The importance of using common language when communicating about back pain has been well documented in the medical literature. There are three main areas that lead to difficulties in communication about back pain:

• patients seeking information from health care professionals can experience difficulties understanding them and the medical literature
• misunderstandings among health professionals concerning terminology can arise
• lack of standardized definitions for back pain terms can make comparison of research studies problematic

A study just published in the BMC Musculoskeletal Disorders aimed to explore the meanings and issues surrounding the use of existing medical terms for back pain from the perspective of health care professionals and lay people. Focus groups were used to explore participants’ understanding and samples included general practitioners, chiropractors, osteopaths, physiotherapists, and lay people.

Lay participants understood the majority of the terms explored in the group differently than the health professionals. Some terms were not understood, some misconstrued and some had inadvertent negative connotations or implications. (For example “wear and tear” instead of the harsher term “degeneration” gave implications of wearing away or rotting).   The commonness of misunderstandings, unintended meanings and negative emotional responses to terms used in this study have a number of implications.

Firstly, it must encourage providers to ensure their patients understand what has been explained to them including the contextual and emotional implications. Secondly, patients and providers should have an ongoing dialogue to promote understanding of terms and comminality of language.  Third, this study should be used as a lesson to chiropractors who cling to old, antiquated terminology that we know has differing meanings both intra- and interprofessionally. If other chiropractors cannot agree on a term’s meaning, and other professions cannot agree on that term’s meaning, you can sure as heck bet that your patients have no idea what you are taking about either.

I was recently told that we should take antiquated terms and reframe them so we can continue using them in a different context. To me, this study implies that is not a wise course of action.

Brett L. Kinsler, DC is a chiropractor in Rochester, NY who avoids using antiquated terms when he blogs at www.RochesterChiro.wordpress.com

The sky is falling!  The sky is falling!

Wait, what?

Oh, sorry. 

The sky is rising! The sky is rising!

Wait, sorry.  What now?

Oh, okay. 

The autism rates are rising!  The autism rates are rising!

Alright kids, let’s go over this again.  Autism rates, really the autism spectrum disorder (ASD) rates, are on the increase.  You’ve heard the new 1 in 100 number quoted, right?  I’m not saying that’s inaccurate.  It’s just that there is no real increase represented.  How can that be? Clearly something (or someone) must be to blame for this terrible condition.  Who can we hang?  Quick, after them!

There were two recent studies concerning the prevalence of autism in the US that have attracted a lot of attention.  One study conducted by the CDC (not yet published) reports that the new prevalence of autism spectrum disorder (ASD) is now estimated at 1% or 100 in 10,000 children. This is an increase over the last few years. In 2002 the prevalence was estimated to be 66 per 10,000 (0.66%).

The second study published in the journal Pediatrics was a telephone survey of parents where they asked if they had any children who had ever been diagnosed with an ASD.  This non-clinician scored study estimated ASD point-prevalence at 110 per 10,000.  These are slightly higher numbers than the CDC data but that is to be expected, since diagnoses from the phone survey were not confirmed by a doctor.

There is no argument that the number of ASD diagnoses has been steadily increasing for the last 20 years. The real question is whether or not the increase is  a true increase in the disorder or an artifact of increased surveillance and an expanded diagnosis.  Without a doubt, the evidence strongly supports the conclusion that the increasing autism prevalence is due to increased efforts to make the diagnosis and a broadening of the definition of autism. The evidence is not sufficient to conclude that there is not also a real increase in ASD incidence, but nor is there data to support this conclusion.

Recently, more data have come out of the National Health Service (UK) that looked at a very interesting statistic.  They looked a the prevalence of ASD in adults.  See, if there is a true rise in autism, the adult population should have a lower number of cases than the current children.  Guess what?  1% across the board.  Kids and grown-ups.  Oops.  Sorry conspiracy theorists, move it along…nothing to see here. 

What can be concluded is that 1% is likely close to the true prevalence of ASD in the population.  And, the strong evidence points to the lack of an increase ASD rates.  Let’s continue to use good science to get to the bottom of ASD and not sheer panic and anti-vaccination finger pointing.

Dr. Brett L. Kinsler is a chiropractor in Rochester, NY who blogs at www.RochesterChiro.wordpress.com

“Tell me, Doctor, what do you think of Quantum Light Weaving?” my patient recently asked me.

“What do I think of what now?”

“Quantum Light Weaving.”

“You’re putting me on, right?”  My patients know I will usually express my opinion on most things that are wacky and some of them try to get me to take their bait.

“No, it’s a real treatment.  I saw it when I was in California.”

“You’re setting me up for a blog post, right?”

“I have no idea what you’re talking about.  Have you heard of it?”

Well, to be honest, I hadn’t heard of it.  I was almost certain it was something made up and silly.  Light weaving?  Really, now?  I have a friend who was a pretty serious weaver for a while.  I was nearly certain she used wool and fabrics.  Very, very rarely would she weave pure energy or electrons.  Nope, something didn’t smell quite right.  I promised to investigate and get back to this sweet young patient with an opinion.

