Christie Marinelli

You might ask, what does this headline have to do with chiropractic?  It’s often said case management or patient care is much more than just what we do to our patients (such as in chiropractic, applying a spinal adjustment). The patient education portion of our care plan can frequently make or break a successful outcome in a case.  It is the goal of this Health Update to potentially save your life by empowering you with the knowledge needed when it’s time to purchase your next car.  This is about what specific automobile features contribute to crash survival - hence, saving lives!

Did you know the car you choose can improve the odds of crash survival by 400%? In the popular magazine Consumer Reports, they wrote, “Ultimately, safety is active and passive, balancing the ability to avoid an accident and to survive one.” Typically, the first thing we do as consumers when we consider safety in a particular car is to look at the crash-test results.  While this is important, we must first consider the size and weight so we compare crash-test results between cars in the same weight class since statistics show there are two times as many occupant deaths annually in small vs. large cars. Keeping size and weight in the foreground, when evaluating crash-test results, the front and rear end “crumple zone” of the car should be designed to absorb crash forces by buckling and bending in a serious collision. If you’ve ever watched race cars crash, you usually see car parts bend and break off as they bounce off the guard rail or other cars, sometimes to the point where all that is left is the cage surrounding the driver.  Amazingly, the race car driver often climbs out of the cage and walks away, seemingly unharmed.

The next important car feature to consider is a car with a structurally superior passenger compartment. Look for a high quality “restraint system” made up of 3 components: seat belts, airbags, and head restraints. These work together to keep us safe and in place during a crash while the outside of the car crumples, absorbing the energy of the crash.

So where do you look to get this information?  There are several resources available:

• The NHTSA (National Highway Traffic Safety Administration) tests front end impacts at 35 mph, and in 1997 added side impact tests at 38 mph. They also test for the rollover potential for SUVs and trucks and grade the results for each category from 1 to 5 stars representing the likelihood of suffering a life-threatening injury in a crash.
• Since 1995, the IIHS (Insurance Institute for Highway Safety) has used a method reviewed by Consumer Reports as being more realistic by crashing only half of the vehicle at similar speeds into fixed barriers, since most crashes are not direct, whole car strikes.
• Consumer Reports is a 3rd option. They integrate the data from both NHTSA and IIHS and gives us their “CR Safety Assessment,” and run 40 new cars each year through numerous individual tests.

Other important “accident avoiding” features often overlooked include: Tires - greatly impact braking and emergency handling so REPLACE them as needed; Braking-check for the distance required to stop the car at different speeds- the shorter, the better; Emergency Handling-data about accident avoidance and choosing a vehicle with electronic stability control (ESC), especially in SUVs is wise; Acceleration-the quicker a car can get to highway speeds, the better; Driver position and visibility-a good view of the surroundings, especially the “blind spots” is important.  We realize you have a choice in where you go for your health care needs and we truly appreciate your consideration in allowing us to help you.

Fibromyalgia (FM) is a chronic condition affecting multiple body systems is not limited to any one aspect of health. Because of this, there is no ONE diet that works the same for all FM patients. Since most dietary guidelines that address FM are based on general healthy eating principles utilized for many conditions such as hypoglycemia, diabetes, food allergies, headaches, digestive disorders, and fatigue, let’s review some of the most popular and successful dietary approaches that have been reported regarding FM.

Basic Guidelines:

