Figure 1a (Talipes Varus)
Figure 1b (Talipes Valgus)
Figure 1c (Talipes Equinus)
Figure 1d (Talipes Calcaneus)
Is back surgery a viable option for you? Maybe, maybe not; let's take a look into this scary possibility. As it turns out, back surgery, even for a person with chronic back pain, may not be necessary.
Back pain can originate from several sources: aging, injury, faulty body mechanics, and just plain old wear 'n' tear. But, most problems respond well to non-surgical treatments, including restricted activity, pain killers, heat, cold, massage, exercise, physical therapy, and chiropractic manipulations.
If non-invasive treatments don't help, surgery may be the next logical step, although it is most appropriate for situations where there is a severely pinched nerve, the spinal cord is compressed, or the spine is unstable. Back pain along with symptoms of nerve damage may prompt a physician to recommend surgery. Symptoms like: 1) pain that radiates down arms, or legs (sciatica), 2) pain, numbness, weakness, or tingling in arms or legs, or 3) incontinence.
Back surgery seems to be most successful in cases of :
There are three traditional back surgery techniques:
Hypertension (high blood pressure) is a problem in the U.S., especially since many people don't know they have it, and because a large portion of the people are unaware that systolic, not diastolic pressure (Blood pressure is noted as systolic over diastolic (see Note 1).), is more important.
It is estimated that only about 1/4 of the adults in the U.S. with high blood pressure (defined as greater than 140/90) have it under control. It seems that there is less awareness about the dangers of high blood pressure than in the past, as well as the lack of awareness about the seriousness of systolic pressure. This is a reversal of a 30-year trend during which diastolic pressure got most of the attention, but more recently it has been recognized that systolic pressure may actually be more important. Dr. Sheldon G. Sheps, a hypertension specialist at the Mayo Clinic supports this idea, and the National Heart, Lung, and Blood Institute says there is "overwhelming evidence that lowering systolic blood pressure can save lives."
Dr. Sheps emphasizes the importance of maintaining a blood pressure level below 140/90 -- 130/85 for diabetics, and even lower for those with kidney or heart failure.
An optimum blood pressure is: systolic less than or equal to 120, diastolic less than or equal to 80. Normal is: systolic less than or equal to 129, diastolic less than or equal to 84.
This is important, don't take it lightly: increased systolic pressure is implicated in cardiac and vascular disease, and represents the largest risk for heart failure.
So, what is your blood pressure? Don't know? Well, FIND OUT.
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Note 1 - Systolic pressure is the pressure of blood in the arteries as the heart contracts, and diastolic pressure is the pressure between heart beats when the heart chambers refill for the next beat.
It used to be that many doctors thought of migraines as more of a psychological disorder. It was thought that abnormally dilated blood vessels caused the problem, but it is now known that a migraine headache is truly a neurobiological disorder of the brain, according to Dr. Steven Silberstein, co-chairman of the U.S. Headache Consortium and a professor of neurology at Jefferson Medical College. Advances in imaging technology now allow medical professionals to actually view a migraine in progress, which shows an abnormally high number of neurons (brain cells) in an extremely excitable state. As a migraine is triggered, those agitated neurons fire off electrical pulses that move from the back of the brain, across the top, and then back down to the brain stem (the "primitive brain," located at the rear and bottom-most portion of the brain), which is home to important pain centers. These neurons move in a wave-like motion, and cause increased, then waning, blood flow. It appears that migraines are the result of these waves of blood flow -- the resulting blood vessel inflammation.
According to Dr. K. Michael Welch of the University of Kansas Medical Center, those experiencing frequent migraines seem to experience physical changes in their pain centers that can cause constant headaches, and that "we should probably be treating very quickly."
In the past it has been standard practice to start treatment with O-T-C analgesics (pain killers), and then if they prove to be ineffective, move up the ladder to prescription medications. Dr. Silberstein; however, believes that to be the wrong approach. He thinks the initial medications should be selected based on the intensity of pain. For severe pain he suggests not wasting time on lower level drugs. And, of course, if one doesn't work -- keep looking because something else might.
Dr. Gerald Fishback, director of the National Institute of Neurological Disorders and Stroke says that the recently acquired knowledge about migraines has opened new avenues for research, and that more effective treatments may be on the way -- either to reduce their frequency, or to actually prevent them.
A friend recently became a "great aunt" to a child with a birth deformity -- clubfoot. She and other family members wanted to know about this condition, so here is a brief description of the condition, it's treatment, and prognosis.
Clubfoot comes in either of two variations: 1) positional deformities caused by the position of the foot in the womb, and 2) structural malformations where bones, joints, muscles, and blood vessels are malformed -- a condition of heredity. Whether positional or structural, there are four common types of clubfoot (see Figures 1a, b, c, d).
Figure 1a (Talipes Varus)
Figure 1b (Talipes Valgus)
Figure 1c (Talipes Equinus)
Figure 1d (Talipes Calcaneus)
The cause of clubfoot is presently unknown, as is the question why does it occur in boys more than in girls. The treatment; however, is largely successful in terms of footwear, and sports; although sometimes it becomes necessary (at a later time) to make shoe modifications like arch supports, or even perform more surgery.
Osteoporosis, that well-known bone thinning disease, afflicts about 25 million Americans, and results in more than a million bone fractures yearly -- commonly in the spine, hip, or wrist. Half of Caucasian women 50 and over (see Note 2) can plan on a bone fracture resulting from osteoporosis; and one-third of men over 75 can expect to experience some osteoporosis.
