Health and disease can be understood in the context of 3 dimensions of health, all couched within the larger domain of emotions or “attitude.”

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Mechanical

July-Aug Chemical

Energetic

Emotional

2008

Health Coach The Center for Spine Pain & Wellness

Volume 2

FOCUS THIS ISSUE: The Holistic Triad

Which Treatment is Right for Me?

Dr. Joel Carmichael, DC, DABCSP We are bombarded with information. I googled “Google” recently. In 1/5th of a second I received 2.75 BILLION hits. It’s mind boggling. As a healthcare practitioner faced with a continuous flood of new data, it’s a race to keep up. I’m glad I practice with a dedicated group of energetic, smart, passionate colleagues in several health specialties. We pool our knowledge, share information and keep pursuing excellence together. The prospect of isolated, solo practice makes me shudder! So, faced with the flood of health information out there and so many therapeutic options to choose from, how do we help you choose which therapy is right for you? First and foremost, we use a holistic paradigm that embraces three fundamental, overlapping spheres of health: chemical, mechanical, and energetic. The chemical sphere includes inflammation, infection, and even genetics. From a therapeutic standpoint this sphere includes drugs, vitamins, supplements, food, herbs, ointments, etc. Historically, mainstream American medicine sees health and disease almost exclusively in terms of chemistry. It is deeply entrenched in our healthcare culture. There’s a pill for everything: to wake up, go to sleep, relax and unwind, wind up, numb out, cough less, weigh more, weigh less, and improve love life. Don’t get me wrong. Millions of lives have been qualitatively enhanced by pharmacy; chemistry has given us things like antibiotics, pain medicine, and Lorenzo’s oil. We have medicines and chemistry to thank for some of the greatest advances in the life expectancy of the human race. And apart from big pharmaceutical enterprise, there are profound strides being made in natural medicine, phytotherapy (using food as medicine), and herbal medicine Continued on the bottom of page 4

EDITOR Joel P. Carmichael, DC, DACBSP President of The Center for Spine Pain® and Wellness

Use of Complementary & Alternative Medicine (CAM) in Young People Contributed by Hang T. Nguyen, DC, DABCO Source: CAM at the NIH, Volume XIV, Number 1: Winter 2007

What is Complementary & Alternative Medicine? In this article we’ll define what “CAM” is, how children are using it, and what you and your kids need to know to benefit from CAM. According to Steven Bratman, MD, the term alternative medicine, as used in the modern western world, encompasses any healing practice "that does not fall within the realm of conventional medicine." Commonly cited examples include naturopathy, chiropractic, herbalism, Traditional Chinese Medicine/acupuncture, yoga, biofeedback, hypnosis, bodywork, homeopathy and diet-based therapies, in addition to a range of other practices. It is frequently grouped with complementary medicine, which generally refers to the same interventions when used in conjunction with mainstream drug treatments under the umbrella term complementary and alternative medicine, or CAM. How many children are using CAM? There has not yet been a large, nationally representative survey on this topic that covers the full range of CAM therapies. There have Continued on page 5

Trusted. Preferred. Experts.

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Volume Issue July-Aug 2008

Natural Hormone Case Studies

Dr. Jason Barker, N.D. Hormone imbalance is a very common, and often mistreated, condition affecting both men and women. Women can suffer from hormone imbalance at any point in their reproductive life span, but most often this occurs between her late 30’s to mid-50’s and happens over a few short years. Men also experience hormonal decline; testosterone declines at a rate of 1% a year after the mid- to late-20’s, but clinical symptoms typically don’t manifest until the early 50’s. Interestingly, this is also when the stereotypical ‘mid-life crisis’ occurs. Hormones can be thought of as the body’s ‘fountain of youth’ as they are responsible for physical and reproductive maturity. Once our biological clocks begin signaling the end of our most useful reproductive years, hormones begin to decline. This also correlates with much of the general aging process and we begin seeing age-related signs and symptoms. Hormone balance does so much more than just resolve hot “...hormones can be flashes, night sweats and irritability. Adequately balanced thought of as the hormone levels are also necessary for bone, heart and brain body’s fountain of health. They play an important role in physical and mental well being. youth” Hormone balance is an integral part of a healthy aging plan and more studies are showing the preventive health benefit of improving hormone balance. Case Study I: Anna, age 53 Anna is like many women her age. She has worked hard at raising a family over the last 20 or so years, and once her children were old enough, she started a small business. Like many of her friends, she is overworked, overtired and just hasn’t had the time to take good care of herself. In just the last few months she has noticed some hot flashes, and occasional drenching night sweats. More disturbing to her is that her memory is not as good as it used to be, she is more irritable, and just exhausted. After submitting a saliva sample (a newer, more accurate way of measuring hormones), it was apparent that her symptoms were related to an imbalance of several important hormones. We started her on a naturopathic program that was designed to restore the balance of all the hormones, because they all work together like a symphony, and changing the level of only one hormone would just cause more symptoms. After taking a detailed health history, ruling out other conditions, and evaluating her diet, nutritional supplements and prescription medication regimen we started Anna on a comprehensive health plan designed to restore and balance her hormones using specific nutraceuticals and bio-identical hormones. Almost immediately her sleep improved, giving her more energy to exercise. Her hot flashes and night sweats began to slowly fade away. Next she noticed her “brain came back,” restoring much of her lost confidence in herself. An added “bonus side effect” of balancing her hormones was an improved love life with her husband, as her libido was restored as well. Case Study II: David, age 50 David is also like many men his age. He works extremely hard and the last few years’ work has limited his ability to exercise and eat right. He is now very tired, and feels unmotivated. His muscles ache. His libido is gone and David has even noticed the beginnings of some impotence. His testosterone has dipped to the ‘low-normal’ range, and it is reflected in his overall health. Testosterone replacement has been shown to be very safe and an effective preventive health approach in recent years. Testosterone is necessary for Continued on page 4

