Big Boy Townson is busy being a good older brother.  He loves school at The Lamb and has lots of friends there as well as in our neighborhood.  He is building a fluent vocabulary as well as the occasionally amazing hand-eye coordination. 

We are truly blessed.

Happy Mother's Day to all you Mommys out there!

Best,   Dr. Green

Consumer Reports Ranks Chiropractic #1 for Low Back Pain

Treatment Options for Sciatica: Neuromobilization and Low Back Pain

Understanding Chronic Pain, video link

Understanding Chronic Pain, video link

For Neck Pain, Chiropractic and Exercise Are Better Than Drugs

Tony Cenicola/The New York TimesWhat’s the best treatment for neck pain?

Seeing a chiropractor or engaging in light exercise relieves neck pain more effectively than relying on pain medication, new research shows.

The new study is one of the few head-to-head comparisons of various treatments for neck pain, a problem that affects three quarters of Americans at some point in their lives but has no proven, first-line treatment. While many people seek out spinal manipulation by chiropractors, the evidence supporting its usefulness has been limited at best.

But the new research, published in The Annals of Internal Medicine, found that chiropractic care or simple exercises done at home were better at reducing pain than taking medications like aspirin, ibuprofen or narcotics.

“These changes were diminished over time, but they were still present,” said Dr. Gert Bronfort, an author of the study and research professor at Northwestern Health Sciences University in Minnesota. “Even a year later, there were differences between the spinal manipulation and medication groups.”

Moderate and acute neck pain is one of the most frequent reasons for trips to primary care doctors, prompting millions of visits every year. For patients, it can be a difficult problem to navigate. In some cases the pain and stiffness crop up without explanation, and treatment options are varied. Physical therapy, pain medication and spinal manipulation are popular options, but Dr. Bronfort was inspired to carry out an analysis because so little research exists.

“There was a void in the scientific literature in terms of what the most helpful treatments are,” he said.

To find out, Dr. Bronfort and his colleagues recruited a large group of adults with neck pain that had no known specific cause. The subjects, 272 in all, were mostly recruited from a large HMO and through advertisements. The researchers then split them into three groups and followed them for about three months.

One group was assigned to visit a chiropractor for roughly 20-minute sessions throughout the course of the study, making an average of 15 visits. A second group was assigned to take common pain relievers like acetaminophen and — in some cases, at the discretion of a doctor — stronger drugs like narcotics and muscle relaxants. The third group met on two occasions with physical therapists who gave them instructions on simple, gentle exercises for the neck that they could do at home. They were encouraged to do 5 to 10 repetitions of each exercise up to eight times a day. (A demonstration of the exercises can be found at www.annals.org).

After 12 weeks, the people in the non-medication groups did significantly better than those taking the drugs. About 57 percent of those who met with chiropractors and 48 percent who did the exercises reported at least a 75 percent reduction in pain, compared to 33 percent of the people in the medication group.

A year later, when the researchers checked back in, 53 percent of the subjects who had received spinal manipulation still reported at least a 75 percent reduction in pain, similar to the exercise group. That compared to just a 38 percent pain reduction among those who had been taking medication.

Dr. Bronfort said it was a “big surprise” to see that the home exercises were about as effective as the chiropractic sessions. “We hadn’t expected that they would be that close,” he said. “But I guess that’s good news for patients.”

In addition to their limited pain relief, the medications had at least one other downside: people kept taking them. “The people in the medication group kept on using a higher amount of medication more frequently throughout the follow-up period, up to a year later,” Dr. Bronfort said. “If you’re taking medication over a long time, then we’re running into more systemic side effects like gastrointestinal problems.”

He also expressed concern that those on medications were not as empowered or active in their own care as those in the other groups. “We think it’s important that patients are enabled to deal with as much control over their own condition as possible,” he said. “This study shows that they can play a large role in their own care.”

Sports Medicine Said to Overuse M.R.I.’s

NY Times interviews renowned sports medicine expert Dr James Andrews about MRI studies.

“Patients often feel like they are getting better care if people are ordering fancy tests, and there are some patients who come in demanding an M.R.I. — that’s part of the problem,”

In asymptomatic pitchers “M.R.I.’s found abnormal shoulder cartilage in 90 percent of them and abnormal rotator cuff tendons in 87 percent.”

