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health

Human Error to Blame for OR Deaths

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I don’t normally like to reference the newspaper for any sort of health information, but I came across this article last weekend and decided to make an exception.

Based on figures from a national adverse events survey, it is estimated that up to 920 people die in BC each year from preventable human mistakes in surgery. And that is only based on reported adverse events. How many mistakes are not reported, or blamed on other issues (patient’s poor health, it was a risky surgery etc.).

This article highlights a changing tide in the public. More and more patients are starting to question the safety of hospital and surgical procedures that are performed everyday. They are looking to take a more proactive approach in their own safety in health care. Recently, the first “Empowered Patient Conference” was held in BC and was a rousing success.

In my opinion, hospital care and/or surgery is an important and valuable tool for those who need it. We are lucky in Canada to have such an excellent critical and urgent care system. However, many people head in that direction much sooner than is needed. People need to start looking at all their options and choose the least risky/invasive therapy first. I don’t think its too dramatic to say that your life may depend on it.

Vancouver Sun Medical Deaths July 01 2010

Dr. Debbie Wright is a practicing Courtenay Chiropractor.

Sad Local Health Story

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I was dismayed to learn a week ago that a military-style raid had been conducted by Health Canada and the College of Pharmacists on our local Marigold Pharmacy.  All compliance issues aside, I don’t believe that this had to go down the way it did. Marigold provides a unique service to the community, and I wish them a speedy re-opening!  You can read Marigold Pharmacy’s blog here for an account of what happened:

http://marigoldnatural.blogspot.com/

Start ‘Em Young!

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I had the pleasure of participating in the local Tri-K triathlon here in Courtney a few weeks ago. I didn’t manage to get in any training beforehand, but managed to have a pretty good time along the way. If you consider burning legs and a numb bum a pretty good time.

One thing that was a pleasant surprise for me was the number of children involved in the mini version of the triathlon. Children as young as 8 years old were doing small versions of the sprint triathlon, and there was even a smaller course for 5-7 year olds. It was very apparently that parents in the Comox Valley were very proactive about passing on their love of activity to their children.

In my opinion, if there is one thing you can instill in your child in order to promote future health and well-being, it is the love of sport/activity. We exist in a society where too much food and not enough movement is leading to staggering amounts of lifestyle diseases such as Type II diabetes, high blood pressure and cardiac disease. Creating healthy habits around exercise in youth will help them to maintain a healthier lifestyle in adulthood. And it all starts locally – hats off to the organizers of the Tri-k for a fabulously run event!

Dr. Debbie Wright is a practicing Courtenay Chiropractor.

Vitamin Water? No Thanks.

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Thanks to Dr. Kinsler for reminding me that I haven’t yet ranted about this inane product.

About 6 months ago a sales rep came around to our office and dropped off 2 massive cases of a brand of vitamin water. We usually carry some bottles of water for patients since we don’t have room for a water cooler in our waiting room (some people will actually look at us with scorn if we offer them tap water, even though Vancouver tap water continually beats bottled water on testing). We figured we’d hit the jackpot and didn’t have to shop for a while.

Then I read the label. The amount of sugar is staggering, and even though it makes reference to fruit juice in the name of the product, there is nothing of the sort inside. What ever happened to getting your vitamins in your food? What ever happened to being happy with simple water to drink?

This is just another example of misleading marketing to latch onto the health and wellness craze. You can read Rochester Chiro’s blog post to find out more about the class action lawsuit that is currently being filed against one brand of this product. Just goes to show you when it comes to health, don’t believe everything you read (especially if its advertising!).

Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

How Chiropractic Can Help You

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Chiropractic is a safe and effective form of treatment for neuro-musculoskeletal complaints. Below is a 30-minute video produced by the BC Chiropractic Association detailing how chiropractic can help you. Whether its a workplace injury, motor vehicle accident or chronic headache, discover how your local chiropractor can get you back on the road to recovery.

[viddler id=755952b3&w=437&h=370]

Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

How Much Chiropractic Treatment Do I Need?

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Each new patient that comes in for a consultation in my Comox Valley Chiropractic office receives a personalized and detailed report of findings. In this report, I explain the patient’s diagnosis in everyday language and what that actually means with respect to their spine or other joints. I explain what I think caused the problem, and why they were so susceptible to the injury. We talk about what the treatment is going to entail and the results I hope to see. I then will go through the various stretches and strengthening exercises that are necessary to address the problem when the patient is out in the world. Finally, I always sit down and discuss my proposed treatment plan and make sure that it sounds reasonable to the patient.

Every chiropractor uses their own education and clinical judgment to determine what a patient will need in terms of treatment. This will vary from person to person based on such characteristics as their age, the nature of their injury (car accident? workplace injury?), their previous history, their response to treatment, how active they are, genetic factors etc. etc. etc. The bottom line is that you can’t determine how much care someone will need until you see them, evaluate them and then see how they respond to an initial course of care.