The risk for acquiring osteoporosis is dependent largely on how much bone density (peak bone mass) you have developed between the ages of 25-35 (the period where peak bone mass is achieved), and then how fast you lose it. Bone density is constantly changing (being "remodeled," a process by which old bone is replaced by new bone); but after reaching your mid-thirties bone replacement falls behind bone removal resulting in a loss of about .3% to .5% per year.
In addition to age, other risk factors include:
Note 2 - Race is a risk factor for osteoporosis. The greatest risk is for Caucasian women, while the lowest risk is for Blacks; followed by Hispanics, then Asians. Typically Blacks have the highest bone density of the racial groups identified, and Caucasians have the lowest.
Lp(a), lipoprotein(a), is a cholesterol-related component in the blood that has been associated with risk for heart disease and strokes. Back in 1963, Scandinavian researchers found that men with high levels of Lp(a) had a higher risk for coronary artery disease than those with lower levels. But this information remained buried for years because of the difficulty in testing for it. More recently American researchers have started taking a new look, and have found it to be a major risk factor for atherosclerosis (hardening of the arteries). High plasma levels of Lp(a) appear to be related to about 25% of early heart disease, and stroke with carotid artery involvement.
No evidence exists to suggest that lowering Lp(a) lowers risk, but for those with high levels, lowering total cholesterol is recommended (and aggressively) because lowering Lp(a), itself, is quite difficult.
There are ways to lower Lp(a), but none are currently recommended.
(Q) I recently read an article that claimed that eating tofu may increase the risk for dementia. Can that be?
Y.F., San Jose, CA
(A) Such a study has been reported, but its conclusion is questionable. There have been both positive and negative results reported from studies of soy products, but you shouldn't accept the results of any one study. It takes consistent results from several well-designed studies before accepting their conclusions. And considering the millions of Asians who have consumed soy products for so long, negative health results are unlikely. Don't however, take supplements of soy or isoflavones -- stick to whole foods for these nutrients.
(Q) Yogurt seems to be recognized as a healthy food, but does frozen yogurt share that status?
R.L., Roswell, NM
(A) No, it usually contains too many calories in the form of added sugar, but can be used as a substitute for ice cream, but don't get it confused with health food. A cup of plain yogurt contains about 90-110 calories, plain low-fat is about 130-160 calories, plain regular is in the range 140-210 calories, and flavored yogurt is normally in the range 95-350 calories. Read the labels.
(Q) I sometimes get calf cramps at night. What causes them?
V. L., Christchurch, NZ
(A) Some possible causes are: weak calf muscles from inactivity, calf muscle fatigue from overtraining -- running/jogging especially, pregnancy, circulatory problems, diabetes or thyroid disease, diuretics and other medications, high heels (especially from sporadic use), and maybe loss of electrolites. Try to eliminate these possibilities, but if you can't, see a physician.
(Q) I chronically have bad breath. What can I do to prevent it?
J.R., Lincoln, NB
(A) Some suggestions are to practice good dental hygiene -- brush after meals (and don't forget your tongue), and floss daily; if you have dentures, clean them at least once a day; and keep your mouth moist -- drink lots of WATER; and chewing sugarless gum may help by keeping saliva flowing; regularly visit a dentist; use mouthwash or breath mints. If none of these remedies help, see a doctor.
(Q) I am thinking about taking ginseng to boost my athletic performance. Do you know if this is really supposed to work?
K.L., Casper, WY
(A) Actually there doesn't seem to be any incontroverible scientific evidence supporting its use for anything. There are many claims, and even some supportive studies for some of them, but there are a couple of problems with studying ginseng's claims: 1) what's actually being used, 2) questionable quality control.
Ginseng's active ingredients have been discovered, and are called ginsenosides, of which 13 have been named. There are also various vitamins and minerals, and other compounds that make determining which ingredients are responsible for what is a rather perplexing problem. Additionally, where in the plant it comes from determines which compounds are present -- leaves, roots, stems? AND, there are at least three types of ginseng, each of which has different biological properties -- American ginseng, Korean or Asian ginseng, and Siberian ginseng. So what are you getting, exactly?
Further mystifying the process is the quality control issue. There have been few well-documented studies of ginseng, but none have supported it as an ergogenic aid; that despite some manufacturers claims to the contrary. There are some suggestions that ginseng may have some healthful uses, but obtaining the right stuff in standardized doses is difficult, and the best grades are quite expensive. It turns out that ginseng is contaminated with other plant substances quite easily, making test results unreliable. In the marketplace, there seems to be a complete lack of quality control. Dr. Varro Tyler, the leading American herbal expert (on both plants and plant-based medicine) has reported that of 54 commercial ginseng products analyzed, 60% contained only a small amount of ginseng, and 25% had none. Other sources have found similar results. [This article is based on material in the UC Berkeley Wellness Letter, July 2000.]
(Q) When buying meats (ground beef, lunch meats, etc) I choose "lean," "98% fat free," or something similar; but when I calculate fat content from the information on the back of the package, the fat content is always higher. What gives?
J. O., Portland, OR
(A) You have run up against one of the devious ways that meat is packaged to appear to be lower in fat than it is. With the blessing of your government, meat product producers are allowed to use percentage of weight on the front of packages. This number is relatively meaningless because of the large amount of water added to inflate the weight. The number on the back of the package is more accurate -- use it and disregard numbers on the front.
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