A Healthy Start to a Healthy Year

Can your mind help your body keep your New Year’s resolutions? Mounting evidence says, *Yes.*

The evolving field of psycho-neuroimmunology, or the study of the mind-body connection - often considered fringe beliefs - could help you keep your resolutions. This intriguing subject of scientific inquiry is still shrouded in mystery.

Just as an experiment, put aside your skepticism, pretend that these ideas could be explained by science, and consider how you could harness their power to promote your health.

Placebo Effect

When new medications are tested, one group gets the new medication and another group gets the *sugar pill* or placebo. Why do this? Study after study shows that if you think you’re taking real medicine, your body will respond as if it actually did get the active ingredient, even if it’s a sugar pill. Somehow the belief in the power of the medicine creates the desired outcome of lowered blood pressure or heart rate or weight loss in about a third of people. Is this science? Yes. Is this mind-body medicine? Yes.

Let your beliefs help your body achieve your desired goals. If regular exercise is your goal, tell yourself, *I’m invigorated by my daily 20 minute walk.* The placebo effect suggests that your belief that you have more energy with regular exercise makes it so.

Nocebo Effect

In November 1998, a teacher noticed a *gasoline-like* smell in her classroom, and soon thereafter she had a headache, nausea and dizziness. Given the concern about a toxic environmental substance, the school was evacuated and closed for 5 days. Almost 200 students and teachers were seen in the ER for similar symptoms. But no environmental cause was ever identified. One explanation is that the belief that a toxic exposure occurred led to the symptoms, or the nocebo effect. This is the flip side of the placebo effect.

I reflected on this study as I was waiting with my son for his turn in the dental chair. He repeated, *It’s going to hurt; it’s going to hurt.* I suggested to him that he might be better served by saying, *It’s going to be fine; it’s going to be fine.*

Has the nocebo effect undermined your New Year’s resolutions in the past? Barry saw this in action last March as he told himself,*I hate to exercise.* He made a commitment to daily walks in January and talked himself out of them before the winter snow melted.

Harness the power of the placebo effect and minimize the nocebo effect this year, even if your resolution is something challenging like smoking cessation. In years past you might have told yourself, *This never works. I’ll never be a non-smoker.* Consider replacing that thought with, *In the past it didn’t work. Now I keep my promises.*

Gelotology

It’s the study of humor and its effects on the human body. Researchers are asking the question, *Is laughter good medicine?* You know from your own experience that laughter breaks stress and tension. Evidence suggests that laughter enhances the function of your immune system and stimulates pleasure centers in the brain.

You always have the choice about whether to laugh or cry. Ann remembered that as she completed an interview for the job of her dreams. She bought a new suit that made her feel like she already had the job. It wasn’t until she left the group interview that she discovered the toilet paper stuck in the waist of her skirt streaming behind her like a tail. After an initial rush of embarrassment she laughed.

Prayer

We are a deeply religious nation, and many of my patients use prayer as a source of strength and comfort. Can prayer promote healing? Growing evidence from well-respected clinical studies suggests it can, although not enough evidence for the medical community to conclude that prayer is good for health.

What kind of evidence would you need to use prayer as part of your health regimen? Interestingly, you would consider the same factors whether you’re re-considering Vioxx or Naproxen (recently found to cause heart problems) or Aryuvedic remedies (recently found to be associated with toxic levels of heavy metals). What are the desired benefits, and what are the risks?

What harm could prayer do? We doctors get concerned when patients forgo conventional therapy that has proven benefit for therapies like prayer or shark cartilage that do not have proven value. Consider using mind-body therapies such as prayer together with proven medical treatment. Now, shark cartilage is another matter - and simply not proven at all.

Gratitude and giving

Some interesting, if preliminary, studies suggest that the expression of gratitude and the act of giving increase brain serotonin levels, the same chemical change antidepressant medication helps. That might support your own experience of feeling better as you reach out to the tsunami victims or express gratitude for the health and safety of those you love and the extraordinary richness of your life.

You have the power to carry out your New Year’s resolutions, whether it’s achieving greater physical, financial or spiritual health. Who knows-maybe one day with greater understanding of the mind-body connection, you doctor may prescribe the power of your mind to help you get there.

Fats and the Brain

It is said that the brain is 40-60 % fat. So when we take fats out of our diet, our brain along with other parts of our body suffers. What we need to do is change the bad fats that we eat to good fats. Good fats nourish our body and keep us young and healthy. Good fats consist of: flax oil, extra virgin olive oil, salmon oil, fish oils, primrose oil, hemp oil and their combinations. Also eating raw nuts, seeds and avocadoes will provide good fats in the diet; the body cannot make them, they must be consumed.

Firstly, the good fats (efa’s) are a part of the structure of the cell membrane. They help form the barrier against viruses, bacteria and other foreign substances. This barrier also keeps important items in the cell, such as: genetic materials, proteins, enzymes and the cell organelles. What goes in and what goes out of each cell is also regulated by the cell membrane. It is said the health of the body is dependant on the health of its cells.

