This year it doesn't quite seem like June.  The weather here in Minnesota has been unseasonably cool and wet.  It's great weather for duck hunting, but yard work and leisure activities do become a challenge!  Those of you who are local, hang in there, it will get better.

I was reading recently that chiropractic, as a health care profession, was one of the most emotionally satisfying professions for both the person providing the care and the person receiving the care.  I'm not sure if the person writing that article was a new chiropractic patient or someone educated in self-care, but I'll bet that the author hasn't read the first article in this newsletter.  This is more commonly what happens in delivering chiropractic care.

The second article is a nice comeback to the depressive first article.  There are good things happening in the chiropractic profession and diligent doctors who sacrifice much to bring it to you!  Dr. Rondberg is one of those people.

The Nocebo Response is a topic that I bet few of you have even heard of, but it is fascinating.

Eileen's 'Creamy Crab and Artichoke Dip' follows and it is equally fascinating.  This is one that I could eat every week.  It's that good!

I end this newsletter with a short discussion on herbs.  The herb market continues to grow, but the adverse reactions to herbs is largely ignored.  I hope that this article shines a bright light on the dangers of improper herb use.

Enjoy this issue of ENews!

Blue Cross calls Chiropractic for Kids 'Experimental'

Just when you think that you have heard it all, someone surprises you!  You usually expect it from someone who is selfish, devious, or dishonest, but when an established corporation like Blue Cross tries to dishonestly 'pull a fast one', it is quite disturbing.  Before I go into the particulars of why this is a foolish attempt to raise money, I will first give you a brief background of this story.

A number of Chiropractors in Maryland received notification from CareFirst Blue Cross/Blue Shield denying benefits for children under 12 years of age that they had treated for varying complaints.  The insurance company letter stated that...."the CareFirst Medical Policy Committee considers spinal manipulation services to treat children 12 years and younger, for any condition, to be experimental/investigational."  This decision included treating non-musculoskeletal disorders like asthma, GI disturbances, colic, bedwetting, etc.

I can't remember how many childhood instances of bedwetting, colic, and asthma that I have successfully treated in the past 20 years, but I can assure you that the parents of these children believe chiropractic to be God sent.  Watching a child suffer is much more difficult than watching an adult suffer.  The reason is that an adult likely contributed to their own demise, while children rarely do!  When a child's condition responds rapidly and completely with chiropractic care, it can seem amazing, especially if the parents were told that the child would have to live with it or wait to 'grow out of it'.

Insurance companies do know what they are doing, but unfortunately, the general population doesn't seems to grasp it.  Insurance companies are not into health care, home or auto coverage, they are into MONEY!  We give an insurance company our hard earned money for a promise.  They promise, by contract, that they will offer a specific amount of monetary coverage if we need it at some time in the future.  We often fail to recognize the fact that the insurance company will delete coverage, at will, if it provides them more profits and doesn't make us mad enough to drop the policy.  

That is precisely what has happened in this instance.  Blue Cross/Blue Shield knows that a parent is not likely to drop coverage if a child under 12 is denied chiropractic care , as long as the parent's coverage remains in tact AND if the child will be allowed to receive care at some time in the future.  This then seems more palatable to the parent and they don't seem to mind being nickel-and-dimed on their policy.  I say this because I rather doubt that the cost of the insurance was reduced when the child's coverage was removed.  This means that Blue Cross just gave themselves a raise!!!!

Department of Defense Names a Chiropractor!!!

This article is in stark contrast to the antics of Blue Cross/Blue Shield.  While the insurance industry continues to use the chiropractic profession as a whipping boy, the Federal government is beginning to wake up.

For decades the chiropractic profession has been held in 'no esteem' when it comes to military matters.  Chiropractors, licensed doctors of physical medicine, were not afforded the same rank or privileges as other doctors when trying to join the military.  We would not even be allowed to practice chiropractic in the military.  A military Dentist practices dentistry while enlisted, a Medical Doctor practices medicine while enlisted, but a Chiropractor would be forced to perform any duty other than chiropractic!  I know that this sounds ludicrous, but no one other than a Chiropractor seemed to care, so nothing changed.

Dr. Terry Rondberg, the president of the World Chiropractic Alliance has finally made an inroad with the United States Military.  Dr. Rondberg has often been maligned by the 'real association' (American Chiropractic Association), as a renegade, who is out to do harm to the profession, but nothing could be further from the truth.

Dr. Rondberg was recently invited to serve on the Department of Defense Chiropractic Advisory Committee, which will help to establish protocol for making chiropractic services available for active military personnel.  It is about time!!!

Dr. Rondberg's main concern at this time is that a medical gatekeeper is not implemented to restrict the availability of chiropractic care.  That is exactly what happened with the Veterans Affairs Health System (VA).  After many years of trying to provide care to Veterans and failing, it appeared that legislation was going to be enacted to allow Chiropractors to not only treat Veterans, but to also be allowed to work in Veterans Hospitals.  This fell apart when the advisory committee, made up of MD's and Chiropractors of the 'real association', decided to place a gatekeeper on care.  The chiropractors did not have the foresight to think that a prejudice would exist, but it did!  Now Veteran's can only use chiropractic services if a 'gatekeeper' Medical Doctor thinks that it is okay to do so.  What do you think happens?  That's right.  Nothing has changed and Veterans still can't receive chiropractic care!