I performed my usual deep level of research which can be partly reproduced for you by clicking this link.  I learned some amazing facts — and by “amazing” I mean “silly” and by “facts” I also mean “silly.” Quantum Lightweaving is, according to the experts (“salespeople”) ”an evolving and ever-expanding body of work that is bringing forth new aspects of spiritual work that embodies The Christos energy from the heart of Creation itself. The vibration is brought forth to this earth and Galaxy through The Council of 14 and your personal healing and support team of masters and angels.”

Okidokie then.  We’re got ancient Christian and presumably Last Supper stuff mixed with galaxy energy and personal support teams of masters and angels.  Hell, I can’t even put together a team that includes a decent plumber, how am I going to get an angel on such short notice?

Have no fear!  Your personal guide is Kenji who teaches you “how to be a miracle man, miracle woman, miracle kid and miracle pet.”  Miracle pet, huh?  Whoa.  Deep, dude.  And for only $25 to $50 there is an assortment of attunements you can download right to your computer.  You can even use your mystical Paypal account!  Let the miracles begin!

Well it all makes sense when you learn that “when we align through the meditative state, or “hook-up,” miracles beyond time and space and distance can occur in the twinkling of an eye.”  Wait…hook-up?  Do they really use “hook-up” to describe a state of being?  How is your hook-upedness today?  I am attempting to achieve the 9th level of hookopcity. Can I hook up my angels to my masters?  Do I need a special adapter? Will that create a miracle pet?  Will my miracle pet still puke on the carpet?

“Lightweaving affects all 144,000 dimensions of your being, or the 12 major levels of your embodiment.”  Awesome.  Lately, I have only sensed like 120,000 dimensions but I thought it was just the weather.  I feel enlightened.  I feel empowered.  I have seen the quantum light show and now know the true answer.  Quantum Lightweaving is…just…another magical way to separate people from their money.

Don’t panic.  I may have done it.  Yes, your friendly chiroblogger may have accidently solved the national healthcare crisis.  I found an existing health insurance company that provides comprehensive health coverage for under $40 per month.  And this isn’t just some catastophic Roadrunner gets smushed by a falling safe and winds up in traction kind of coverage.  This is really good.  Really, really good.  Just look at these benefits:

Interesting.  These are pretty tangible preventative health benefits.  I may have solved the health insurance situation after all.  I mean, obviously the pet insurance companies won’t cover people.  But if the benefits of pet ownership are so great for health, I might just start instructing my uninsured patients to take two kittens and call me in the morning.  Problem solved.

Next?

Dr. Brett Kinsler is a chiropractor in Rochester, NY.  He is insured but his cat (favorite hobby = peeing in corners) has no coverage.

We are fairly insulated in Rochester from sleazy, totally unprofessional chiropractor advertisements.  They occasionally pop up like freaky little mushrooms and usually get stomped on rapidly.   Here’s one that appeared in a local fishwrapper this week.  Let’s have a little contest – how many unprofessional, insulting or just plain factually incorrect items appear in this ad?  Keep in mind the total ad has less than 100 words!

Sinusitis is an inflammation of the sinuses that occurs with a viral, bacterial, or fungal infection.  There can be pain and nasal congestion.  Acute sinusitis often follows a cold, but chronic sinusitis can last for extended periods and make people miserable.  More than 30 million Americans suffer from chronic sinusitis, meaning symptoms last longer than two months or regularly recur. Patients repeatedly try antibiotics, decongestants or steroid-containing nasal sprays, but about a quarter are thought to get inadequate relief.  Sometimes, surgery is the best option for chronic sufferers.  Standard surgery involves cutting away bone in the sinus cavity to open the passage way and allow drainage.

This week, a patient asked me about a procedure where they stick a balloon up a patient’s nose and inflate it in order to ‘move the skull bones’ and help with sinus problems.  I thanked him for the idea for a blog article and began to do my research on what I was sure would turn out to be some wacko in a clinic in California (why is it always California?) sticking things up people’s noses and declaring them “Sinus Free!”

Instead, I got educated on a new alternative to the standard sinus surgery.  Balloon Sinuplasty is compared to angioplasty — you know the procedure where a catheter is fed through an artery and plaques are squeezed to the sides with an inflatable balloon.  With the sinuplasty, the catheter is inserted into the sinus cavity and inflated to open the passageway and promote fluid drainage and pressure reduction.  Inflating the balloon aims to stretch the sinus opening back to its original size or little bigger, thus letting air (and antibiotics) into the sinus.

The research looks promising for this technology and it is most certainly not a novel means of cranial adjusting as I initially suspected.  Whew.  Patients who have the balloon catheter procedure appear to have significant improvement in symptoms two years after surgery.

The best part is that the research generally scores patient symptoms using my favorite clinical instrument:  the SNOT – 20 which I discussed in a previous post.

Dr. Kinsler is a chiropractor in Rochester, NY.

