HAPPY THANKSGIVING !

Thanksgiving is nearly here and that officially kicks off the Holiday Season.

The Holidays seem to bring out both the best and the worst in people.  Stress levels rise, and while some people thrive on the excitement, others fall in to varying states of irritability, loneliness, and even depression. 

This month's ENews will give you tools to deal with the stressors of the Holidays, leaving you more stress-free time to enjoy the company of family and friends.

Also in this issue, I will be discussing some recent drug-related issues and public concerns.

Finally, having recently attended the Fall Activator Methods^® Research Seminar, there is new and exciting news in treating injured people.

I hope that you have as much fun reading this issue as I did writing it!

Take Care and Enjoy the Holiday!

I Fell and I Can't Get Up!

That was the advertising campaign for a popular medical alert company just a few short years ago.  The advertisement featured the safety benefits of having this service to help you when you 'fell and couldn't get up', but what they failed to acknowledge was why the person fell in the first place!

It is not uncommon that elderly patients suffer with balance problems due to stroke, disease and even cerebellum shrinkage.  What is rarely talked about, however, is how often balance is affected by medication or the side-effect of medication.

Did you know that even the common aspirin that we buy over the counter has side-effects that effect balance?  That's right!  Most people associate taking too much aspirin with developing and ulcer and ringing in the ears, but there is much more.

Aspirin Side-Effects

If you experience any of the following side-effects, stop taking aspirin and call your doctor:

• An allergic reaction, such as difficulty breathing, closing of the throat, swelling of the lips, tongue, face; or hives

• Black, bloody, or tarry stools

• Nausea, vomiting, or abdominal pain

• Fever

• Blood in your urine

• Seizures

• Decreased hearing or ringing in the ears

• Dizziness, confusion, or hallucinations

Side-effects are the result of chemical reactions within your body because of the drug you ingested.  We live in such a drug-dependent society that it is sometimes easy to forget that all drugs, even the 'simple ones' we buy over the counter, can harm us.

If you are taking drugs for high blood pressure, diabetes, and other diseases you should consult your doctor or pharmacist before 'mixing' drugs.  Something as seemingly simple as giving a child with chicken pox an aspirin, means that you may induce a fatal condition called Reye's Syndrome. 

Be smart in taking medication:

1. Follow label directions.

2. Do not share medication.

3. If the medication is out-dated, throw it away.

4. Have medications monitored and check ups are mandatory!

Stress: How Can I Cope?

Stress is common to everyone. Our bodies are designed to feel stress and react to it. It keeps us alert and ready to avoid danger. It is not always possible to avoid or change events that may cause stress. We can feel trapped and unable to cope. When stress persists, the body begins to break down and illnesses can occur. The key to coping with stress is identifying stressors in your life and learning ways to direct and reduce stress.

What is stress?
Stress is your reaction to any change that requires you to adjust or respond. It's important to remember that you can learn to control stress, because stress comes from how you respond to stressful events.

What causes stress?
Stress can be caused by anything that requires you to adjust to a change in your environment. Your body reacts to these changes with physical, mental and emotional responses. We all have our own ways of coping with change, so the causes of stress can be different for each person. Common causes include:

• Death
• Crowds
• Heavy traffic
• Confrontations
• Marriage
• Pregnancy
• Deadlines
• Legal problems
• Job change
• Moving
• Accidents
• Divorce
• New job
• Retirement
• Money problems
• Illnesses

When you are not sure of the exact cause of your stress, it may be helpful for you to know the warning signs of stress. Once you can identify these signs, you can learn how your body responds to stress. Then you can take steps to reduce it.

What are the warning signs of stress?
Your body sends out physical, emotional and behavioral warning signs of stress.