Dr. Rondberg does have the intestinal fortitude to see this through.  I just hope that the chiropractic profession has the integrity to support him!  Congratulations to Dr. Rondberg on this important appointment.  The coming months may be very exciting and beneficial to our men and women in the armed services!

The Nocebo Response

Most people have heard of a placebo effect, but few health professional have even heard of the nocebo effect.  It, however, is just as real.

The placebo effect literally means "I will please".  A placebo effect occurs when a sugar pill or other inert substance (or situation) is used to deceive an individual into believing that a pleasurable result will occur by ingesting the pill or accepting the situation.  

For example, if an individual believes that a sugar pill is a sedative, they will begin to experience sedative effects after taking the pill.  It is a physiological occurrence that is real.  The placebo effect will usually not work for long periods, but in a short course of therapy, the placebo effect can be quite beneficial.

The nocebo effect, however, is quite different than the placebo effect.  The nocebo effect means "I will harm".  The nocebo effect is also a real physical phenomenon that occurs outside of an individual's conscious awareness.  A nocebo effect is a negative response that results in dizziness, nausea, headaches, pain, and even difficulty holding concentration.

The nocebo effect has been shown to occur in many experiments:

• Volunteers were told that they would be receiving small electrical shocks to their heads.  The participants did not receive the electrical impulses, even though they thought that they had.  At the end of the experiment 2/3's of the people reported headaches as a result of the electricity.

• Patients with asthma were divided into test groups and one group was given a bronchoconstrictor (which should make asthma worse) and told that it was a bronchodialator.  This placebo effect reduced the asthma symptoms by nearly 50%.  Next, a bronchodialator was given to the second group and they were told that it was a bronchoconstrictor.  The results showed a 50% drop in the real effectiveness of the drug!  This is the nocebo response.

• There have even been studies performed that measured the amount of a muscle relaxant present in the bloodstream after ingestion.  If the person believed that the muscle relaxant was actually a stimulant, there was less actual muscle relaxant absorbed into the bloodstream than if they did believe that it was a relaxant.  This also shows that both the placebo effect and the nocebo effect are real entities that must be acknowledged.

These studies show that it can be interesting as well as challenging when treating a patient for ANY condition.  A patient's physical response to care may be, at least temporarily, effected by their own thoughts, beliefs and behavior.

Eileen's Corner

See you in July!

Eileen

Herbs For Cures?

It never ceases to amaze me how so many people can be so easily duped.  Television may contribute to this by continually bombarding us with the 'new drug of the week' or the 'magic weight loss pills, tonics and shakes', but we as viewers are guilty of allowing ourselves to fall into the trap.  Maybe it is just human nature to want to believe in miracles to make our lives easier or maybe we are just getting too lazy to do things the right way.  One thing is for sure, if we don't critically evaluate what we are being told or sold, we will be taken advantage of, harmed, or worse!

I am surprised at how many people will pay good money to go to a doctor for advice and treatment, only to ignore that advice and treatment and "sorta, kinda, come up with their own treatment at home'" using tabloids, hearsay, and just plain bad advice.  That line of thinking, is what concerns me as people jump head-first into the ever-growing herbal drug market.  

Here is my first recommendation regarding herbs.  "Herbs are drugs; give them respect!"

I seem to be putting out more fires lately with patients who are taking the wrong herbs and improper combinations of drugs and herbs, than I do recommending appropriate herbs.  This is concerning because herbs can do physical harm to your body and even result in death.  If you are going to take herbs you need to LEARN ABOUT THEM!  That means you need to, at the very least, purchase a PDR of herbal medicine.  This can be purchased at most large booksellers like Barnes and Noble.  You would also be wise to take a course on herbal medication at your local college or university.  Herbs should not be played with just for the fun of it.  The consequences may be life altering.

A common advertising theme for selling herbs is to state that they are 'natural and safe'.  What that means is that the herb grows in the wild and may not kill you at low doses, but it does not meant that it is harmless.

Here are some of the side effects and simple drug interactions with common herbs that are generally regarded as safe.

• Feverfew - This plant is used for migraines, arthritis, rheumatic diseases, and allergies.  The problem with this herb is that it slows down platelet clotting and slows histamine release.  This means that it works on the vascular system.  Those people taking aspirin, warfarin and any other 'blood thinners' must be careful not to impair their ability to clot blood.

• Aloe - This commonly used plant derivative is found in many hand lotions, shampoos, and topical ointments.  It is commonly used as an anti-inflammatory and soothing agent.  It is also used a laxative.  Aloe Vera is now such a part of society that few people realize that its usage can actually increase intestinal problems, as well as lead to an electrolyte imbalance of potassium.  

• Valerian - Valerian is commonly used for sleeplessness, agitation, and mental strain.  It is also commonly used for headaches, cardiopathy and menstrual complaints.  In low dosages there may be some benefits, but long-term use of this herbs leads to headaches, sleeplessness, dehydration and cardiac problems.  

These are just a few of the hundreds of herbs available on the market today.  I do like herbal therapy, but before beginning any herbal treatments on your own, please do consult with someone who is knowledgeable on herbs and who can investigate the safety of that form of treatment on an individual basis.  Call me if you have questions!

Have a Great Month!

Dr. Frisch