an increased risk of fracture (I'll comment more on this in a later post). The term osteoporosis describes the loss of bone density, which increases the patient's risk of skeletal fracture. Hence, any substance that would further increase the likelihood of fracture would be counter-productive, right? You would definitely think so. Unfortunately, long term use of Fosamax has caused a frightening amount of fractures in people performing every day activities like walking. Of course, one must always determine whether or not the risk of any health intervention outweighs its intended benefits, but how often does a medication actually make the patient sicker than when they started? More often than you might think.
But doesn't the Hippocratic Oath state that the doctor should "First, do no harm?" It sure does, but new doctors who recite the Hippocratic oath also state that "I will prevent disease whenever I can, for prevention is preferable to cure." Is this why my mother's physician tried putting her on Lipitor and never ONCE mentioned diet, exercise, or supplements (which actually work better than statins and without the pesky muscle aches, liver damage, and loss of memory)?
Unfortunately, the likelihood of unintended consequences is evident with so many other medications that the public doesn't know about. Biased research creates a perceived benefit, which gets the medication cleared for public consumption. Even conservative estimates on Vioxx (a pain medication which had an annoying side effect of causing heart attacks and strokes) state that the final Vioxx death toll reached 28,000 people, or nearly TEN TIMES that of the attacks on the World Trade Center. A more recent re-analysis of the data estimates the death toll could be up to FOUR TIMES higher still. To put it in perspective, this would put the Vioxx death toll greater than the number of Americans that died in the wars in Vietnam, Afghanistan, and Iraq combined.
Just let THAT sink in.
The problem is that these facts do not come to light until well after patients have been exposed. Since the drug companies themselves usually conduct the research that proves a drug's safety and efficacy (or they just give a pile of money to a university to do it for them), the real "test" of a drug occurs once it is on the market. Patients become the lab rats, the only difference being that that real lab rats don't actually have to pay for their medications at 200 dollars per bottle. The organization whose mission is to protect us, the FDA, is funded by pharmaceutical companies. The agency is so corrupt, that a group of scientists at the FDA have urged that the white house step in and "clean house"in an open letter to the President. The organization itself is loaded with former doctors and big pharma employees. In this case, the fox actually owns and manages the henhouse.
So who do you trust? Your doctor? She is too busy seeing patients (and fighting with insurance companies). She doesn't have time to pour over research journals all day (which are biased, anyways) and keep up with every single drug on the market. Of course doctors want to make sure they are offering the latest treatments in order to help their patients. They rely on pharmaceutical reps to keep them updated on the newest medications, taking it on faith that the information they receive is unbiased and accurate. Are we seeing a problem yet? The pharmaceutical representative is paid on commission. Of course they are going to paint as sunny a picture as possible when peddling their wares, like any good salesman. By the way, have you noticed that most pharmaceutical salespeople you see are attractive females? No, that is not a coincidence. In fact, drug companies have been known to recruit college cheerleaders to help sell more pills. If these life saving medications are all they're cracked up to be, why would you need paid models, errr..."salespeople" to convince the doctors to prescribe them? The whole system itself has gotten a pass for decades. It is high time we question the credibility of the medical establishment when it comes to the safety and efficacy of pharmaceuticals.
However, I am not asking anybody to throw the baby out with the bathwater. Good, appropriate medical care has its place, for sure. My mother, the same woman who was frustrated by her doctor's flippant Lipitor prescription, also received a life saving surgery by a brilliant neurosurgeon after she suffered a brain aneurysm. When it comes to acute crisis care, medicine is where it's at. No doubt about it. What we do need to keep in mind, however, is that we must make informed decisions when it comes to our personal health care, especially when it comes to preventing and managing chronic disease. Relying on large pharmaceutical companies and government bureaucracies to look out for our best interests when budget concerns, stock prices, and commisions are at stake is a risky proposition at best. Listen to your doctor, but make sure your doctor is willing to listen to you. Be open and honest about your concerns. Inquire about healthy alternatives to medications. Do a little research before putting anything in your body (or allowing somebody to take something out). If your doctor is unwilling to take your concerns seriously, find one who will. There are some fantastic medical physicians who are willing and able to treat you as an individual and not just a list of symptoms.
With that in mind, let's turn the tables and identify the person who is most often to blame if you are not healthy: yourself. You owe it to yourself and those who depend on you to "first, do no harm." The healthier you make yourself, the better off you will be in the long run, decreasing the chances you will ever be exposed to invasive treatments like drugs and surgery. The (wo)man in the mirror is the most important figure in your health care, not just a Michael Jackson song.
Quit drinking soft drinks (yes, even the diet ones). Quit smoking. Quit your sugar addiction. Quit stressing about things you can't change. Quit using cleaning supplies with harmful chemicals. Quit eating processed food with 14-syllable ingredients. Quit putting off sleep so you can facebook, watch TV, and play video games. Quit covering up your poor health decisions with stimulants, painkillers, and antacids. Quit making excuses about why you haven't done this already.
