Milk is Not a Freaking Vegetable

Vegetarian eggs

Vegetarian eggs

I don’t care what you eat.  I really don’t.  If you’re one of those people who is on the doughnut and bacon double cheeseburger plan to ensure an early path to heart disease, that’s fine with me.  It’s a choice you are allowed to make and I honor that.  Seriously.

I also couldn’t care less about your freaking shoes.  Leather?  Plastic? Paper?  Whatever.  Okay, so I did join a Facebook group called “I don’t care how comfortable they are, you look like a dumbass in Crocs” but it’s really not a big deal to me.  It’s not like I started the group — I just thought it was funny.  So, I’m certainly not going to get all uppity about killing a cow for footwear.  In fact, I got some pretty harsh looks from that pale chick who works in the health food grocery the other day.   I kind of went in to shop wearing my black leather jacket and leather shoes.  She scowled at me like the cow was still attached and I was dragging it along the aisles behind me.  Moooo.  Listen up: leather is a fine product and wears a whole lot better than clothing from Wal*Targ that feels like it’s made of cheese.

Oh, so speaking of cheese, have you noticed that milk is not a vegetable?  Yeah, I hate to be the one to burst your balloon, but it’s true.  I only bring this up since after reading The China Study, my wife and I have eaten only a vegan diet.  If you don’t know the difference between vegan and vegetarian, here it is: 

A vegan diet is one of only plant based foods with no animal products.

A vegetarian is the same thing except they think milk, eggs and sometimes fish are plants.

I don’t care if someone chooses to be a vegetarian or vegan or pescatarian or Episcopalian.  This is not a rant about hypocrisy.  It’s a rant about why the hell is there cheese and eggs in vegetarian products?  Why can’t I pull a prepared thing out of my friendly grocer’s freezer that is labeled “vegetarian” (like veggie sausage) only to find it is made with milk and eggs?  When did cow’s milk and chicken embryos become vegetables?  If my kids plant a fish upside down in the dirt am I going to get a minnow tree?

There should be a different labeling system for products that are non-meat but still contain animal products like dairy.  Vegetarian is a lousy term for that.  How about “Non-Meat”?  “Veggie but Cheesy”?  “Eggful Veg”?  Got a better term?  According to my son, the best description is “Made from Things That Poop”  and “Not Made From Things That Poop.”  Okay, I’m cool with that.

Brett L. Kinsler is a chiropractor in Rochester, NY who keeps his vegan Star Wars lunchbox right next to his leather jacket.  Clinic website: www.rochesterchiro.com

More Enhanced Watery Water + Sugar + Lies = Liquid Crap

vitaminwater

Back in September I wrote about enhanced water (It’s More Watery Than Water).  Looks like the Coca-Cola is now going to have a little trouble with their VitaminWater product.  The Center for Science in the Public Interest (CSPI) has decided that Coca-Cola’s line of VitaminWater drinks is not really vitaminy enough nor is it watery enough. Coke is being sued for deceptive and unsubstantiated claims via a class action lawsuit.

The drinks are positioned as a healthy alternative to soda and make claims including that its drinks variously reduce the risk of chronic disease, reduce the risk of eye disease, promote healthy joints, and support optimal immune function.  Buzzwords like the “power of triple antioxidants to help keep you healthy and fight free radicals” and “it is definitely au naturel” are included.

Statements like that might make a buyer assume that the product is, I don’t know, filled with powerful antioxidents.  And, I don’t know, healthy?

In reality, VitaminWater has a lot of added sugar (about the same as a can of soda) and contains between zero and less than 1 percent juice (depending on the flavor) thus doing more to promote obesity and diabetes than fix health problems.

Saying that a food is “natural” is meaningless when it comes to health. Both Salmonella bacteria and arsenic are natural but you wouldn’t want to drink them.

It gets sillier.  The VitaminWater flavor “XXX Blueberry Pomegranate Acai,” for example, contains no blueberry, no pomegranate, and no acai juice.  The other flavors lack their claimed namesake’s cranberry, grapefruit, dragon fruit, peach, mango, kiwi, or strawberry juice .

Okay, even if the nutrients listed are in the product that means nothing about the impact it may have on your health.  “Vitamins + Water = all you need.”  O rly?  Recent studies show that the effects a nutrient may have in isolation do not match the effects when the same nutrient is combined synergistically with the other nutrients present in its original, raw, whole food form.

