June comes in like a lion!

We have been blessed with some outstanding weather in Minnesota for the past several weeks.  I know that it is early for 80 and 90 degree weather, but hey, we have earned it!

This month I am going to revisit a couple of topics that we have discussed before.  The first topic is the use of prescription drugs.  I am an advocate of early medication intervention when necessary, but I think that after reading this article you may question, as I do, what determines necessary.  This is scary stuff.  I do suggest that you re-read my December 2003 ENewsletter.  I was pretty on the money 3 years ago.

The second topic is our old friend whiplash.  I continually preach on the severity of a true whiplash.  People often take simple 'fender benders' too lightly and they suffer greatly later.  Unfortunately, the person may have just wanted the problem to 'go away', only to find out later that any possible insurance coverage lapsed because he or she didn't want to report a minor crash.  Early intervention is the key to proper stabilization and healing of the trauma.

Following the auto crash theme, I wrote an article on teen driving habits and trauma.  It is worth a read, especially if you have teens at home.

Headaches round out the stories this month.  Chiropractic continues to valid itself, even in medical circles.

Eileen brings you a great summer classic that I have taste tested and of course, given my approval!  

I brought back the Fender Bender Buddies this month.  They are an unfortunate, but very necessary glove box accessory.  If you don't have one, you need one.  I even have one in my vehicle!

Finally, this month I have exciting news to report.  I was recently nominated to the Governing Board of the Minnesota Society of Clinical Hypnosis.  It is quite an honor to have been asked to perform a role in this medical society.  Minnesota is looked at as the gem of Medical Hypnosis training, education and clinical use throughout the United States.  I will serve proudly and effectively.  It may also open doors of future treatment protocol for all of you who are patients at this clinic.  My work, to date, has not gone unnoticed!

Dr. Frisch

Prozac Revisited

I had written a paper a couple years ago that detailed some of the inadequacies and short-comings in making an accurate psychological diagnosis.  If you would like to review that paper it can be found in the December, 2003 ENewsletter within this web site.

In that paper, I discussed how a psychological diagnosis can be manipulated to follow you throughout your lifetime.  One common way of doing this is calling a diagnosis "...in remission".  The initial  problem, no matter how simple it may have been to treat  (e.g. divorce, death issues or even insomnia), may be used as a tag to complicate your life later on.  I had voiced  this problem in my paper 2 1/2 years ago and it would appear that this exact problem is now coming true!  How unfortunate.

A story recently published nationally, discussed the dilemma of a Boston area attorney.  The man had sought some counseling for problems at home that resulted in fighting with his spouse.  Since he did have insurance coverage for psychological resources, he decided to use his insurance for the counseling sessions.

Little did the man know that when he tried to apply for added insurance coverage at a later date, he would be denied insurance because his records indicated psychological counseling.  Even if the problem had been insomnia and medication remised the condition, he would be penalized for the rest of his life when trying to get insurance coverage.  If he had no insurance at the time, he might not even be able to buy insurance after the counseling sessions!

If this seems unfair to you, you are probably in the majority.  I actually consider it very sane and responsible behavior to seek help, follow recommendations given, and stabilize the problem.  The insurance industry, however, considers any person seeking counseling, for any reason, a risk!  What it really does is give them an excuse to extort extra money from a payer.  It is not emotional to them at all, it is just how insurers do business!

The man's medical therapist reported that he no longer accepted patients unless they could pay for care out of their own pockets.  This, he said, was done so that a diagnosis does not negatively follow each patient throughout their lifetime.

Some easy ways to become uninsurable: 

1. Become self-employed!  I know that this may be hard to believe, but self-employed people are often (usually) unable to buy independent insurances for themselves or their employees.

2. Become Independent.  When you are no longer parental-dependent, your chances of gaining insurance on your own are virtually nil.  I wonder how a childhood diagnosis of ADHD impairs future insurance options? I think that you can pretty well guess that one!

3. Take 'ongoing' prescription medication.  This includes anti-depressants, blood pressure medication and even allergy medication!

There are few tricks that insurers miss in their attempts to raise revenue and increase profits.  Your health and well-being are irrelevant to insurance companies.  For example, people think that what's on TV is important, but the programmers don't give a hoot what show is on.  They consider TV shows as the filler between the commercials.  If they can get you to watch the commercials, they make more money.  If an insurer can get you to give them money and never do anything.....they win....you're the 'filler'...they kept your money!!!  

Creativity is the key to keeping insurance profits up, so be careful in what you do and what you report, or it may come back to haunt you!

How Serious is Whiplash, Really!

I have reported in many prior ENewsletters on the lingering and often devastating effects resulting from suffering a whiplash injury, but I think that it warrants repeating.

First, lets recall that a true whiplash is not just sore muscles that occur after a crash.  A true whiplash involves neurological, ligamentous, discal, bony, and even vascular components.  It is a serious condition resulting from an 'acceleration-deceleration' force. 