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Acupuncture Q&A Sara Pavone, Dipl.OM.

Volume Issue July-Aug 2008

At our Open House and Health Fair last month at our Highlands Ranch / Town Center Clinic, I realized that a lot of people have heard about acupuncture and are aware of its use as a form of alternative healing, but there were many good questions that were consistently brought up. In an effort to educate our patients and your friends and family about the basics of acupuncture, I have provided a “frequently-askedquestions” list to broaden understanding about one of the oldest healing practices in the world. 1. ! ! ! ! ! 2. " " " " " " 3. " " " 4. ! ! ! ! ! 5. " " " " " "

What is acupuncture? Acupuncture is an effective, holistic medical system that has been utilized for thousands of years in Asia. It involves the insertion of sterile, hair-width needles into the skin at specific points. This activates the body’s energetic system (which aligns closely with the nervous system) to create specific responses in the brain and body. It is a safe, painless, and effective way to treat a variety of conditions. What should I expect during my first treatment? During the initial exam, a full health history is taken. This includes questions regarding symptoms, health, and lifestyle. A pulse and tongue diagnosis may be taken, which indicates possible internal conditions such as insomnia, digestive disorders, menopausal symptoms, acid reflux, or allergies. This information is then used to create a Chinese medical diagnosis. You will then receive a 20-30 minute treatment, in which most of the time is spent relaxing or sleeping! How many treatments will I need? The number of treatments varies from person to person. For acute conditions, 2-3 treatments may be all it takes to get back to 100%. For more chronic problems, a series of weeks or even months of treatment may be necessary. What do the needles feel like? You may experience a vague dull, achy, or tingling sensation upon insertion of the acupuncture needles. This is a positive response since acupuncture involves the movement of stagnant energy or qi (pronounced “chee.”) After treatment, most people feel a sense of deep relaxation. Many patients tell me they sleep extremely well that night also! What does acupuncture treat? Acupuncture is recognized by the National Institute of Health (NIH) (see NIH-funded Acupuncture Study -- page 6 of this Newsletter) and World Health Organization (WHO) to be effective in treating a wide variety of medical conditions. Since acupuncture has been used for thousands of years in Asia as a primary form of medicine, it has historically been used to treat everything from colds to serious internal medical diseases. I have included a short list of the most common conditions Julie Johnson and I see in practice at CSP & W: • acute and chronic pain • digestive disorders • insomnia • weight issues • headache • stress and anxiety • fertility issues • menopausal symptoms Please contact Sara Pavone, Dipl.O.M. at [email protected] for further answers about acupuncture. Call our scheduling staff at 303-382-3616 to set up an appointment with Sara at our Orchard Road clinic, or with Julie Johnson, Dipl.O.M. at our Highlands Ranch/Town Center Clinic.

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Health Coach The Center for Spine Pain & Wellness

“Energy is a key aspect of our lives and our health. Disturbingly, most people still don’t know this.”