Emotional Warning Signs

• Anxiety
• Sleep disruption
• Anger
• Inability to concentrate
• Unproductive worry
• Sadness
• Frequent mood swings

Physical Warning Signs

• Stooped posture
• Sweaty palms
• Chronic fatigue
• Weight gain or loss
• Physical symptoms that your doctor cannot attribute to another condition

Behavioral Warning Signs

• Over-reacting
• Acting on impulse
• Using alcohol or drugs
• Withdrawing from relationships
• Changing jobs often
• Feeling agitated most of the time

What can I do to reduce stress?
Keep a positive attitude.

• Accept that there are events that you cannot control.
• Be assertive instead of aggressive. "Assert" your feelings, opinions or beliefs instead of becoming angry, combative or passive.
• Learn to relax.
• Exercise regularly. Your body can fight stress better when it is fit.
• Eat well-balanced meals.
• Rest and sleep. Your body needs time to recover from stressful events.
• Don't rely on alcohol or drugs to reduce stress.

How can I learn to relax?
There are a number of exercises that you can do to relax. These exercises include breathing, muscle and mind relaxation; relaxation to music; and biofeedback. A few that you can try are listed below. First, be sure that you have:

1. A quiet location that is free of distractions.
2. A comfortable body position. Sit or recline on a chair or sofa.
3. A good state of mind. Try to block out worries and distracting thoughts.

RELAXATION EXERCISES
2-Minute Relaxation-Switch your thoughts to yourself and your breathing. Take a few deep breaths, exhaling slowly. Mentally scan your body. Notice areas that feel tense or cramped. Quickly loosen up these areas. Let go of as much tension as you can. Rotate your head in a smooth, circular motion once or twice. (Stop any movements that cause pain.) Roll your shoulders forward and backward several times. Let all of your muscles completely relax. Recall a pleasant thought for a few seconds. Take another deep breath and exhale slowly. You should feel more relaxed.

Mind Relaxation-Close your eyes. Breathe normally through your nose. As you exhale, silently say to yourself the word "one," a short word such as "peaceful" or a short phrase such as "I feel quiet" or "I'm safe". Continue for ten minutes. If your mind wanders, gently remind yourself to think about your breathing and your chosen word or phrase. Let your breathing become slow and steady.

Deep Breathing Relaxation-Imagine a spot just below your navel. Breath into that spot and fill your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon. With every long, slow breath out, you should feel more relaxed.

Where can I get help?
National Alliance for the Mentally Ill:
1 (800) 950-6264

National Mental Health Association:
1 (800) 969-6642

This information was gathered from the Cleveland Clinic. It was designed to be an aid to personal care and not a replacement for a Doctor/Patient Relationship.

***In addition to this material, you may want to go to the home page of MY WEB SITE and press the 'Relax for Free' button.  'The 5-Minute Relaxation Program'^™ will likely be of benefit to you!

IT'S FREE!

VIOXX

"What's the big Deal"

For those of you who may not have heard.  Vioxx, an anti-inflammatory and analgesic drug, was removed from the market on September 30, 2004.

It was taken off of the active market because it was found that a great number of people were having cardiac problems if they were on the drug for an extended time period.  

The most recent research was determining the effectiveness of Vioxx in the treatment of colorectal polyps.  It was determined that people taking Vioxx had a higher incident of heart attacks and strokes than did a placebo control group.

This was not reported in earlier research by Merck, but a March 2000 study by VIGOR (Vioxx Gastrointestinal Outcomes Research) did find a higher incidence of cardiovascular problems with Vioxx when compared to Naproxen.

The findings were only reported if a subject had been taking Vioxx for a period of longer than 18 months.  Less than 18 months has not been reported as having a correlation to heart disease or vascular incident.

The ink is barely dry on the report and the attorneys are already licking their chops!  The law firms seeking clients to represent actually comes up before the Merck website when investigating Vioxx online.

I personally feel that Vioxx is an effective short-term therapy for both acute and chronic types of pain.  Many patients have derived great benefit from using Vioxx.  

I would hope that they don't scrap the drug completely, but rather, investigate if there is a threshold of use that is safe vs. dangerous.  Even cortisone used extensively can erode a joint.  