One of those people with a good sense of the absurd?  Here is something absurd that’s probably right in your kitchen.  Get out your favorite brand of cooking spray (found in almost all American homes) and check the serving size.  Chances are, it will be somewhere between 0.25 and 0.33 seconds.  That’s between 1/4 and 1/3 of a second.  The servings per container will be between 350 and 600. 

This is a perfect example of why we have such a problem with achieving health in this country.  No, not cooking spray.  Misleading information presented as fact.  Maybe somewhere, in some test kitchen, a trained professional can spray for only .25 seconds but everyone I know really wants to coat that pan with ‘non-fat’ cooking spray.  Problem is, used the way most people really do, it is not non-fat.  In fact, it is oil.  Pure fat. 

For comparison, a can of cooking spray is about 6 ounces. A stick and a half of butter is 6 ounces.  Imagine cutting that stick and a half of butter into 557 pieces.  Now, spread one on your toast.  Congratulations, you have just had ‘fat-free’ butter.

We have been led to believe that non-fat cooking spray is much healthier than oil.  So which is better?  Well, one comes in a spray can with propellants.  At least with the pure oil most people would try to be judicious. 

In fact, if you are using non stick pans, then the cooking spray is redundant.  If you are trying to cook with no fat, it would be preferable to cook  just with broth or water.  Yes, you really can sauté in just plain water.  I prefer broth or wine for flavor but water works just fine.  Plus, it’s free –no spray can needed.

Dr. Michalene Elliott is a chiropractor in Rochester who writes for RochesterChiro’s blog and has tried to spray for less than half a second but, sadly, cannot.

I like Wikipedia as a shortcut to quick information but I am afraid to use the information there for any serious projects.  After all, the people producing and editing the content there are just average Joes.  Sure, if you put together enough average Joes and solicit their opinions, you are more likely to come to an accurate conclusion…sometimes.  Not exactly a bet I’d want to place.

Wouldn’t it be cool to have a wikifor medical information where only verified medical professionals can directly edit the material?  There is so much medical misinformation on the internet it would be nice to have a source that is more apt to be responsibly written.

Medpedia looks like it might fit that description.  Still in beta phasebut set to fully launch soon, the Medpedia Project is backed by Harvard Medical School, Stanford School of Medicine, Berkeley School of Public Health, University of Michigan Medical School and other leading global health organizations. The goal is to create a new model of how the world will assemble, maintain, critique and access medical knowledge. Over time, they expect to have a collection of up-to-date unbiased medical information, contributed and maintained by health experts around the world, and freely available to anyone who is interested.

This week, I was contacted by a Medpedia staffer. They requested permission to put my blog posts onto the News & Analysis section on their site.  I am pleased and proud to be among the bloggersinvited to participate and welcome the new Medpedia readers and their comments.

Turns out meat is the new bread.  Thanks to a loyal blog reader for alerting me to this all-in-one vegan nightmare, cardiology freak show and only in America culinary death missle that virtually punches you directly in the organs.  KFC introduced in several test markets their “Double Down” sandwich.

This “sandwich” consists of two deep fried chicken fillets wrapped around bacon, cheese and some type of sauce.  The chicken is the bread.  You heard me — instead of  bread, they use two pieces of fried chicken.  Even Robert Atkins would push this away as being just a bit too meaty, dontcha think?

The name, “Double Down” (which won out over ”Double Bypass”), is linked to the chances of developing heart disease during that meal (easily doubled).  And, after signing the required medical release form KFC requires,  you can listen carefully and actually hear your own arteries hardening.

I wish I could make stuff like this up.  We are fortunate enough to live within a couple of miles from Wegmans, one of the best grocery stores in the world.  And since I have recently taken over most of the grocery shopping, I am there once or twice per week in between stops at the Farmer’s market. 

Wegmans has several checkout aisle options.  In addition to the 7  or 15 items or less aisles there’s a no-candy lane and, my favorite, the natural products checkout lane.  I just feel better surrounded by natural chocolate and dried fruitrather than the latest UPC encrusted craptacular chemical bombs of nutritionally void Satan food found in the regular checkouts.  Perhaps I am a tab bit biased. 

So this week, as I awaited the obligatorily double nose-ringed cashier to ring out my newly acquired bounty, I glanced at the conveyor belt full of items placed by the woman in line behind me.  Silly of me to think that just being in the natural products lane would attract some sort of healthier customer.  I’m sure it just happened to be the shortest lane.  The irony, however, was stellar.

Garbage product after garbage product from store brand mac and cheese (a dozen boxes)  to chips to Little Debbie snactacular chemical infusions.  Then soda, next hot dogs followed by bleached white bread.  I had to chuckle at the opposition of her items that seemed to outwardly offend the Amy’s and Newman’s and Natural Wonder’s around them.

And then I saw it.  Something that made my retinas burn.   All natural, 100% organic, hand made with no preservatives — dog biscuits.  Dog biscuits!  Yes, of course it’s nice to know this woman is treating her dog well.  Who cares what she eats as long as she isn’t mistreating an animal that cannot make it’s own decisions, right?  Did I mention she had a little girl in the shopping cart?