^{Dr. Glenn Frisch}

Welcome to February!  I hope that the New Year is finding each of you well on your way to what you desire for 2005.

This month's ENews is a varied lot!  I had no set agenda of topics that I wanted to cover so I decided that a potpourri was in order.  So, you won't find a 'theme' with this issue.

I do, however, touch on what I feel to be serious and significant material.  The first article is my thoughts on one of, if not the most important, emotional drive that we have, HOPE!  

Hope is a realization that is met and understood, but unlike George Bailey in 'It's a Wonderful Life', we don't get to peek into the future.  We must make the right choices today.  After reading this article, you may look at the world somewhat differently than before.

Following my personal interpretation of hope, I have included an updated article on Attention Deficit/Hyperactivity Disorder.  The Medical community continually strives to find answers with ADHD, but this article shows why this discovery is so hard.

The next topic is on Shin Splints.  I continually speak to patients about low back and leg pain being the result of an arch problem in the feet.  Anyone who has ever been a runner realizes how important the arches are to performance and how debilitating it is when your 'arches drop'.  Shin Splints, however, can happen to anyone, at any age.

This month, Eileen has provided a wonderful recipe for Cherry Cheesecake (Remember Valentine's Day!).  This was her mother's recipe. The love of your life will smile when this melts on his or her tongue!

Finally, I revisit the topic of mouth and jaw pain resulting from trauma to your neck and head.  TMJ or TMD pain and dysfunction is more involved than earlier thought.  The jaw is actually a part of central nervous system and brain function.

I talk daily, and yes sometimes I do preach, about how we are integrated beings and that your toes are your knees, and your knees are your hips and low back, etc...

This German research on TMJ/TMD was actually printed in a Dental Journal.  They are beginning to understand the mechanism of the imbalance, but they are unable to treat it because it is actually a chiropractic problem that relates to 'structure and function' and not to the mouth.

Chiropractic is based on neurology, rather than on bones.  The nervous system controls structure and function.  The treatment given at our office focuses on neurology and how it commands the healing process.

Those of you who are patients know that at this point, I could pretty much talk for hours, but it's time to let you read on........

Enjoy this issue of ENews

Dr. Frisch

HOPE

What is it that drives each of us to get out of bed in the morning, go to work each day, carry on relationships with others and even plan for the future?  The answer to each of these questions is the same....HOPE!  Hope is not about winning the lottery or pining after an attractive man or woman.  Hope is related to goals, but they are not the same.  Hope is much more involved than that.  

Hope is an internal instinctive realization that matures with age and brings 'meaning' to life.

Here is an example of hope:

A boy grows into manhood looking forward to going on to school and becoming a lawyer, marrying and having a family, but not necessarily in that order.  (These would be goals or aspirations, but not necessarily hope.)

Now, that young man did go on to complete law school and build a moderately successful law practice.  He also fell in love with an attractive career woman who professed similar life goals and desires as he did, including a family.  (These again are goals and achievements, but not hope.)

As their marriage flourished, a family soon followed.  Both parents were nurturing and attentive to the children and each other.  Their respective careers were productive and satisfying and provided a comfortable life for their family.

With time, the couple began to realize that what was important in life was not financial success, even though it was nice, but rather, the interpersonal relationship that they had with each other, their family members and those around them.  They realized that the reward of life was being able to be productive, share of themselves, and enjoy the self-satisfaction that accompanies it.  

This realization of life and the projection that it continue

..... is Hope!

This scenario, however, could have been different.  Let's suppose:

The young lawyer actually hated being a lawyer, but needed the money to pay student loans, and then a mortgage, braces, private school, etc. and he stayed trapped in an unsatisfying career, waiting for the day that he could somehow retire.  He hated going to work, but he felt that he had no choice.  

OR

The marriage may have been one of convenience for either or both, and their personal relationship may have been non-existent, with the exception of a couple of children to make it 'a real family'.  The home life became nothing, but chaos.

I could continue with many different, negative scenarios, but what is important to realize is that when someone feels trapped without a direction of productivity in one or more aspects of life, hope is at risk.  The most serious thing that someone can lose is hope.  You can lose a limb, or worse, but to lose hope is to become unproductive in a downward spiral of despair that may have dire consequences!

To lose hope in life results in a loss of focus of why you exist, and the satisfaction that comes from mature realizations.  To lose hope is akin to starvation, the end is apparent, only the timeline is variable.

The Remedy

Hope is not dependent on any one outside factor.  In times of turmoil some people turn to the church looking for answers, while others may turn to their family or friends.  Outside influences may give you comfort, encouragement and direction, but only you can realize hope!

