BOO!

Well, I don't have to tell you what this ENewletter's theme will be!

This was actually a fairly interesting ENewsletter to write because there are so many diverse topics that revolve around the Halloween Holiday.  There are ghost and goblin stories, witches, as well as America's history and the religious correlation to All Souls Day. Whatever your delight is with this Holiday, you have to admit that it is kind of weird!

There are some interesting injuries that occur at this time of year.  Who ever thought that egg throwing could result in significant or permanent trauma?  My first article reports on just that topic!

More noticeable at this time of year are food allergies and illness from improperly prepared food.  The Holiday Season is famous for doctor's visits for just this reason.  Some kids are allergic to different dyes in candy and they need to be careful.  Home-made candies and, especially perishable food, should be evaluated for safety.  Remember, if in doubt, don't eat it or share it with others.

Also common at this time of year are sports-related traumas.  Fall football is beginning to wrap up and activities like wrestling will be starting soon.  Injuries, unfortunately, can and often do carry-over from one sport to another, making the original injury much more difficult to treat when the student finally seeks care.  Athletic injuries are serious enough, but my 2nd article sheds new light on adolescent and young adult trauma.

How cells die is too cool to explain.  I won't ruin it for you.  You'll have to read it yourself!

Eileen brings us Sloppy Joes this month and I did taste test this recipe, in fact I have had this recipe many times.  I am sure you will make it over and over. (I think that Colby Jack or Dill Havarti cheeses accompany this recipe just fine!)

The final article discusses some of the new research findings regarding headaches and TMJ pain.  Chiropractic has always proved successful in treating headache and TMJ pain and the research continues to validate what every Chiropractic patient already knows...

Chiropractic Works!!!!

Have fun with this issue of ENews,

Dr. Frisch

Trick, Treat or Egg in Your Eye

Trick or Treating is a fairly new ritual of Halloween that didn't actually begin until the 1950's with the introduction of costumes.  Prior to that more ritualistic, pagan and religious protocols were in place. Little goblins and ghouls were eventually replace by movie actors and cartoon theme characters, whichever was more popular in society at the time.

Through the years not too much has changed.  Children dress up and are usually chaperoned by an adult to various houses in the neighborhood or nowadays, to a school or mall if safety is a concern.  Most kids (and adults too) seem to have a good time.  Behind Christmas, more money is spent on Halloween than any other Holiday.  This year it is projected to exceed $3.3 billion dollars.  That's right....billions!

Treats still consist of candy, popcorn balls and surprisingly more often...toys!  A study conducted at Yale University¹ found that children were just a likely to enjoy getting a toy while trick or treating than candy.  

In the study, 284 children from 3-14 were studied.  They designated 7 households to give all 'treaters' the choice between receiving candy and an equally sized toy.  The results did show that each child was equally happy with his or her choice and that they were just as likely to choose a toy over candy.  There was no differences between boys and girls in their choices.  I would, however, make sure that the toy doesn't break right away or you might have to deal with a 'tricker'.

A study published in the Emergency Medical Journal this month, stated that the public should be made aware of the dangers of 'egg throwing'², especially around Halloween.  Over a 14 month period from 2004, St. Paul's Eye Primary Care Department reported 13 ocular injuries as a result of unsuspecting people being hit in the face with an egg.  They did not say whether the eggs were raw (I suspect), hard boiled (maybe), or scrambled (doubtful).  All of the egg-throwing incidents, however, were performed by strangers.  The patients all sustained closed-eye trauma, which for some resulted in permanent losses of visual acuity.  

I'm not sure of the ages of those perpetrators, but all parents should be conscious of their older children's antics on Halloween, especially if they are unsupervised.  Tweens and teens don't always make the smartest decisions (We were all there once!), but incidents like these will result in significant lawsuits and erosion of the college fund!!!

If your child does forgo the toy and opt for the candy or food there are a few simple things to consider.  First, some kids have food allergies and will react to certain candies, especially home-made cinnamon candy.  Cinnamon flavoring agents are known to cause a corrosive inflammation in the mouth and gums with many people³.  Cinnamon-flavored toothpaste and gum can be just as reactive as candy for those unlucky people who are reactive.  In the erosive process, skin can slough from inside the mouth and also cause a painful gingivitis.