In my office (and I would like to stress I speak ONLY for myself), I will usually start off with a course of 6 visits over the course of 3 weeks. This plan consists of the initial visit, 4 subsequent visits and then a re-evaluation. Its with this re-evaluation that we can see how much improvement has been achieved, and we can perform all the testing done on the first visit for comparison purposes. At this point, we will have a much better idea of recovery time. If more treatment is needed, the frequency of treatment will usually go down with time (i.e. from twice a week to once a week).

People who come in with simple uncomplicated pain – mild ache in the low back or a crick in the neck – will often be feeling better by the 4th or 5th visit (or sooner!). I usually will schedule the re-evaluation 1-2 weeks later in order to ensure that the problem hasn’t returned and that the home program is working. People who have very chronic complaints, are in great amounts of pain, have been in a car accident or have suffered a workplace injury will take longer. I’ve had people get better in one visit, and people who take 2 years.

I do speak about prevention with most of my patients. Its not something I push on them, I simply educate them on the benefits and its up to them if they want to do it. I would say about 50% of my patients seek preventative care, anywhere from once per month to once per year. The other 50% pop in for a course of visits when they hurt themselves. When you look at each of these groups, the funny thing is that on average I see them both for the same amount of treatment.

I welcome your questions and comments, as I am sure every chiropractor and every person has a different opinion on this subject.

The Top 4 Chiropractic Myths

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Day in and day out in my Comox Valley Chiropractic practice, I encounter new patients who confess that they didn’t try a chiropractor sooner due to hearing negative (and misleading) information. I spend a lot of my time explaining the true situations behind they myths they’ve heard. Over the next few weeks, I’ll expand upon my favourite 4 myths that I hear again and again. They are as follows:

  1. Chiropractic is addictive – once you go, you have to keep going back for the rest of your life.
  2. Chiropractors aren’t doctors, they have very little education compared to medical doctors.
  3. There is no evidence to show that chiropractic works.
  4. Chiropractic treatment is dangerous.

I will start with myth #1 – once you go to a chiropractor, you have to go over and over again, and keep going for the rest of your life. This one amuses me for many reasons, not the least is which its a perfect example of why people seem to measure chiropractic with a completely different yardstick than any other health profession.

I like to compare chiropractic to dentistry. Most of us are born with a beautiful and healthy mouth of teeth. Over our lifespan, we are encouraged to go to the dentist twice a year for check-ups, cleanings and the occasional cavity filling. If we are diligent with our prevention, hopefully we will never have to have a tooth pulled or a root canal performed.

Similarly, you are also born with a beautiful and healthy spine. Over our lifetime, our spine will also undergo stress and strain due to our relative inactivity, prolonged sitting and excessive amount of computer work (similar to too much candy and soda for the teeth). Just because you can’t see your spine every day in the mirror, doesn’t mean that stress doesn’t accumulate – just ask someone with bone spurs. Seeing a chiropractor for prevention, or treatment of small episodes of back pain, will help to avoid those major episodes which can lead to more invasive treatment such as surgery.

So, are you addicted to your dentist? What would happen if you didn’t go? You’d either have a horrible set of teeth, or you would be forced to go for major work when the pain became too unbearable. Also, more research is starting to surface between a healthy mouth and a decreased risk of heart disease.

What would happen if you didn’t go to a chiropractor? Your episodes of back pain would probably still resolve, albeit much slower and with more of an effect on your life. Its possible that the simple back strain you didn’t address would just keep coming back over and over, until it ended up becoming a chronic condition.

People don’t become addicted to chiropractic. They simply discover a simple and effective treatment to get rid of their aches and pains quickly, so that they don’t become major events. That being said, in my opinion a good chiropractor will also be providing home stretching and strengthening exercises that will help the patient to maintain as much self-sufficiency as possible. So why do we completely accept regular visits to the dentist, but scream bloody murder when a chiropractor suggests preventative care?

In my next post, I’ll discuss what is considered a normal treatment plan in my office and what I think is reasonable for preventative care. “How long until I get better?” is the most common question I have to answer in my office.

Pain Medication Reduces Breast Cancer Risk?

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Nothing irritates me more than reading incredibly misleading health related headlines in the Vancouver Sun with my morning coffee. Thus was the case this week when I was greeted with this headline upon sitting down in the kitchen: “Aspirin May Prevent Breast Cancer“.

Now, before you run out and start buying Costco sized aspirin bottles, let’s take a closer look at this study. First of all, its an observational study which means that an association was found between women who take pain relievers and a lower risk of breast cancer. It is important to note that an association does not necessarily equal causation (i.e. the drugs don’t necessarily cause a lower breast cancer risk).