According to Dr Andrews, “If you want an excuse to operate on a pitcher’s throwing shoulder, just get an M.R.I.,”

Stuart McGill: The Right Way to do do Core Training for Low Back Pain

Mom and baby are resting comfortably.

Many thanks to all of you who have been so supportive and helpful along the way. 

Yours in Health,

Dr. Green

***This minute and a half video is invaluable for persons with neck pain.

Currently we are also awaiting the arrival of precious cargo number 2.  7 weeks to go.

The Tour de France is a grueling bike race where competitors have to push their bodies, and their bicycles, to the absolute limit for three weeks. NBC Sports recently reported that American cyclist Christian Vande Velde (currently in 27^th place) sees his DC each night of the tour to help his body recover from the arduous day of racing. The Tour de France concludes in Paris on Sunday, July 24.

It's always down to $.  Sad but true. 

If you have been injured or simply even in a mild fender bender, you may want to put your auto carrier on notice and see a professional for an evaluation so today's aches don't become tomorrow's chronic problems.

What is Whiplash?

The term "whiplash" was first used in 1928 to define an injury mechanism of sudden hyperextension followed by an immediate hyperflexion of the neck that results in damage to the muscles, ligaments and tendons – especially those that support the head.  Today, we know that whiplash injuries frequently do not result from hyperextension or hyperflexion (extension and flexion beyond normal physiological limits), but rather an extremely rapid extension and flexion that causes injuries.

Due to their complicated nature and profound impact on peoples lives, few topics in health care generate as much controversy as whiplash injuries.  Unlike a broken bone where a simple x-ray can validate the presence of the fracture and standards of care can direct a health care professional as to the best way in which to handle the injury, whiplash injuries involve an unpredictable combination of nervous system, muscles joints and connective tissue disruption that is not simple to diagnose and can be even more of a challenge to treat.  In order to help you understand the nature of whiplash injuries and how they should be treated, it is necessary to spend a bit of time discussing the mechanics of how whiplash injuries occur.

The Four Phases of a Whiplash Injury

During a rear-end automobile collision, your body goes through an extremely rapid and intense acceleration and deceleration.  In fact, all four phases of a whiplash injury occur in less than one-half of a second!  At each phase, there is a different force acting on the body that contributes to the overall injury, and with such a sudden and forceful movement, damage to the vertebrae, nerves, discs, muscles, and ligaments of your neck and spine can be substantial. 

Phase 1

During this first phase, your car begins to be pushed out from under you, causing your mid-back to be flattened against the back of your seat.  This results in an upward force in your cervical spine, compressing your discs and joints.  As your seat back begins to accelerate your torso forward, your head moves backward, creating a shearing force in your neck.  If your head restraint is properly adjusted, the distance your head travels backward is limited.  However, most of the damage to the spine will occur before your head reaches your head restraint.  Studies have shown that head restraints only reduce the risk of injury by 11-20%.

Phase 2

During phase two, your torso has reached peak acceleration - 1.5 to 2 times that of your vehicle itself - but your head has not yet begun to accelerate forward and continues to move rearward.  An abnormal S-curve develops in your cervical spine as your seat back recoils forward, much like a springboard, adding to the forward acceleration of the torso. Unfortunately, this forward seat back recoil occurs while your head is still moving backward, resulting in a shearing force in the neck that is one of the more damaging aspects of a whiplash injury.  Many of the bone, joint, nerve, disc and TMJ injuries that I see clinically occur during this phase.

Phase 3

During the third phase, your torso is now descending back down in your seat and your head and neck are at their peak forward acceleration.  At the same time, your car is slowing down.  If you released the pressure on your brake pedal during the first phases of the collision, it will likely be reapplied during this phase. Reapplication of the brake causes your car to slow down even quicker and increases the severity of the flexion injury of your neck.  As you move forward in your seat, any slack in your seat belt and shoulder harness is taken up.   

Phase 4

This is probably the most damaging phase of the whiplash phenomenon.  In this fourth phase, your torso is stopped by your seat belt and shoulder restraint and your head is free to move forward unimpeded.  This results in a violent forward-bending motion of your neck, straining the muscles and ligaments, tearing fibers in the spinal discs, and forcing vertebrae out of their normal position.  Your spinal cord and nerve roots get stretched and irritated, and your brain can strike the inside of your skull causing a mild to moderate brain injury.  If you are not properly restrained by your seat harness, you may suffer a concussion, or more severe brain injury, from striking the steering wheel or windshield.