Second, popcorn balls may contain Salmonella⁴.  There are many studies that have investigated the safety of cooked popcorn.  The Salmonella cells are tough little things and they can survive both conventional popping methods as well as microwave cooking.  I know that popcorn balls are a popular treat on Halloween, but if I had to make one recommendation, I would stress eating only commercial, store-bought, popcorn balls.  The manufacturer would have to follow a more stringent cooking process than the home baker and there would be less chance of contamination and illness.

Well, that's enough of the yucky stuff for now...let's move on!

1. Schwartz, M., Chen, E., Brownell, K., 2003. Trick or treat, or toy: children are just as likely to choose toys as candy on halloween. J Nutr Educ Behav. Jul-Aug; 35(4): 207-9.

2. Stewart, R., Durnian, J., Briggs, M. 2006. "Here's egg in your eye": a prospective study of blunt ocular trauma resulting from thrown eggs. Emergency Medical Journal. Oct; 23(10): 756-8.

3. Endo, H., Rees, T. 2006. Clinical features of cinnamon-induced contact stomatitis. Compend Contin Educ Dent. Jul; 27(7): 403-9.

4. Anaya, I., Aguirrezabal, A., Ventura, M., Comellas, L., Agut, M. 2006. Survivability of salmonella cells in popcorn after microwave oven and conventional cooking. Microbiol Res. Jun 20.

Fall Sports Injuries

Sports are generally acknowledged to be beneficial in raising student's grades, increasing social interaction and building self-confidence that can last a lifetime.  One thing that is often overlooked, however, is that injuries sustained during school sporting events may also last a lifetime.

The number of kids participating in sports has increased dramatically over the years.  In 1971-1972 is was estimated that there were 4 million students involved in organized sports throughout America¹  That number had risen to 7.2 million students during the 2005-2006 school year.  It not only means that more kids are participating in sports, but it also means that nearly double the number of kids are at risks for a sports-related injury.

High school athletes suffer about 2 million injuries a year and over 500,000 of those injuries require a visit to a doctor.  There are also about 30,000 students hospitalized each year because of sports-related trauma.  These findings are significant and mean that predictable outcome protocols may be required, in the future, to determining if and when a student athlete may return to competition.

A classic example is shoulder trauma and dislocation.  A study published in September of 2006 investigated the recovery outcomes of traumatic shoulder dislocation in athletes².  In the group of 29 athletes studied, it was found that while 65% of the athletes could return to the same sport at a 90% + recovery rate, 17.2% suffer with continued shoulder instability after surgery, and 5 of the athletes had more dislocation, even after surgery.  

I think that the most important thing to note with this study is that even with surgery, recovery is never truly 'complete' and with young people this is concerning.  They have a long time to live with a damaged body.  Should they be allowed to return to a sport if they are at greater risk for added trauma....even if they want to!  

How about the 17% of athletes that may return to the same sport, even though they have an unstable shoulder. Is that a wise decision and who should make that choice?  Please, don't leave it up to the athlete because you know what he or she will opt for.

I think that it may be wise to set limits on the degree of trauma that a student athlete may sustain and still be allowed to compete.  The guides should be fair, but also realistic.  This might sound harsh to some, especially a few 'driven' parents, but I can tell you from experience that post-surgical shoulder pain will occur.  In fact, the arthritis that accompanies shoulder dislocation surgery nearly insures that by the time that student athlete turns 40, he or she will not need an alarm clock to wake up in the morning! The pain will see to that.

1. CDC, 2006. Sports-related injuries among high school athletes-United States, 2005-2006 school year. MMWR Morb Mortal Wkly Rep. Sept 29; 55(38): 1037-40.

2. Cho, N., Hwang, J., Rhee, Y. 2006. Arthroscopic stabilization in anterior shoulder instability: collision athletes versus noncollision athletes. Athroscopy. Sept; 22(9): 947-53.

How Cells Die

(It is Halloween, isn't it?)

This is a somewhat morbid topic, but also a fascinating one, if you approach it from the right prospective.

Cell death happens within each one of us, each and every day.  That is how cells regenerate, grow and multiply.  If there was never cell death in our bodies we would not live very long.  The existing cells would get old and that would be it! 

"Wow I see that the Alpha-1 organism made it to three weeks old...What an accomplishment."