Get more exercise. Get more sleep. Get a water filter. Get more vegetables and grass fed meats into your diet. Get a massage. Get your spine adjusted. Get your teeth cleaned. Smile more. Laugh more. Read more. Think more. Be a regular at your local farmer's market. Pick up a hobby. Volunteer. Spend less time at the computer and more time at the community center. Be a better spouse. Be a better parent. Be a better friend. Be a better you.
You are in control of your own health. Your body is the most valuable thing you own. Take care of it and it will last you much longer.
Spinal problems are very common in the elderly. The wear and tear that accumulates in one's spine can often lead to problems down the road, especially when they go untreated for long periods of time. Back pain, headaches, neck pain, and limb pain are very common as a result. In fact, back pain is the most frequent reason for activity limitation in those over 55. This limitation in activity causes depression, loss of muscle mass, fatigue, and overall poor health. The problem is that they seldom have anywhere to turn for these problems. They are often told by their doctor that their age is the cause of all their concerns and they are given meds they can't pronounce and a few empty words about the caveats of old age. I for one do not ascribe to the whole "It's your age" or "It's just arthritis" catch-all excuses for every single ache, pain, and problem plaguing our seniors. Elderly people should be tending gardens, attending their grandchildrens' recitals, and playing the Wii!
In most cases, prescription pain medications are the first thing offered to these patients by their doctors. However, the majority of elderly patients are already taking several medications for various other conditions, increasing the risk of harmful drug interactions. In addition, the medications are only covering up the symptoms rather than actually relieving the cause of the problem. This sets the patient up for failure because the drugs may make them "feel good," even though they are not, which will increase the chances of making the problem worse by abusing already damaged joints and soft tissue.
The absolute worse case scenario involves spinal surgery. Nowhere in the history of medical care will you find a more dubious practice. There is absolutely NO statistical evidence showing any long term benefits of spinal surgery for backpain, except in extreme cases like fracture, disc herniation, and dislocation. In fact, most studies show that the patients that have lumbar fusion surgery are actually worse off in the long run: Read "Why You Should Never Get Fusion Surgery" from Forbes magazine.
The interesting thing is that despite this lack of evidence, American doctors perform 5 times more lumbar fusion surgeries than doctors in the UK, which is the most comparable country to us in regards to lifestyle and genetic factors. Why? Because there are so many more surgeons that perform this surgery in the US. And companies that make the equipment to perform the surgeries pay MILLIONS in fees back to the doctors that perform the surgery. It doesn't take long to figure out why so many surgeries take place. Just follow the money. To quote well-respected pain management expert Dr. Seth Waldman, MD, who is critical of back fusion surgery, "If you have a screwdriver, everything starts looks like a screw." We apparently have a health care system stacked to the gills with screwdriver-toting surgeons that cut first and ask questions later. Luckily, many primary care MDs try to steer their patients away from surgery, and try to encourage alternatives, which is a refreshing step in the right direction.
So what is an active, virulent elderly person to do if they have back pain (or would like to avoid it)? if you are wary about the risks of drugs and surgery, you may want to consider checking into chiropractic care. Chiropractic care has been around for over 115 years and has become the 2nd largest primary health care profession in the US. Chiropractors offer a safe, effective treatment for back pain, neck pain, and headaches, even for the elderly. Unfortunately, some critics of chiropractic spin yarns of fracture, stroke, and other risks which often scare off patients. However, when asked where the research is to back up these risks, these critics often shrug and have nothing to offer, because there is no research indicating that chiropractic is unsafe. In fact, there is plenty of research proving that it is safer and more effective than drugs and surgery. In a recent study done by Consumer Reports, chiropractic care was rated #1 in regards to patient satisfaction for treatment of back pain.
Of course, all the research and testimonials in the world mean nothing if you cannot fathom the thought of someone "snapping and cracking" your joints. Fortunately, doctors of chiropractic have a number of different techniques to choose from. Some utilize the more traditional manipulation while some, including my Muskegon practice, use gentle non-manipulative techniques. Using the Atlas Orthogonal and Activator methods of chiropractic treatment, we utilize precision instruments to adjust the spine, re-aligning the spinal joints, and taking pressure off the nerves and soft tissue without the pain associated with more aggressive manipulation. This makes our treatment safe even for those with osteoporosis, advanced arthritis, and other bone abnormalities. Once the spine becomes more stable, we also encourage stability exercises to help keep the joints flexible and strong to help prevent flare ups. Plus, the extra range of motion gained by chiropractic does fantastic things to your golf swing! (There's a reason why the PGA has a chiropractor on hand at each event).
So, what do you have to lose? The drugs aren't fixing the problem and they're probably causing some side effects you would rather avoid. Surgery is costly, risky, and generally not effective. There is another option. When I talk to patients or teach at seminars in the community about ditching what hasn't worked and trying something new, I remind them of one of my favorite quotes of all time from the late great Albert Einstein when he tried to define insanity:
Although I am not saying that you or your doctor are insane, I can tell you that the only way you are ever going to get to a different place in regards to your health is if you take a different path. A consultation with a doctor of chiropractic may be the first step on a journey towards better health and renewed vitality.