This is a quick and simple exercise to aid in the realization of hope.  These are questions that you ask of yourself on a daily basis.

• Who ...... Who is doing what?

• What ..... What am I doing?

• When ....  When am I going to do it?

• Where .... Where will it occur?

• How ........ How will it happen?

• Why ........ Why am I doing this?

One method of achieving and maintaining hope is to question ourselves on a regular basis.  These questions will bring focus, clarity, and direction to daily life.  We may not like the answer, but at least the question has been examined and a realization met.  Change results from direct, personal examination, rather than following of the 'herd' mentality.  Hope is the result of a life realized.  Some people can lose hope and never realize what they missed.

Hope does not occur because a set of guidelines has been met, but rather, because a realization was allowed to come to fruition.

Attention Deficit Disorder

New Evidence

Attention Deficit/Hyperactivity Disorder (ADHD) took hold as a clinical entity in the 1970's and has gained momentum since that time.  The problem with a diagnosis of ADHD is that there are so many possible variables and contributing factors that it seems to come off as a 'catch all' term that may apply to anyone as long as the diagnostic coding is correct.  For a review of ADHD and the diagnostic problems, you may look back at the December 2003 issue of my ENews.  I wrote quite a lengthy piece on ADHD that is still relevant today!

Another long-term study was recently published that looked at the issue of how we TREAT  ADHD.  This study evaluated the success rates when comparing drug intervention alone, drug therapy with behavioral modifications and finally, drug therapy with behavioral modification, academic help and parental training.

The children were divided into three groups.  1/3 received Ritalin by itself, another 1/3 received Ritalin along with intensive guidance, parental education and academic assistance, while the final 1/3 received Ritalin plus play groups (attention controls).

About 80% of the children finished the testing and the outcomes were EQUAL for all three groups.  It didn't seem to matter what type of therapy was used in conjunction with Ritalin.  Ritalin seemed to be the key for success in all three groups.

After one year, all of the children were taken off the medication and given a placebo pill, and only put back on Ritalin if they seemed to slip in their stability.  For those who were placed back on the medication, the benefits seemed to last the full two years of the study.  The same number of children in all three groups were able to successfully remain off of their medication in the same time frame.

What this study really says is that medication does appear to help children with ADHD, but that educational attention, parental training and social behavioral skill training were of no benefit in the actual treatment of ADHD.  The continued concern is that medication doesn't work for everyone.  Additional studies will undoubtedly look for psychosocial and behavior measure to aid with drug treatment and possibly (hopefully) replace the use of medication completely.   

Shin Splints

Check Your Arches

"Pain in the front of your shin or in the calf that does not go away with rest deserves attention."

Shin splints is a painful condition that is often misunderstood.  Before I explain what it is, let me explain what it is not.

Shin Splints is Not:

• Muscle tearing away from the bone.

• Splintering of the bone.

• Wasting of the muscle.

• A muscle disease.

I have heard shin splints described in each of the above terms, but they are wrong.  Although shin splints may feel like a fracture or a tearing off of the muscle, it is accurately described as a Compartment Syndrome.

A Compartment Syndrome is exactly what it sounds like.  The sheath around each muscle forms a compartment that encases and supports the muscle.  When there is an injury or other stressor to the muscle or compartment around the muscle an inflammation may develop.

If the inflammation goes away with rest, it is a self-limiting problem and it is no big deal.  If the area is continually being irritated or stressed and it is unrelieved, a swelling/inflammation occurs within the sheath and it stretches the sheath, compressing the muscle, nerves and even the blood flow to the area.  At this point the problem becomes significant.  If the activity causing the problem is stopped, with time and rest, the pain and impairment will go away.  At least for a while.

One of the most common causes for Shin Splints is fallen arches.  There are three main arches (muscles) in your feet that if stressed to failure, will induce the condition known as Shin Splints.  That is why runners and jumpers are so commonly affected by this disorder.  Anti-inflammatories may benefit the individual, but unless the structural weight-bearing imbalance is corrected, the problem will return as soon as the activity is resumed.  It is pure 'structure and function'.

Supporting the arches with a taping may give relief until the arches rebuild.  It this helps, but does not totally relieve the problem, custom arch supports can be molded right here in the clinic.  They are leather and move with the foot unlike the plastic orthotics that do not! 

Just because you may need orthotics at one point in your life does not mean that you will need them for the rest of your life!  Supporting arches is done on a patient-by-patient basis because everyone is different!