Bottom line it for me Doc, would ya?  Sure, faithful blog reader!  Thirsty and looking to avoid soda in favor of a healthier beverage?  Great.  VitaminWater isn’t it.  How about just plain water?  Want some antioxidants with it?  Have a piece of fruit.

 

Dr. Brett L. Kinsler is a chiropractor in Rochester, NY and is available most days for a drink but not VitaminWater because it’s silly.

Ergonomic Keyboard Bobs and Weaves

smartfish pro motion keyboard

Engadget is reporting on a sighting at the International Consumer Electronics Show in Las Vegas– an invention by Englewood, NJ chiropractor Jack Atzmon. Dr. Atzmon developed a regular-sized keyboard that contains a small motor and enough computer power to tilt slightly every so often — on three different axes — thus moving the user’s typing position.

His production company, Smartfish, has not conducted any clinical trials to support the theory, but it collaborated with the Hospital for Special Surgery in Manhattan on the keyboard design.

A design such as this has the potential to decrease the incidence of carpal tunnel syndrome. Ergonomic keyboards are nothing new, but Atzmon’s appears to be a novel approach.

Atzmon had the idea for his keyboard during a trip to a Best Buy about two years ago. He realized that by having the keyboard itself move slightly every so often, it would shift the angle of a typist’s wrists and keep the carpal tunnel region from staying in the same position all the time.

Smartfish’s Pro:Motion keyboard, with a suggested retail price of $130, moves every 4,000 to 6,000 keystrokes, according to the company.

It remembers the last user’s typing pattern and will reposition itself about eight times a day. It also knows when you pause, and moves only then, so it doesn’t interrupt work flow.

Atzmon says his 20 years of chiropractic training and experience, including treating people with repetitive stress injuries related to typing, helped spark the inventor side of his brain. “Chiropractors are not taught to treat pain; we’re taught to fix it.”

About the same time, he injured his own arm while swimming with his kids, limiting his ability to perform chiropractic adjustments and giving him both the time and the motivation to turn his idea into a real product.

Patient Advocacy for Chiropractic

Dr. Duncan over at his “Chiropractic Discussions”  blog discusses a new online tool for chiropractic patients… http://chirotalk.wordpress.com/2009/01/12/patients-for-chiropractic/trackback/

Live & Let Live or Sort ’em Out?

carefulSome of my more outspoken opinions (who, moi?) on topics like decompression and autism have sparked an interesting debate that is being held mostly by private email.  Without naming names and pointing fingers, I would like to hear what you think…

If a colleague is practicing in a manner that you find objectionable and unethical, what should be your course of action, if any?  Some people are saying that people should be able to practice however they see fit and writing like mine actually harms the practices of others.

Other folks say that it is the job of honest, ethical chiropractors to weed out the “sick” members of the chiropractic flock in order to advance the heard.

Yet another sect says that, yes, in fact we should denounce unethical practices but for Pete’s sake, do it quietly.

Ready for a fun social experiment?  Here is a practical, real world example and I will abide by the most convincing argument.  I was recently given an advertisement of a chiropractor who is basically offering money for referrals of patients.  Illegal?  Probably.  Unethical?  Definitely.  Should be stopped for the benefit of the profession?  Certainly.

What to do, what to do.careometer

Choice A: Ignore it and let him go on doing what ever he wants — after all, he’s a fellow chiropractor.

Choice B: Send Dr. Bribes-a-lot a private note asking him to kindly stop making the profession look bad.

Choice C: Pass the ad along to the state board and let them handle it.

What do you think?

Honest Decompression Salesperson One Flight Up

A lawyer relative used to have a sign in his office that read “Honest Lawyer – One Flight Up”.  The oxymoronic possibilities of the phrase ‘honest lawyer’ struck me at a young age.  I would have thought, with all of the hyperbole and dogma attached to non-surgical spinal decompression therapy, finding an honest spinal decompression representative would prove to be equally difficult.  Not so fast.  This week I met Chris Peetros from the Chattanooga Group.

I am not writing to endorse any product or company and my readers know that I will not hesitate to call someone on their bullcrap when I see it.  That is why it was so refreshing to hear Mr. Peetros discuss the line of spinal decompression devices from Chatt.  I asked him numerous questions about research and superiority and each time, he answered with honesty.  There was no exaggeration, no dogma, no suggestions on how to squeeze more money out of patients.  Here were some take home points:

(1) Chiropractors are getting ripped off by spinal decompression companies.  In many cases, doctors are spending two to ten times more than a product is worth.