Sincerely,

Christopher M. Green, DC, CMUA, PES

Nearly 40 percent of youngsters affected have had severe reactions, large study finds

http://today.msnbc.msn.com/id/43447764

Question:  Do you think this has anything to do with commercial farming and the change hybrid foods?

The American Academy of Pediatrics Committee on Public Education recently issued a comprehensive statement regarding television and children. The group noted, "More than 1000 scientific studies and reviews conclude that significant exposure to media violence increases the risk of aggressive behavior in certain children and adolescents, desensitizes them to violence and makes them believe that the world is a 'meaner and scarier' place than it is."

A study published in the April 2005 issue of Archives of Pediatrics and Academic Medicine found a strong correlation between the amount of time a child spent watching television at age  and the likelihood he would become a bully later on in school. As the study explains, bullying behavior is a sign of lack of empathy and poor social skills, which can make a child disliked by others, including his teachers.

EXCESS TV INCREASES THE RISK FOR ADHD

A groundbreaking study published in Pediatrics, a leading medical journal, revealed that children who watched the most TV between the ages of 1 and 3 were most likely to develop attention problems by age 7.

We here at CCRC wanted to make everyone aware we are running a Summer massage special.   This is for 10 one hour massage sessions.  Our rates have not changed, however if you purchase 7 sessions at regular price, we'll give you 3 for free.  These must be used from year to date of purchase and our cancelation policy is still in effect, but WOW!!!!! What a deal!!  Especially with Josh and Brenda doing the massages.

Ok, best to everyone this Summer.  Give us a ring or stop in if interested.

We are providers on many health insurance plans:

• Blue Cross Blue Shield Provider
• Aetna Provider
• Health Options Provider
• Medicare Provider
• Medicaid Provider
• Auto Accidents – All Plans – Allstate, State Farm, USAA, Progressive, Geico and others…
• Workman’s Compensation Cases
• School Physicals
• DOT Physicals
• Sports Physicals

We also distribute durable medical equipment like TENS units and back braces and wrist and elbow supports and neck collars.  We carry Biofreeze and Sombra and offer nutritional and exercise counseling.  Lastly, if you do not have insurance, we offer reasonable cash rates.  Phone for information at 239.495.1166

“The Dr. Oz Show” recently touted new research that found chiropractic care is just as effective as over-the-counter pain relievers for back pain. Dr. Oz explained how the spine gets misaligned and what chiropractic care can do for patients. The episode even featured an adjustment right in the studio. Watch the segment now.

Of course Dr. Green and CCRC has the flex bar for the exercise, as well as the appropriate physiotherapy to allow quicker healing.

Google or You Tube the 'Tyler Twist' if you think you're having tennis elbow or phone today for an appointment.

Show up. Get fit. Have fun.

Touch rugby is here.  Estero Community Park welcomes the new "league" every Wednesday night at 6:30. 

No experience required.  We are simply looking for people who want to run around and get fit and have fun.

See you there!

Medicare at a Glance

          Check out our most recent update on the FCA's website regarding Medicare. It has the most frequently requested links to Medicare, based on questions to the Insurance Liaison Office - ALL in ONE place. Click here for more.

Medicare Fraud Arrests in Florida

            Recent news articles spotlight sweeping arrests in Florida for alleged Medicare fraud. Click on the links below to read more about the increased law enforcement activity to catch licensed providers and others charged with billing millions in fraudulent claims.

· Organized Crime Ring Has S. Fla. Ties - S. Florida Business Journal, February 16, 2011

· Record-breaking Medicare fraud case includes 10 arrests in Tampa area - Tampabay.com/St. Petersburg Times, February 17, 2011

Esteemed authors Niteesh Choudhry, MD, PhD, Harvard Medical School and Arnold Milstein, MD, Mercer Health and Benefits, San Francisco, CA, developed this authoritative report which reviews the existing peer reviewed literature and arrives at the following conclusions:

* Chiropractic care is widely used with almost half of all patients with persistent back pain seeking out this form of treatment.
* “Chiropractic care for the treatment for low back and neck pain is highly cost effective, represents a good value in comparison to medical physician care and to widely accepted cost effectiveness thresholds.”
* “The addition of chiropractic coverage for the treatment of low back and neck pain…will likely increase value-for-dollar by improving clinical outcomes…”
* “We project that insurance coverage for chiropractic physician care…is likely to drive improved cost effectiveness of US care.”
* “Our findings support the value of health insurance coverage of chiropractic care for low back and neck pain at average fees currently payable by US commercial insurers.”