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Hormone Case Studies

Volume Issue July-Aug 2008

Continued from Page 2

maintaining muscle mass, brain health, and even prevention of heart disease. The fact that men experience and suffer from hormonal decline has gained much-needed recognition in recent years; now men can get attention for the symptoms they are experiencing but were previously ignored, or even worse, were prescribed an antidepressant for treatment. Many male symptoms of low testosterone are still mistaken for depression, and treated incorrectly. Restoring testosterone levels in aging males can restore many aspects of health that were previously written off as just aging, fatigue or depression. After David’s testosterone levels were improved, and he started a healthy diet and nutritional supplement program to support his health, he was able to regain his motivation, and had the energy to recharge his exercise plan, and was able to regain libido and sexual function he thought were gone forever. Hormone imbalance is so widespread, it is safe to say that everyone -- males included -- suffers from this at some point in their life. Restoring hormone balance is a great way to regain the vitality and youthfulness that seemed to be slipping away over the years. Through August Dr. Barker offers $50 off an initial consultation for hormone balance. Call (303) 382-3616 to schedule an appointment or to find out if you would benefit from Natural Hormones.

Which Treatment is Right ... Continued from page 1

that cannot be ignored. Many conditions respond just as well or better to a natural substance as they do to a pharmaceutical drug, and without the side effects. (Naturopathy, here we come!) My point is simply this: chemistry is only one sphere. Being one-dimensional is not cool -- it has limitations. The next sphere is mechanical. It’s where chiropractors, massage therapists, foot orthotics, exercise, physical therapy and rehabilitation live. It took half a century for political medicine in the U.S. to recognize that back pain is mechanical, and that chiropractic adjustments for a mechanical problem just makes sense. It is now universally accepted that chiropractic manipulation for back or neck pain due to locked spinal joints a first-line treatment of choice. In fact, manipulation for low back pain is the most-studied of all forms of treatment for low back pain. While a drug (such as an anti-inflammatory medication) may reduce the inflammation associated with a locked up back, it falls far short of restoring the normal movement to the spinal joints. Many studies have proven that restoring movement as early as possible is more effective than anything else when the spinal joints are stiff, restricted and locked up. The third sphere is energetic. This is not “woo-woo” energy. This is applied quantum physics. From sports injuries to fibromyalgia, to the degenerative aging process, the depletion of excited electrons from our bodies may a fundamental problem in many disease states. Acupuncture has recognized the power and importance of balanced energy (“qi”) for millenia. Low level laser therapy, electrical stimulation and ultrasound put energy back in your body in different ways and for different purposes. And we were taken aback at first -- to be honest -- by benefits of the MRS 2000: using pulsating magnetic fields to replenish depleted electrons and energy to every cell of the body simultaneously. We are delighted by the profound results we see using energy medicine. Energy is a key aspect of our lives and our health. Disturbingly, most people still don’t know this. All three spheres of health must be understood in the context of emotion, faith, attitude and belief (see the diagram on the front page). If you hold a basic assumption about yourself that is negative, this will impact your health. Grief, loss, stress, disharmony and a myriad of other emotions modify how and whether we sleep, move, eat, digest or play. And we now have evidence that your thoughts trigger changes in cell function. Effective care starts with an accurate diagnosis, and this requires an understanding of the interaction between your body mechanics, your body chemistry, and your body’s energy. We gain insight when you tell us about your stresses, your diet, your exercise activity, etc. This insight and your diagnosis are the bases for your treatment!

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Health Coach The Center for Spine Pain & Wellness

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CAM in Young People...

Volume Issue July-Aug 2008

Continued from page 1

been limited surveys which support the fact that many young people are using CAM, with some groups having a particularly high rate of use -- those who have diseases and conditions that are chronic, serious, painful, or disabling, and conditions that do not have an established cure or have an unpredictable course. In a national, generally representative survey of 1,300 adolescents 13-19 years old, 80% had used CAM at least once in their lifetime and 50% had seen a CAM health provider in the past month. CAM use is high among the young for chronic pain syndromes, upper respiratory illnesses and asthma, headaches, juvenile arthritis, skin conditions, diabetes, autism, cancer, cystic fibrosis, mental health problems, and ADHD (attention deficit hyperactivity disorder). Just as importantly, CAM is used to prevent illnesses (like colds and flu), for ear infections, for weight loss, for strengthening the immune system, for anxiety and stress, and for general health promotion. Families often get their introduction to CAM by word-of-mouth referral, when they!ve grown up using CAM, when they!ve been dissatisfied with the prevailing pharmaceutical-based system, or when they want to be more pro-active, holistic and natural with regard to their health. Discussions With Health Care Providers Parents and their children do not always tell their medical doctor that the child is receiving CAM. Many adolescents fear their pediatrician doesn't know about CAM or would not approve of it. For their part, pediatricians appear to have mixed views on some aspects of CAM. A 2001 survey of 745 pediatricians it was found that 87% had been asked about CAM therapies by a patient or a parent in the 3 months prior to the survey. Most often they were questioned about herbs and dietary supplements, areas where medical training and knowledge lags significantly behind CAM specialties such as chiropractic, naturopathy and Traditional Chinese Medicine/acupuncture. In fact, in this survey fewer than 5% of pediatricians said they felt very knowledgeable about the CAM approaches to health they were being asked about. Sixty-six percent of pediatricians believed CAM therapies could enhance recovery and relieve symptoms, but at the same time 75% were concerned about the possible side effects of herbs and dietary supplements being prescribed. Thus, pediatricians aren’t "against" CAM approaches, but naturally do not understand them as well as they do the drugs they prescribe according to their conventional medical training. The important take home message here is that parents/young patients should talk with the their pediatricians about every therapy they are using or considering. There is an interesting shift among the broader medical profession to beef up their knowledge in CAM. And in fact, many physicians are making major shifts in their treatment approaches to include CAM procedures as first-line therapies. Final Points To Consider As you consider the variety of treatments under the “CAM” heading for you and your family -- or as you recommend this treatment to your friends and loved ones, consider the following points: •Discuss all your treatments with ALL health care provider(s). Give your health care team a FULL picture of what you do to manage health. This will help ensure coordinated care. •On the question of whether a therapy works, ask a reputable, trusted provider and seek results of rigorous scientific studies on the specific therapy in the age group of concern. •A CAM therapy should not be used in place of conventional care or