(2) Chiropractors in turn upcharge their patients in order to pay off these ridiculously overpriced machines.

(3) Spinal decompression is a result, not a procedure.  These machines are mechanical traction guided by a computer for accuracy and repeatability.  There is nothing magical, mystical or truly new about this therapy.

(4) Non-surgical spinal decompression is traction.  Period.  It is mechanical muscle and ligament stretching in the axial plane.

(5) There is no proof of superiority for spinal decompression to flexion-distraction or any other means of traction but some patients tolerate it better and with an acute patient, it might be easier to start slowly with a computerized traction device.  Many traditional traction devices do not have the same control of depth and rate.

None of this is news.  None of this is groundbreaking.  All of it was honest and was spoken by someone whose company sells these units.  The difference from what I can see is that Chattanooga sells theirs for a much more fair price (around 10k) and without all the hype and claims of the other companies.

Am I buying one?  Probably not yet.  I am still not convinced that I cannot achieve the same results and with better control manually.  Most of our patients do extremely well without spinal decompression so I am not sure where the advantage would be.  However, I have now located a device that I would consider using should the research so sway me.

Got an opinion or comment?  Do you have any experience with these tables?  I’d love to hear it.

 

Dr. Brett Kinsler is RochesterChiro, a skeptical chiropractor in Rochester, NY.  www.RochesterChiro.com

Our Critics Plus Cocktails

A few weeks ago, the leader of a local chiropractic organization sent out a panicky email to the local chiropractors.  “Please read this!  Important!  This is an outrage!”  Or something to that effect.  What was sent was a link to a satirical article commenting on the questionable and often ridiculous history of the chiropractic profession.

We need to act!  We cannot stand for this!

So what is a skeptical, reasonable chiropractor to do?  I tracked down the author of the article and took him out for drinks last night.  Seriously.  We had a great chat.  I brought along a fellow responsible chiropractor and the three of us chatted about everything from politics to religion to, of course, chiropractic.

You see, people who are critical of us are actually doing us a favor.  Often times we may be too close to a situation to see the flaws.  To have someone else point them out can be quite educational and provide us a pathway for improvement.  People who automatically call out the dogs and become defensive miss the opportunity to learn from such an experience.

Here is a link to the article: http://www.baskeptics.org/ (look for the article “Chiropractic History.”)  It is certainly not without its flaws and some misguided facts but I’m glad I had the opportunity to discuss those points with the author in a rational, peaceful environment. 

Oh, and to the bartender at Hogan’s: please stop asking people if they want a cherry in their Johnnie Walker Black – it’s embarrassing and silly.

What are your thoughts?

Rochesterchiro is written by skeptical chiropractor Brett L. Kinsler

More Spinal Decompression Lies You Should Know

None of my blog articles have caught more attention or been the subject of more flack than when I tell the truth about non-surgical spinal decompression like the VAX-D, DRX-9000 and other pieces of equipment that are similar.  You will recall that I am not against the use of these machines in general — only that the marketing of them is seriously misleading and the practitioners who use them frequently sell patients on long term, prepaid care plans that are highly unethical.  The marketing of non-surgical spinal decompression also frequently falsely claims superiority over other techniques like flexion-distraction — such claims have not been proved.

As a result of some of the feedback I have received, I came across an article from the journal Chiropractic & Osteopathy titled “Non-surgical spinal decompression therapy: does the scientific literature support efficacy claims made in the advertising media?” published in May 2007.

What’s the bottom line?  Does the decompression hype live up to the claims?  That’s a big, giant, whopping “NOPE!”

A little more detail, you say?  Okay.  The article examines this “heavily marketed” version of traction therapy that “can cost over $100,000.”  The authors extensively search all the major medical and scientific literature databases to find every scientific research article published on nonsurgical spinal decompression.  It turns out,  there was only 1 randomized controlled trial, 1 clinical trial, 1 case series and 7 other papers.  Each was reviewed individually. 

The authors concluded that “In general the quality of these studies is questionable.”  And that there was “only limited evidence…available to warrant the routine use of non-surgical spinal decompression, particularly when many other well investigated, less expensive alternatives are available.”

Gee, that sounds just like what I told you a few months ago.

 Also interesting was that this intervention has never been compared to exercise, spinal manipulation, standard medical care or other less expensive conservative treatment options which have an ample body of research demonstrating efficacy.  How the practitioners can get away with claiming any superiority and not be restrained from doing so is a mystery to me.