About the Authors:

Niteesh Choudhry, MD, PhD: Assistant Professor at Harvard Medical School and Associate Physician in the Division of Pharmacoepidemiology and Pharmacoeconomics and the Hospitalist Program at Brigham and Women?s Hospital.

Arnold Milstein, M.D, MPH: Medical Director of the Pacific Business Group on Health(PBGH),the largest employer health care purchasing coalition in the US.. He is also Chief Physician at Mercer Health and Benefits, San Francisco, California.

We would also personally like to thank our vendors AMA Medical, Bioskin, Script, Meyer, Compliance Medical as well as our local colleagues and imaging companies for helping make our patient centered care as best it can be.  

God Bless.

Dr. Green

With that said, it appears our road are swelling a little and our friends from the north are down again.  We have seen a few of our seasonal friends and are welcoming them with open arms.  We are getting a little busier here at CCRC and recommend to our established patients, just a simple phone call to schedule an appt, just so there is not too long a wait. 

Best wishes to everyone this season.

Dr. Green

Brenda Norris hours are: Tuesday, Wed AM and Friday PM.

Josh's hours are: Monday, Wed PM, Thursday and Friday AM.

FYI, Brenda Booth has decided to go out on her own and step away from CCRC.  We of course parted on amiable terms and wish her the best. 

Dr. Green

http://www.ny1.com/content/124990/doctors-stress-backpack-safety-as-new-school-year-begins

June 9, 10, 11 and 12 I was in Austin Tx completing advanced classes sponsored by TeamCME, Western States Chiropractic College and the American Chiropractic Association.

I am now an accredited TeamCME medical examiner.  This allows me to perform DOT physicals for CDLs, drivers licenses for people who drive trucks/vehicles over 10000 and over 26000 lbs.  The office is now offering these physicals, as well as drug screens and breath alcohol testing.

Here is a picture of Townson where he knows he's not supposed to be.

Now...the fun begins so I hear.

On a clinical note, our office has gone through some changes recently.  We think they are for the best.  Stop in or phone us for an appointment and let us help you with those nagging aches and pains.  Or, if you have recently been injured.  We look forward to hearing from you.

All the best, Dr. Green

A member of the Albany Knickerbocker Rugby Football Club, Michael is not only a long time player, prop and friend of rugby, he is a proud husband and father of two young children.  His wife Lisa has been steadfast and strong while staying down here in Florida (Ft. Lauderdale)by his side. 

Donations to "The Jonesy Fund" can be made via pay pal at the Life University Alumni web site or by check by contacting the Albany Knicks RFC.

http://www.liferugbyalumni.com/

IF MAKING A DONATION BY CHECK, MAKE IT CLEAR TO MAKE ALL DONATIONS AND CHECKS PAYABLE ONLY TO : MICHAEL JONES SUPPLEMENTAL NEED TRUST.

MAIL IT TO THE ALBANY KNICKERBOCKERS R.C.F.

Albany Knickerbockers R.F.C.
P.O. Box 1654
Albany, NY 12201


THANKS,

CHARLES I. COLLEY(grandcyclist@msn.com)

Townson, Dr. Michelle, Natalie, Michelle T., our new massage therapists, Brenda and Brenda, and myself are hoping you had a wonderful holiday season and new year.  And for those of you still up north, we hope you're keeping warm. Our short cold snap down here appears over as the AM fog and evening humidity seem to be slowly creeping back in.

Anyway a few changes around CCRC.  Yes, we have two new LMTs.  Lynette retired and got married.  She has a few irons in her fire and is playing some mean golf these days.

We are slowly growing and seem to be getting busier each day.  A recommendation for those who are used to walking in for appointments is to phone ahead in advance as we have experienced some log jams when folks walk in.  We are able to schedule just about everyone for same day service.....were not that busy!!!  Just always hoping to treat people right and not have them wait excessively.

Feel free to drop us a line or stop by.  Again,  here's to a happy and healthy 2010!