If you have been on Vioxx for longer than 18 months and you do have concerns for your health, I would recommend that you schedule and appointment with your primary care doctor for a cardiac evaluation.  If you have taken Vioxx regularly for less than 18 months, there is little evidence for concern at this time.

If your HMO does not want to perform this service, you may have to seek out a cardiologist on your own. 

This topic will be a hot potato for quite some.   

Women Suffer More

It has long been known that in automobile accidents, women seem to have more symptoms of pain after the accident, complaints of pain for longer durations than men, and actually suffer more injuries than men in the same crashes.

This was initially attributable, by men, to the fact that women suffered with hysteria, and that they were emotionally unstable than men, hence the term 'the weaker sex'.  This is only partially true.  It has been determined that women are physically weaker than men, but not for the reasons some want to believe.

Earlier studies have reported that women were more commonly injured than men in the same accident as a result of faster head acceleration during a crash.  Men and women actually had differences in head motion during an accident!

A new study by Stemper¹, found that in addition to the earlier findings of head motion, there are physical reasons why women are more often injured than men.

The above picture reveals the joint capsules of the cervical spine (neck) that sit directly behind the body of the vertebra.  These small, angular joints allow motion and maintain stability of the neck.  The little joints also protect the discal cushions between the vertebrae.  Trauma to the small joints (facets) is what most often happens in a ‘whiplash-type’ crash and the resulting instability and pain can be quite severe and debilitating after a crash.

  This interesting study found that:

1. Hormonal differences may be a culprit in long-standing pain and instability.  Estrogen affects the strength of ligaments and can make women more susceptible to injury and allow for a slower recovery.  
2. Women have a different distribution and a smaller amount of cartilage in the facet joints.  This structural ‘problem’ is a key component between men and women and the extent to which one is injured, while the other only experiences soreness.

1. Stemper BD, Yoganandan N, Pintar FA. Gender- and region-dependent local facet joint kinematics in rear impact. Spine, 2004;29(16):1764-1771.

Note:  A simple way to lessen any damage sustained during a crash is to make sure that the top of your headrest is level with the top of your head!  It stops your head and neck from ‘ramping’ up and over the headrest during impact.   GF

Interesting, isn't it?

    * Permission to use these links was granted by RxList.com

Eileen's Corner

Pumpkin Pie

This is my mother's pumpkin pie recipe. I think you will enjoy this classic dessert!

Heave a nice Holiday,

Eileen

Pumpkin Lady

Many of you couldn't believe that the carved pumpkin in our clinic was real, but IT WAS!! 

It was carved by Kathy Goodman.  She does a beautiful job and each pumpkin is unique.

If you are interested in having her carve one for you, she can be reached at 763-658-7585.  

She was recently featured live on KARE 11 and at the St. Paul 'Boo Fest'.  

Congratulations Kathy!

What I Did on My Summer Vacation

(Boy, does that line bring back school memories!) 

I thought that since I finally did take a week's vacation this year, I would share some of my pictures with you.  Eileen and I went to San Francisco for the first time and it is quite a place!  It took a couple of days to adapt, however, because the people and the culture are different enough that you feel like you might be in a different country.  

If you have never been there, however, I highly recommend going!  It was a lot of fun.  Enjoy the pictures.

This is a beautiful California Blue Jay.  It was neon blue in the dark forest.

This was a neat Cyprus tree at Pebble Beach that grew out of the rocks.

The redwood trees at Muir Woods outside of San Fran are incredible.  You can build 6 homes from the wood of one tree!

I had to dramatically lighten this picture so that you could see what I saw.  Standing 20 feet from me was a 'black buck' (look under the branch).  The deer was completely black, including the horns.  This made it hard to see in the dark, dense forest.  If you are able to blow this picture up, it is quite a sight.  He kept looking back at me, but he didn't think that I saw him!  Silly deer, he thought he could sneak by a 'farm kid'.

Have a Great Month!

Dr. Frisch