The force (mass x speed) may come from behind, in front or from either side.  The head and neck do not have to strike anything in the vehicle for the trauma to occur.  In fact, the damage is actually done before the head moves!  Let me repeat that statement because it is key in understanding the whiplash injury.

"The tearing of tissue, whether it be muscle, ligament, blood vessel, or spinal cord, occurs before the head even moves!"

A muscle can contract as fast as 150 milliseconds (ms).  That is the speed of a reflex.  The 'shearing force' that passes through your body and the vehicle during a crash, however, occurs at 50-75 ms.  A protective muscle reflex is slow in comparison.  This means that the muscles could not even protect you on impact.  They never had a chance! 

A famous race car driver died during a crash a couple of years ago.  When reviewing the video, it does not look like the impact on the wall should have been hard enough to kill him, but the speed and mass (force) across his neck and spine actually sheared his spinal cord at the level of breathing and organ function.  He may have survived the impact, but he didn't survive the shearing force because it was too fast and his muscles could not protect him.

This information about whiplash is not new to those of us who treat the injuries, but the public is still in the dark about why we need to be so careful in a motor vehicle.  Here are some facts published as far back as 1996 in the Journal of Bone and Joint Surgery, as well as other sources previously reported.

1. 70% of whiplash injuries continue to be pain-generating 15.5 years (mean) after the injury.

2. 10-15 years after the whiplash trauma, 18% of patients improve, but 28% had gotten worse.

3. Most whiplash trauma reaches a final stage by 2 years after the trauma, but 20-40% of injured people can still suffer with a 'late-whiplash syndrome' that induces pain for many years.

4. 80% of women and up to 50% of men continue to have pain 15 years after a whiplash injury.

5. Most pain is generated from motion-joints called facets (Who hasn't heard me talk about these little beauties?).

6. Chronic whiplash causes abnormal psychological assessment by 3 months post-trauma!

If these findings from multiple studies aren't enough to scare you then you may need to take your pulse.  The long-term affect of whiplash trauma, which is undetected or ignored is devastating both physically and financially.

Why Do Kids Drive So Fast?

It has always been supposed that teens drive too fast, are irrational in their judgments behind the wheel, and have a higher number of accidents than do more seasoned drivers.  This type of talk might make for interesting conversation, but is it true?  The older that we get, the more we tend to think that they (younger drivers) might be more dangerous on the road than we were at that same age.  Teens, of course, deny that supposition and contend that they are being wrongly targeted.

Who is Right?

I do not necessarily think that all teens are poor drivers.  I have driven many miles over the years, while following a senior citizen with a flashing turn signal, but who has no intention on turning.  In Florida retirement communities I believe that they call that the 'eventual left'.  Just as dangerous is the middle aged driver who insists on applying make up, shaving, eating full bowls of cereal (with milk and spoon), and reading the paper or a novel. I have seen each of these on a fairly regular basis, but this month took the cake.  As I was driving to work I was nearly rear-ended 3 times by a middle-aged man who appeared to be smoking something other than a cigarette.  Rush-hour traffic was heavy, I couldn't get a plate, and I also couldn't get out of his way until my turn.  How irresponsible!  

For these reasons I can't blame all youths for poor driving habits, after all, look at the examples that we set for them.  I do have concerns, however, when looking at statistical research regarding young people's driving habits and the injuries or death that they do inflict on themselves.  Some of the trauma is from carelessness and inattention, while some injuries are purely derived from a lack of experience behind the wheel.

In a meta-analysis of research data from the Northeastern United States during the period 1998-2002, it was found that the number of crashes on slippery roads, and ratio comparison to crashes on dry roads, were the highest among the youngest drivers.¹

A greater number of crashes on slippery roads were found when comparing those aged 16 to 19 years of age within the following parameters:

1. Speed for conditions.

2. Time of day (5:00 to 9:00 am vs. 10:00 am to 2:00 pm).

3. Time of year (January vs. July).

4. Type of road (rural vs. urban roads ).

5. Age (16 to 17 years vs. 18 to 19 years). 

An interesting side note to this study was that as individuals got older, there was an increased risk for women being involved in a crash on a slippery road when compared to men.

If being a young driver on the road is dangerous, how about being too young on the road?

A 2006 Texas A&M research study evaluated the topic of underage driving ².  It was found that when children and teens under 16 years of age got behind the wheel, the results were devastating.  They evaluated 4170 underage accidents between 1995- 2000 and found that 65.5% resulted in serious injury or death.  The greatest factors for a crash were driving later in the day and at night, younger was worse, rural areas were worse than city, passengers in the vehicle increased risk and black youths had greater rates of crash injury than white youths.  These were a lot of accidents that objectively point to repeated problems.

Helping the young become better drivers is mandatory.  I treat many accident-related injuries and I can report that it is difficult and, usually, labor-intensive to regain health that is lost by a senseless accident.  States are beginning to recognize this and some are taking smart measures to protect younger drivers.