Dr. Green

There is a happy hour informational on Jan 21 at Johnny Malloy's in Estero.

http://main.acsevents.org/site/TR?pg=entry&fr_id=21066

Townson and Mommy and Daddy

Townson at 3 Months

Just letting you know there is a definite need for sponsors, volunteers and supports for this year's Relay for Life.  This annual charity event for cancer research is again being held at Estero High School.  The event is April 30th.  The next local meeting is January 11, 2010 at the San Carlos Fire Dept on Ben Hill Griffin at 6pm.  Dr. Giroux, Townson and myself are all on Team TRCE, The Rotary Club of Estero.  Inquire within the office for details.  Click the link below for details. 

Here's to a happy, healthy and safe holiday season.

Dr. Green

go to:

youtube/watch?v=yC5rE8NPzd4

There is a lot of talk, controversy, etc regarding flu, swine flu, legislation in this country.  With this post I simply would like to highlight the possible double standard between the AMA and their written stance on vaccines, and their historical libel/slander regarding chiropractors manipulating patient's cervical spine.

This link is from youtube.  It is an isolated event, however it is an actual occurrence to a once healthy young lady.  She had a flu shot and 10 days later....developed dystonia, see wikipedia.  The AMA stands firm that this is a one in a million event. 

http://www.youtube.com/watch?v=mScGC7nFDxM&feature=popt00us0a

And it probably is close to 1+ million isolated event, however......the point I REALLY WANT TO HIGHLIGHT HERE IS THIS....it is rare, just like when a chiropractor 'adjusts' a patient's neck and a VBAI occurs, vertebral basilar artery interruption/stroke occurs.  There has forever been the reports/heresay/opinion/recommendations to patients from their doctor....that this is bad and should be avoided.  MY POINT IS THIS......if all chiropractic manipulation of the neck was detrimenal, why do all professional, olympic, collegiate athletics progarms have a chiropractor?!?!?!  Why do millions of regular folks, you, me and my MD...use chiropractic services annually??

I certainly hope the AMA and it's memebers state to patient's this is also 'one in a million' event when someone is injured with neck manipulation.  Actually, for chiropractors the number is estimated at more like 1 in 6,000,000!!!  And please keep in mind, these recorded events are not always TIA or stroke, many are headaches or lightheadedness which resulted in the patient seeing their doctor, going to an ER or urgent care, etc.  Also, just so we're clear....one of the last documented case in the US where a patient had a stroke after having their 'neck cracked'...the manipulation was performed by an MD!!!!!!  This is not a dig on medical practitioners, it is fact. Fact that all procedures and services have some risk.  This should be discussed between patient and doctor prior to the service being performed and by law, consent must be given.  There certainly are some cases in the US and Canada which have made headlines and they can be found on the web, google, etc.  Most notably there is a woman in Connecticut who has petitioned local gov't to post anti-chiropractic bill boards in her area.

Of interest,one other DOCUMENTED fact, many companies are now only allowing MDs or DOs to bill for 'manipulation codes' and are excluding chiropractors!!!!!!!!!!!!!!!!!!!!!!!  Many of these doctors do not know, have never been trained, do not perform at all/EVER!!!! 'neck popping' in their offices,  yet payors are giving them the exclusive right to perform and bill the codes!  Talk about an upside-down world.  Sorry for that tirade.

Please see Dr. Cassidy's report below...especially the results and conclusion sections. 

Risk of Vertebroasilar Stroke and Chiropractic Care: Results of a Population-Based, Case-Control and Case-Crossover Study
 
Study Design:  Population-based, case-control and case-crossover study.
 
Objective:  To investigate associations between chiropractic visits and vertebrobasilar artery (VBA) stroke and to compare this with visits to primary care physicians (PCP) and the occurrence of VBA stroke.
 
Summary of Background Data:  VBA stroke is a rare occurrence.  Neck pain and headache are common symptoms of VBA dissection and typically precede VBA stroke.  Chiropractic care is popular for neck pain and headache, but has been associated with an increased risk for VBA dissection and stroke.  People experiencing headache and neck pain may also choose to consult a primary care physician.
 
Methodology:  The cases studied comprise eligible incidents of VBA stroke admitted to Ontario hospitals over a nine year period from April 1993 to March 2002.  Four controls were age and gender matched to each case.  Visits to chiropractors and primary care physicians during the year before the stroke date were determined from Ontario Health Insurance Plan (OHIP) billing records.  In the case cross-over analysis, cases acted as their own controls.