In order for new cells to be stimulated to grow, old cells must be in the process of expiring and then die.  Sometimes this death process happens quietly and the body doesn't seem to even notice and other times there are inflammatory reactions, like allergies, that can make us quite ill.

Our bodies are quite remarkable on the cellular level.  There are cells within each of us that not only know what function they are to perform, but also when to stop doing that job and implement a 'programmed cell death'¹.  That's right, the cells are pre-programmed when to die!  How cool is that?

A classical case of tissue cell death would be that of necrosis. The cells may have been damaged by trauma, burns or bacteria (Think 'flesh-eating bacteria.) and the cell walls can't contain membrane components.  The spill-over starts an inflammatory reaction and the cellular necrotic (death) process speeds on its merry way.  This type of process speeds up a disease process or pathology.  This is the 'bad' type of tissue death.

Cells that are programmed to die at a specific point in time are actually beneficial to the body.  Whether the cellular death is coded into our DNA or by some other neurological/biological process, it seems to pass under the brain's response system.  When a cell expires this way, small little 'Pac-men' called phagocytes come in and devour the cell debris, making room for new cell development.  Cells that use a programmed-death sequence actually aid in preventing a disease process from starting!  It is the body's way of taking out the trash!

I am continually amazed at how little control we truly have over body processes.  We can intervene with trauma or disease, but the body is perfectly able to take care of itself on a day-to-day basis without our outside help.

1. Fietta, P., 2006. Many ways to die: passive and active cell death styles. Riv Biol. Jan-Apr; 99(1): 69-83. 

Eileen's Corner

"If your little goblins need something fast, warm and satisfying before trick or treating, this is a perfect dish."

Enjoy!

Eileen

Headache and Jaw Research

The National Headache Foundation reported last year that 45 million Americans suffer with chronic headache pain.  There are over 150 different types of headache diagnosis.  This makes diagnosing and treating a headache accurately very difficult.  On any given day, 2.5% of the American population does have a migraine and 10% of the population has a tension headache.  Those numbers are consistent EVERY DAY!

Most people like to think that the headaches they experience are Migraine-Type headaches, but the fact is that 78% of all headaches are Tension-Type headaches, while only 16% of headaches are true Migraine-Type headaches.  Headaches, as a whole, account for over $4 Billion dollars in annual revenue to the pharmaceutical companies for over-the-counter medication.  Let's face it, that is a lot of money being spent for a symptom!  WOW!

The process of all headaches is similar and not that involved, really.  A trigger (emotional, physical, dietary, social, etc.) stimulates neurochemicals that fire the trigeminal nerve (face) and upper neck nerves, which then fire the blood vessels of the face, upper neck and head.  The blood vessels become swollen and sensitive (inflamed) and they dilate.  This causes a subsequent irritation to local nerves, which then tell the brain to fire the sequence again.  This is a loop-headache and it is frequently found with most headache patterns.  The longer that the headache persists, however, the autonomic nervous system kicks in and the person also gets nauseated, sweaty, dizzy, etc.  There are many added variations of this process, but for the most part, this is the most common sequence of headache development.

Chiropractic care has shown steady and predictable results in treating headaches and jaw pain.  When compared to drugs like Amitriptyline, chiropractic care is actually far superior.   Studies have found that drug therapy has benefits for a headache in the acute state, but once the individual stops taking the drugs, the headaches return.  Study subjects who use chiropractic care continue to receive relief of their headaches, even when the chiropractic care is stopped.  This means that the benefits of using chiropractic care for headaches extends beyond the actual care period.  How many drugs can make that claim?

We live in a drug society.  "I have heart burn" (Take a pill), "I can't sleep" (Take a pill), "I'm too wired"" (Take a pill), "I get headaches" (Take a pill), "I can't get motivated" (Take a pill).  I could go on and on (That's a different pill too!).

Headaches are a neurochemical problem that changes vascular flow via the nervous system.  78% of all headaches are structural in nature affecting the nerves, which run the blood vessels. It's that simple!  Headaches do not happen because you are deficient in Tylenol or Advil.  There is no Recommended Daily Allowance (RDA) for Motrin or Amitriptyline.  America needs to wake up and realize,

"If you have a headache...You need a Chiropractor!"

Enjoy the Halloween Holiday and be safe,

Dr. Frisch