I’m not saying that any chiropractor who has a spinal decompression unit is a crook.  If he or she is charging you the same as a regular visit in order to use the experimental equipment, then that may be fine.  If he or she tries to convince you to pay in advance, sign up for a dozen or two visits or tells you how fantastic the device is compared to other treatments, don’t walk….run away and find another chiropractor.

Dr. Kinsler and Dr. Elliott Recognized by the NCQA

Treatment for uncomplicated low back pain varies widely. While most physicians follow the recommended approach of pain management and gradual return to physical activity, some prematurely prescribe costly imaging, epidural steroid injections-or refer their patients to surgery.

NCQA, the National Committee for Quality Assurance, has a Back Pain Recognition Program (BPRP).  This program seeks to recognize medical and chiropractic physicians who deliver superior care to millions of Americans who suffer from low back pain. The BPRP program consists of 13 clinical measures and three structural standards that address the broad spectrum of low back pain and focus on underuse, misuse and overuse of treatment modalities.

NCQA BPRP Seal

NCQA BPRP Seal

NCQA developed BPRP requirements from widely accepted medical evidence, with significant input from physician specialists and health plan and employer representatives.

Our office has been recognized as part of this program and Dr. Elliott and I are among only a dozen physicians at this time in New York State to achieve this honor.

http://recognition.ncqa.org/PSearchResults.aspx?state=NY&rp=4

We feel the NCQA BPRP program is a step in the right direction toward evidence based chiropractic treatment and are thankful for the opportunity to earn this recognition.

Dr. Brett Kinsler and Dr. Michalene Elliott are NCQA recognized chiropractors in Rochester, NY.  Their website is www.RochesterChiro.com

Types of Doctors for Patients With Back Pain

Back pain is one of the most common reasons for patient visits to a doctor’s office and patients often wonder who they should see for back pain treatment.  Below is a list of some of the most common types of doctors seen for back pain and what one might expect on a visit:

Family Physicians, General Practitioners, Internists

These are the most frequently visited physicians for low back pain. The medical doctor may be called upon to make an initial diagnosis. After taking the history, the medical doctor can review the systems of the body to determine the cause of pain and determine any risk factors. This group is experienced in the treatment of acute low back pain, they are able to rule out the serious problems such as organic disease, cancer and infection. In the absence of high risk factors listed above, this group of physicians may elect to treat low back pain with medications, ergonomic recommendations and chiropractic or physical therapy referral.  If the patient’s symptoms fail to respond, they will often perform additional testing or imaging and/or refer the patient to a specialist.

Chiropractors, Chiropractic Physicians

Chiropractic is the largest non-surgical and drugless healing profession and is the third largest healthcare profession in the United States after medicine and dentistry. Many patients with low back pain obtain relief using chiropractic care. The Agency For Health Care Policy Reform says that chiropractic treatment and exercise is often the most beneficial form of treatment for acute low back pain. Chiropractors perform manipulative treatments or spinal adjustments and treatments which may also include passive modalities like cold laser therapy, electrical stimulation, ultrasound, stretching, exercise, rehabilitation and nutritional counseling. Chiropractors do not prescribe medications and do order special diagnostic testing when needed.

Physiatrists

This group of medical doctors specializes in the treatment of musculoskeletel injuries as low back pain. They are medical doctors who practice physical therapy, physical medicine and rehabilitation.  The therapy they prescribe often includes exercise, therapeutic modalities and hot and cold packs. They prescribe medications and order other laboratory or diagnostic testing as indicated. They may also include physical therapists and occupational therapists as part of the treatment plan and sometimes have them as part of their staff.  Some physiatrists work in pain management clinics (see below).

Neurologists

These physicians specialize in the treatment of disorders of the nervous system. They perform detailed neurological exams, and order tests to diagnosis causes of pain and weakness.

Pain Management Specialists

Pain Specialists and Anesthesiologists see patients who fail to improve under the more conservative approaches but for whom surgery is not an option. Their treatments may include medications and injections,  nerve blocks, implantable pain devices or stimulators. Pain Psychologists are also included in this group for the evaluation and treatment of the psychological component of low back pain. 

Neurosurgeons and Orthopedic Surgeons

These physicians concentrate in the surgical treatment of low back and lower extremity pain. Spinal attempts to maintain or enhance stability to the lumbar spine, while taking pressure off of the nerves to relieve pain and increase function.

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