In 1997, the State of Georgia enacted the Teenage and Adult Drivers Responsibility Act (TADRA).³  This was described as ..."a comprehensive legislative package that attempted to reduce fatal crashes of teenaged drivers by introducing graduated driver's licensing, "zero tolerance" of underage impaired drivers, and automatic license revocation for speeding greater than 25 miles per hour over the posted limit and other dangerous driving behaviors."

Data accumulated on 317, 16-years old drivers who were involved in a fatal crash (57/100,00) for the 5 1/2 years prior to the study were compared to 230 drivers killed in the 5 1/2 year period (36/100,00) after the law was enacted.  The 11 year period was significant for trends and behaviors related to fatal crashes by teens.  The reduction in deaths of 16 year olds was significant when there was a real penalty for bad behavior and poor judgment behind the wheel, rather than just a veiled threat/

1. Marmor, M., Marmor, N.  2006. Slippery road conditions and fatal motor vehicle crashes in the northeastern United States, 1998-2002. Am J Public Health. May;96 (5):914-20.

2. Huber J Jr.,  Carozza S., Gorman D. 2006. Underage driving as an indicator of risky behavior in children and adolescents. J. Adolesc. Health. May;38 (5):612-6.

3. Rios, A., Wald, M., Nelson, S., Dark, K., Price, M., Kellermann, A. 2006. Impact of Georgia 's Teenage and Adult Driver Responsibility Act. Ann Emerg Med. Apr;47 (4):369.e1-7.

Eileen's Corner

"This is one of those dishes that I remember having often when I was young, but forgot about as I got older.  I couldn't remember exactly what was in the original recipe, so I had to call my mom!  This is simple to make and your family will love it!"

Tuna and Shoestring Salad

I think that you will make this 'old' summer classic your 'new' favorite.

Thanks Mom!

Enjoy!

Eileen

Headache Solutions

It is reported that headaches account for over 100 million lost work days each year.  Up to 78% of those headaches reported are 'tension-types of headaches. 

The International Headache Society has just released its latest edition and in that text, 94% of all Primary headaches are broken down into two groups:

• Tension-Stress Headaches ( 78%)

• Migraine Headaches (16%)

This means that the Medical community is recognizing and accepting that headaches are mostly structural in nature and related to the cervical spine most often.  Wow, what a difference 20 years makes.  I remember treating Medical Doctors after hours and they came in the back door, so as not to be seen by anyone!

Secondary headaches only make up about 6% of headaches and the are usually related to an underlying pathology or disease.  These are medical emergency conditions.

Recent research and reports continue to support Chiropractic's claim that the neck, jaw and skull all contribute to headaches.  It is getting harder and harder for nay-sayers of Chiropractic to be taken seriously and their bias becomes obvious.  If you want to find the bias, follow the money trail!

Some of the accepted structures on the neck and head that induce headaches are:

• The first three vertebra of your neck (multiple joints)

• Posterior neck muscles

• Upper back muscles

• Trapezius, Scalene and SCM muscles

• The discs of the upper neck

• The jaw joint (TM) by way of cranial nerve #5 and the cerebellum.

The Chiropractic adjustment continues to amaze the Medical profession.  It does not surprise me that they don't understand the neurology behind the adjustment because their expertise is in chemistry, rather than neuroanatomy.

If you or someone that you care about suffers with regular headaches, then chiropractic will likely help.  If you have to drag them them kicking and screaming to their first visit, that's okay!  A little noise never hurt anyone!!

The days of "Do you think chiropractic can help me?" have long been replaced by "I know what works!"  Education is the key to good health and I try to continually give that to, not only my patients, but to each of you who read my monthly ENewsletters.  Thank you for your continued support!

Fender Bender Buddies are Back!!!!

This was a great idea that I had about 15 years ago to help people after even a minor 'fender bender'.  I used it for several years and patients did find these useful.  Don't ask me why I stopped providing these in the clinic because I don't think that I could give you one good answer, other than, maybe... "We all have them now!"  Well, I'm sure that by now some people need new ones!

These are great little cards to fill out and keep in your glove box.  Each car that you own should have one in it!

People like to think that they know exactly what to do if they are involved in an accident, but the truth is that very few really know what information to gather. 

Preparing for the worst means that you are ready and secure should something happen to you, especially if you are unable to remember vital data at the time of a crash. 

"Who is my insurance agent? What is my policy number? Who is the other driver?  What information do I need from them?  Were there any Witnesses?  What did they see? How do I contact them? Who was the attending officer?  Who is my Doctor?...etc.

The Fender Bender Buddies are in the clinic and free to everyone.  If you or your friends do not yet have them.  Call or stop into the clinic and I will see that you get as many as you need.  Be ready and safe!

Have a Great Month!

Dr. Frisch