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Health Coach The Center for Spine Pain & Wellness

For more information or to schedule an appointment at our Denver Tech Center or Highlands Ranch location, please contact us at: 303.382.3616 or visit our clinical services webpage at www.center4spine.com Inquiries, contact: Rhonda Hurley 303.382.3616 [email protected] ©2008,

The Center for Spine Pain®& Wellness All rights reserved.

Highlands Ranch Health Fair & Open House a Huge Success!

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Volume Issue July-Aug 2008

Dr. Joel Carmichael On June 19th over 200 patients, the Highlands Ranch Chamber of Commerce, and local community leaders helped us officially host a “Grand Opening” celebration for our Highlands Ranch / Town Center Clinic location. Many people were able to meet our providers and clinical support team members, and sample our leading-edge health care technologies. The pictures you see in this edition of The Health Coach are all vignettes of that evening. A brainchild hatched by Dr. Hang Nguyen and Dr. Jason Barker together with Barb Stevenson, we succeeded in expressing sincere gratitude for over 20 years of service to our patients and our community. Several of you won door prizes, and many received orthotics screening, chair massage, body pH scanning, acupuncture pulse and tongue diagnosis, pulsed magnetic field therapy, and more! Thanks to all of you who attended!

CAM in Young People... Continued from page 5

produce a delay seeking that definitive diagnosis or conventional care as appropriate. Again, make sure you have received an accurate diagnosis from a licensed health care provider. (Editor’s Note: The Center for Spine Pain & Wellness is a great place to start!) NIH-funded Acupuncture Study ! •! If you take herbs or dietary supplements, A recent study gave acupuncturists even more do not increase the dose or length of credibility. The ancient Chinese practice of piercing the treatment beyond what is recommended body with needles at specific points was shown to decrease pain and improve function among patients without speaking to your provider. Just with osteoarthritis of the knee when used with other because it is an “herb” and not a treatments, said the study, published in the Dec. 21, 2004 prescription drug does not make it safe Annals of Internal Medicine. for you to alter dosage willy nilly. And Funded by the National Institutes of Health, the study more is not necessarily better. has been heralded as the longest, largest and most ! •! If the child experiences an effect that extensive of its kind. It suggests that acupuncture may be concerns you, contact a health care a safe, effective treatment for those suffering with provider. osteoarthritis. "There has been a lot of interest. It's one of ! •! If you are a woman who is pregnant or the most commonly used alternative therapies in the breast feeding, remember that herbs or country," said Dr. Brian Berman, the study's principal supplements you take may also can affect investigator and director of the Center for Integrative Medicine at the University of Maryland. "Since all the your unborn child or your infant. information in the news about the different drugs, people In summary, CAM use is increasing are looking for, 'Oh, what else can I do?' "As a result of rapidly in the U.S. The Center for Spine the drug scares, "alternative medicine all of a sudden Pain & Wellness, as an evidence-based has become more mainstream – in our minds and in our wellness center using many CAM culture," said Rebekah Christensen,executive director of the American Association of Oriental Medicine therapies, works closely with medical (www.aaom.org) in Sacramento, Calif. physicians of every specialty to ensure The best acupuncturists collaborate with a patient's rapid results, optimal health and patient conventional doctors, she said. "Each has a place in safety. As dissatisfaction with promoting and sustaining our overall health," conventional medical therapies and costs Ms.Christensen said. !

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increases, the demand for CAM will continue to increase. CAM therapies are receiving more research funding, and the results of new studies are being released monthly. Keep reading The Health Coach for up-to-date information regarding CAM!

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