These efa’s are also precursors of things like DHA, which is needed by the brain, as well as the adrenals and eyes. These good fats are used for energy production, oxygen use and electron transport, all of these of course are important to healthy brain function. Basically, without proper fats in the diet, our brain will suffer.

Mental health is so important. Without good fats in the diet, the prostaglandins that regulate the neurotransmitters (the chemicals that transmit information from nerve cell to nerve cell) cannot be made. Mental illness can set in, conditions such as: Schizophrenia, Bipolar, Senility and other undiagnosed conditions, irritability, PMS, anger, etc. Essential Fatty Acids have a calming affect on the nerves and the body; hyperactive children are usually benefited by efa’s. Depression and aging are also helped by efa supplementation.

To get more good fats in your diet, eat fish, raw nuts, seeds, avocadoes, green leafy vegetables and cold pressed oils: flax, hemp and their combinations. Never cook with these good fats, frying should be done with butter or coconut oil.

Remember its not how much fat you consume, it’s the type of that counts.

Carpal Tunnel Syndrome

The Carpal Tunnel is a passageway inside the wrist, a tunnel surrounded by bones and ligaments. Aiming to protect the median nerve, the nerve that runs down the arm and forearm into the hand, the Carpal Tunnel can sometimes be affected by a syndrome. This syndrome, called Carpal Tunnel Syndrome, occurs when abnormal pressure is placed on the median nerve, causing decreased hand and finger function and leaving those affected sometimes unable to perform even the simplest tasks.

Symptoms of Carpal Tunnel Syndrome

Carpal Tunnel Syndrome can develop for many years with no noticeable symptoms. However, when the first symptoms do appear they include burning or tingling sensations in the fingers, pain and numbness in the hand, an inability to grasp onto objects, and a weakness of the hands. Because Carpal Tunnel Syndrome involves the median nerve, it affects the parts of the hand that the median nerve supplies. These include the thumb, the index finger, the middle finger, and half of the ring finger. Since the pinky finger is not controlled by the median nerve, the pinky finger is not usually hindered by Carpal Tunnel Syndrome. Those experiencing symptoms for the first time may notice that their Carpal Tunnel Syndrome flares up at night and that they can sometimes get relief by vigorously shaking their hand.

Known as a “hidden disability,” people with Carpal Tunnel Syndrome may fully function from the view of an outsider, with hands that are able to engage in most normal activities. But, the person with Carpal Tunnel Syndrome usually has some restriction of hand function or significant pain during hand movement.

What Causes Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is often caused by underlying conditions that place a strain on the median nerve, compromising the blood supply it delivers to the fingers. These can include existing diseases such as diabetes, which increases the sensitivity of pressure to the median nerve, and hypothyroidism, which can increase the amount of water retained in the arms and wrists.

Many causes of Carpal Tunnel Syndrome aren’t disease-based, however, causes can be generated from external stimuli, such as wrist injuries, fractures of the arm bone, and dislocation of one of the carpal bones in the wrist. Pregnancy, because it can cause swelling of the wrists, can also place pressure on the median nerve by narrowing the carpal tunnel.

Many instances of Carpal Tunnel Syndrome are thought to be idiopathic, having no obvious cause. However, even with idiopathic instances, certain activities can aggravate the symptoms of Carpal Tunnel Syndrome. These can include using power tools or working on an assembly line, constantly performing repetitive - and sometimes awkward - motions. Certain people can even be born with an abnormally narrow carpal tunnel, making them predisposed to the syndrome that may accompany it.

While Carpal Tunnel Syndrome can affect all demographics, it is far more common in women than in men. It is also most common in those who are middle aged and post-menopausal. Obesity and tobacco use increases a person’s risk.

Treatment of Carpal Tunnel Syndrome

Many people with a mild case of Carpal Tunnel Syndrome will find relief simply in adjusting their lifestyle and workstyle habits. While foregoing repetitive wrist activity may not be feasible, particularly when a career is based on repetitive motion, allowing the wrist time to rest while at work and at play can greatly relieve the symptoms of Carpal Tunnel Syndrome. Resting the wrist for great lengths at a time may seem like a reasonable break, but studies have shown that it is more beneficial for those afflicted by Carpal Tunnel Syndrome to take several small breaks, rather than one that is lengthy. Applying cold packs to relieve any swelling of the hands and wrists is also a helpful form of treatment.

For those with a case of Carpal Tunnel Syndrome that is not aided by rest or cold compressions, wrist splinting is an alterative form of treatment. A person, wearing a splint that keeps their hand still while they sleep, may notice that the symptoms of burning, tingling, and pain are greatly relieved. Wrist splinting, however, is usually only helpful for those who have had symptoms of Carpal Tunnel Syndrome for less than a year.

While Carpal Tunnel Syndrome certainly doesn’t have a magic pill serving as an antidote in its healing, there are certain medications that can relieve its pain and discomfort. These can include Nonsteroidal anti-inflammatory drugs (or NSAIDs) for those whose condition is brought on by inflammation or Corticosteroids to relieve the pressure on the median nerve, decreasing the pain in the process.