Off the top of my head, I can give you one scenario that could be occurring. Maybe women who are more active have more aches and pains from exercise, and therefore take more pain relievers. The increased exercise could be causing the lowered breast cancer risk and the drugs are just a co-incidence. That’s the problem with an observational study – you aren’t controlling for many of these factors that can confound the results. A randomized controlled trial is needed to find clearer answers.

More importantly though, the toxicity of common pain relievers is enough in my mind to neutralize any benefit in terms of a reduced cancer risk. The authors of the study go so far as to admit that NSAID drugs such as ibuprofen (non-steroidal anti-inflammatories) have too high levels of gastrointestinal and cardiovascular adverse effects.

A very comprehensive evidence-based review of NSAID toxicity can be found here. While most of the data is based in the UK, they do list some interesting numbers for the US and Canada.  I’ve reproduced the summary table here:

Table 2: NSAID-related deaths and admissions to hospital

Event UK USA Canada
Annual NSAID prescriptions 25 million 70 million 10 million
NSAID-related admissions 12,000 100,000 3,900
NSAID-related deaths 2,600 16,500 365

In my opinion, that’s a staggeringly high number of deaths for something that is essentially just treating the symptoms of a problem. I’ve stopped being surprised at the sheer proportion of my patients who have absolutely no clue that NSAID medication carries any risks. They assume (as do most people) that since its available over the counter that it must be safe. Relatively speaking it is, but nothing comes without risks.

The bottom line from your Comox Valley Chiropractor? Think twice before you pop that ibuprofen like candy day after day, and look past the headlines when dealing with health related news!

Cut in Half your Risk of Early Death

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All of my patients can now stop rolling their eyes every time this Comox Valley Chiropractor tells them to stop smoking, exercise more, eat well and drink moderately. My patients are quite used to my preachings on living a healthier lifestyle, and now (as if I didn’t have enough research to back me up) a new article has been posted in the British Medical Journal extolling these virtues.

This 24-year long study followed a group of over 77,000 women between the ages of 34 and 59 who had no signs of heart disease (when the study began). They wanted to determine the relation of their health to 5 lifestyle factors:

  1. Being overweight
  2. Smoking
  3. Excessive drinking
  4. Poor Diet
  5. Little physical activity

Over the years 8882 of the women died – 1790 from heart disease and 4527 from cancer. Each of the above lifestyle factors was found to significantly increase the chance of dying from any disease (not just those listed above). Another interesting fact is that women who drank moderately (up to one drink per day) actually had less chance of dying from heart disease than those who did not drink at all.

While it may seem like a tall order to follow the recommendations of this study, it really doesn’t need to be that complicated. You don’t need to hit the gym, lift weights and run ten miles everyday. Often, a healthy lifestyle is all about the little things.

Quitting smoking is a must. No if, ands or buts. If you are having trouble, both acupuncture and low intensity laser therapy are safe and effective options. You don’t need to give up your wine or spirits, simply moderate it to a one-drink a day maximum.

Simple diet choices can significantly improve your nutrition, while decreasing obesity. Choose whole grain foods, less red meats and cut out the soda and excess sugar. As for exercise, walking to work or the corner store will ensure that you achieve the 30 minutes of exercise per day that is considered minimum.

Revamping your entire life to begin an unsustainable nutritional and exercise plan is not the answer – you need to make sure you take small steps in the right direction and change your lifestyle in a comfortable way. These simple changes can literally mean cutting your risk of early death by 50%.

Best Foot Forward

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The Canadian Chiropractic Association has recently launched a falls prevention program entitled “Best Foot Forward”. Below is an excerpt from a press released issued by the BC Chiropractic Association:

One in every three Canadians over 65 are just a step away from falling, and that slip, trip or stumble often has serious and costly consequences. Older Canadians are nine times more likely to suffer an injury from a fall leading to hospitalization and even death.

That is why the BC Chiropractic Association is launching Best Foot Forward, a public education program aimed at preventing falls in seniors. The program follows a Public Health Agency of Canada report detailing the debilitating and even deadly consequences of seniors’ falls.

“Best Foot Forward offers practical advice on many aspects of prevention that most older Canadians can do easily,” says Dr. Brian Gleberzon, DC, who acted as a consultant on the national Report on Seniors’ Falls in Canada and who helped develop the program. “Preventing a fall can be as simple as changing your footwear, taking off your reading glasses before walking to the next room or removing slippery scatter mats.”

“The message we want to get across is – don’t let a fall get you down. Slips, trips and stumbles are preventable,” concludes Dr. Gleberzon.

A self-assessment quiz and illustrated prevention tip sheets covering household hazards, health risks, strength and balance, and safety-conscious behaviour can be obtained at no charge from your Comox Valley Chiropractor or downloaded from your Comox Valley Chiropractic website . Prevention presentations to groups can also be arranged by contacting us.