• Carbohydrates: AVOID all refined carbs (white flour products). Eat whole grain bread, oatmeal, granola, nuts. Avoid artificial sweeteners and limit sugar intake to a max. of 40g/2000 calories. Eat roughly 14 grams / 1000 calories consumed of soluble dietary fiber such as apples, oats, and legumes vs. insoluble fiber such as bran. Your total carb intake from all sources should be between 30-55% of your total calories.
• Fats: AVOID saturated fats (these clog up circulation, lead to inflammation and pain). That means <10% of total calories consumed, so limit or eliminate foods such as cheese, beef, milk, oils, ice cream, cakes, cookies, mayonnaise, margarine, chips and chicken skin. Eat mono- and poly-unsaturated fats and include regular amounts of omega 3-fats. Eat < 300mg/day of cholesterol; Try to avoid ALL trans fats such as cakes, cookies, crackers, pies, bread, margarine, fried potatoes, chips, shortening. Take omega 3 fatty acids like alpha-linolenic acid (ALA) as these help make other omega 3 fats like EPA and DHA, and are very helpful for the brain. ALA is found in flaxseed, linseed oil, or cod liver oil. Limit total fat intake to 20-35% of calories consumed.
• Protein: Go easy on red meat as they are high in saturated fat. Instead, eat more fish and vegetable protein (legumes and soybeans are great). When eating meat or poultry, remove all visible fat and skin before eating. Maintain protein at 20-40% of total caloric intake. AVOID: processed meats, especially salt-cured, smoked or nitrate-cured.
• Fruits & Vegetables: Whole fruits are superior to juices. Include blackberries, strawberries, raspberries, kiwis, peaches, mango, cantaloupe melon and apples. Some FM sufferers cannot tolerate citrus fruits but if you can, fruits like oranges and grapefruits are great. Vegetables are crucial. Good choices include carrots, squash, sweet potato, spinach, kale, collard greens, broccoli, cabbage, and Brussels sprouts. These foods reduce the risk of developing chronic diseases (diabetes, heart disease, stroke and cancers).
• Dairy Products: Choose reduced or fat-free varieties of cow or soy milk. This also applies to yogurt and cheese.
• Healthy drinks: Drink 8 glasses of water a day or diluted fruit juices, or herbal teas. Drinking water helps flush out toxins. Avoid coffee, tea, and alcohol as these increase fatigue, increase muscle pain and interfere with normal sleeping patterns. Limit or eliminate alcohol.
• Healthy Snacks: Chopped vegetables, unsalted nuts and/or seeds; AVOID ALL commercial snack foods (except salt-free air-popped popcorn) as these are high in trans fats & salt. Avoid chocolate and candy.
• Junk Food: Regular consumption of this is BAD for FM patients due to the high levels of fat, sodium, calories and general lack of nutrition.
• Artificial Sweeteners: AVOID them! Examples: aspartame, NutraSweet, & saccharine.
• MSG: (monosodium glutamate (MSG) and Sodium (Salt) can aggravate FM!
•  QUANTITY: Eat smaller light meals, especially in the evenings.

We recognize the importance of including chiropractic in your treatment planning and realize you have a choice of providers. If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

            “Doc, I try to do my exercises but I have to hit the ground running in the morning….to get the kids ready for the school bus….I have morning meetings….I’m not a morning person….I’m pulled in 100 directions during the day….I forget about them until I’m in bed….I exercise on my job and that’s enough….”

            I’m sure we’ve all rationalized our inability to keep up with exercises, especially after our episode of low back pain (LBP) subsides. In fact, only about 4% of LBP patients continue doing their exercises after their pain subsides. That means 96% of us with chronic, recurring low back pain DO NOT exercise even though we know we should.  We feel bad, even guilty for not exercising.  So, what can we do to “trick” ourselves into being more compliant with our low back exercises?

            First, let’s accept the fact that most of us cannot consistently “fit in” exercise into our busy schedules.  With that said, the TIMING of when to do the exercise may be more important than even doing them at the same time every day. In other words, do a few exercises when you need them the most. For example, if you’re working at a computer for more than 1 hour, and you start to feel back pain from the prolonged sitting - especially if your work station set up is less than ideal - do one or two sitting exercises right at your work station, BEFORE your back pain gets any worse. If you wait too long, the exercises may not be of much benefit. Setting a timer next to your screen that beeps every hour is a good reminder to do one or two simple exercises and only takes a minute or two.  Many inexpensive digital watches can be set to beep on the hour/every hour or, you can set a “timer” to beep after 60 minutes as a “gentle” reminder.  Some cell phones also have a timer feature. Here are three sit down low back exercise options (try them all and decide which one(s) feel most productive/helpful):

• 1. “Crossed Knee Stretch”: Cross your legs; pull the crossed knee towards your opposite shoulder (feel the pull in your buttocks); arch your low back and at the same time, twist or rotate to the side of the crossed knee. Hold for 5-10 seconds and repeat up to 3 times. Repeat this on the opposite side.
• 2. “Sit Twists”: Reach across with your right hand and grasp your left leg at mid-thigh. Twist/rotate your back to the left and pull with your arm. Hold 5-10 seconds / repeat 3 times. Repeat this on the opposite side.
• 3. “Sit Floor Touches”: Bend over as if to touch the floor or tie a shoe. Hold 5-10 seconds.

            If you do the math, it would take a minute for #1 and #2, 30 seconds for #3 (total 2.5 min.).  If that’s too long, hold for 5 seconds.  If that’s too long, do 1 rep, not 3.  You get the idea…..MAKE IT WORK!  Modify the dose to fit your schedule or ability to stretch.  If you do this AT THE TIME you start to feel tight or sore, you can PREVENT a LBP episode!

            We realize you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.