The literal hands-on approach of spinal manipulation and deep friction massage can help manage the swelling that is pressing on the median nerve, causing the symptoms to flare up. Manual stretches of the wrist and tendons, additionally, can help increase the blood flow to the hand.

While the evidence is not conclusive, some speculate that dietary changes may lead to diminishing Carpal Tunnel Syndrome symptoms by arming the body with the nutrients it needs to repair nerve damage and decrease inflammation. By taking something as simple as a multi-vitamin, pressure from the median nerve may be diminished, allowing it to repair itself back to its natural state.

While the above mentioned treatment options are usually limited to being beneficial to those who have mild to moderate cases of Carpal Tunnel Syndrome, for those who have severe cases, surgery may be the best option.

Though there are several approved surgeries for Carpal Tunnel Syndrome, they all involve the same theme of the cutting of the ligament that is pressing on the median nerve. They are also all procedures done on an out patient basis, with a small incision cut in the wrist or the palm and a recovery time of just a few weeks. While not all surgeries are successful in relieving the symptoms, roughly 70 percent of patients who choose surgery report satisfaction with the outcome.

Carpal Tunnel Syndrome can happen for reasons that are understood and for reasons that are unknown. However, practicing self-care can prevent some of the symptoms that arise no matter the underlying cause. From keeping hands warm to improving posture, and from relaxing the grip while performing tasks with the hands to taking frequent breaks, the best chance at preventing Carpal Tunnel Syndrome usually lies with some conscientious effort.

About us: The Center for Osteopathic Medicine in Boulder, Colorado believes in The Osteopathic Difference. In a medical industry focused on treating symptoms, The Center is more focused on finding the cause of these symptoms. The Osteopathic Difference is the application of "Hands on Therapeutics" for both the diagnosis and treatment of complaints, disorders, and pain. The Osteopathic Difference will apply the time proven osteopathic fact that function is directly related to structure, and poor structure will lead to poor function.

While The Center tries to focus on health, and above all else, prevention for all those who cross into its threshold, sometimes the best that can be done is to recognize the source of the “DIS-EASE," and to teach every individual how to manage their symptoms. Believing that it is the most important aspect of any treatment regime, and that it is the primary job of the health care practitioner, The Center works to empower the patient in the maintenance of their own health.

Achieving health is also an elusive place, and The Center will work tirelessly to create a path to health which, when embraced by the patient over time, will allow the patient to enjoy a positive return on their rehabilitation investment. The Center teaches a Mindfulness Yoga Program that aims to educate the patient in the power of the mind to minimize, if not rid the body of, aches and pain. Although the ultimate goal of health is to live without the use of drugs, natural or otherwise, The Center for Osteopathic Medicine recognizes the importance of medicinals and their appropriate use. All styles of "Hands on Manipulation" are practiced at The Center. By combining these Manipulative techniques with Structural Integration, massage, meditation and Western Medicine, The Center for Osteopathic Medicine helps people to identify disease before it manifests, quiet pains that have been previously diagnosed as Chronic, and embrace a holistic mindset to Live in the Present- and within that presence, live completely well.

The information discussed in this article is for informational and educational purposes only. If you are experiencing symptoms of a health problem, please visit your doctor. The material discussed on this website is not meant to replace the opinion or diagnosis of a medical professional.

Obesity Letter

Obesity has reached a crisis level in this country, with obesity registering at 30 percent of the population. Gastric bypass surgery is generally considered to be the best surgical procedure for the treatment of morbid obesity. In fact, doctors are expected to perform 140,000 bariatric surgeries in 2005 alone.

As payers and practitioners in the medical community, we are well aware of these statistics and their impact on overall healthcare costs. And, until recently, not all insurance plans considered bariatric surgery as a medically necessary procedure. This is about to change. Federal healthcare authorities have changed obesity to be classified as an illness. This change often results in gastric bypass surgery being classified as a medical necessity for many overweight adults that meet the following criteria:

The patient’s body mass index (BMI) is over 40

The patient has failed one or more non-surgical, medically supervised weight loss programs

The patient has received a thorough psychological exam that confirms he or she is able and willing to conform to the dietary adjustments required by the surgery

Other medical conditions may also have to be considered; however, this change means you, as a payer, may be expected to provide coverage for cases that, in the past, would not have been covered.

At AllMed Healthcare Management, we understand the impact this change may have on your organization – both in terms of cost of services and in the volumes of cases that may require a second level of review. To help you with this process and to ensure you are able to administer claims in a timely and accurate manner, we have added five additional bariatric surgery specialists to our peer specialist panel. These specialists are available to help you ensure your claimants receive the care they need and are entitled to – while also making sure you’re not overpaying for services that may not be covered or are medically unnecessary.

As your Independent Review Organization (IRO), we make it our job to stay up-to-date on the latest medical advancements, medicalrulings, legal regulations and health insurance laws to ensure you receive medical advice and decisions that are based on defensible facts. It’s our commitment to ensure you receive the best service and outcomes.