Results:  Over the nine year study period, there were 818 cases of VBA stroke admitted to Ontario hospitals in a population of more than 100 million person-years.  Among those under 45 years of age, cases were about three times more likely to visit a primary care physician or a chiropractor prior to their stroke compared to controls.  A strong association was found between primary care physician visits and VBA strokes in all age groups.  There was no increased association between chiropractic visits and VBA stroke in those older than 45 years.
 
Conclusions:  VBA stroke is a very rare event in the population.  The risk of VBA stroke associated with a visit to a chiropractor's office appears to be no different from the risk of VBA stroke following a visit to an MD's office.  The incidence of VBA stroke associated with chiropractic and primary care physician visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke.  The study found no evidence of excess risk of VBA stroke associated with chiropractic care compared to primary physician care.
 
Cassidy JD, et al. Spine. Vol. 33, No. 4S, pp. S176-S183.
 
Here is a synopsis of the 2008 Bone and Joint Task force also revealing the safety and efficacy of cervical spine maniplation

http://www.acatoday.org/pdf/NPTF_key_findings.pdf

 Thank you for reading my post today.  Go out and make it a great day!!!!

We took Townson to his first pumpkin patch yesterday.  Dressed in his orange, tan and brown (long sleeve) jumper outfit, he braved the elements, sat on top of some pumpkins and didn't cry at all.  He appeared to have a good time and we defintely did.   

The course was on the American Medical Association's Guides To Permanent Impairment, 6th edition.

Dr. Green is simply now authorized to use these Guides to rate a patient's permanant impairment should they be injured and have problems regarding their everyday activities after the accident.

Just an fyi for everyone who keeps up with our postings.  Townson is nearly 3 months old.  He is just starting to roll onto his side and is showing very strong arms and legs.  He is quite 'kicky' these days.  He is just a joy everyday for us.

In news relating to our clinic, we are getting a bit busier by the day as season appears to be rolling around.  Some advice to our established patients, I would phone in advance for an appointment just so there is no long wait in our reception room if you choose to walk in for an appt.  Either way, I am happy to meet and greet any and all of our patients.  The concensus seems to be the summer up north was cold and wet.  Welcome back to the hot, dry days of SWFL fall and winter my friends. 

Cheers!

Dr. Green

MUMBAI:The International Olympic Committee (IOC) Session has voted that Golf and Rugby sevens be included in the 2016 Olympics that is to be held in Rio de Janeiro.

Following an evaluation by the Olympic Programme Commission of the seven sports seeking to enter the Olympics, the two sports were recommended by the IOC Executive Board (EB) in August.

Says IOC president Jacques Rogge, "Both Golf and Rugby are very popular sports with global appeal and a strong ethic. They will be great additions to the Games.

"The two sports, voted on separately in alphabetical order of the sports, Golf then Rugby, received a simple majority of votes cast by the members of the session. The result of the first vote was not revealed to the session until the vote for the second sport were taken.

International Golf Federation Secretary General Peter Dawson says, “The International Golf Federation is absolutely delighted by today’s results. We thank the IOC for the thorough process and are looking forward to playing our part as a member of the Olympic Movement. This is great for golf and we hope to be of great benefit to the Olympic Games as well.”

Says International Rugby Board president Bernard Lapasset, “I am so delighted and proud. My thanks to the IOC members for their wonderful support. Rugby is honoured to be a part of the Olympic Sports Programme and we are already looking forward to Rio 2016.”

Rugby and Golf are to be part of the 2016 Olympics!!!!!!!!

The IOC (International Olympic Committee) has voted that rugby and golf be allowed in the 2016 Olympic Games in Rio de Janeiro.

http://en.wikipedia.org/wiki/Rugby_union_at_the_Summer_Olympics

Hopefully the US can defend itself as they are the reigning Olympic champions dating back to both 1920 and 1924.  They'd better prepare because South Africa, Argentina, Wales, England, Ireland, New Zealand and Australia all have pretty formitable teams these days.

In unrelated news, Dr. Green has chosen not to participate in these games due to old age and various previously broken body parts.  HaHA.  The selection committee would never even take a look at me, however there are some strong lads who are currently playing at Life U, my chiropractic college.  Life lost in the Super League National Championship last year after finishing the regular season undefeated.  Good luck as they head into competition this year.  Go Running Eagles!!!!!!!!

As Summer 09 closes out, we here at CCRC are hoping you enjoyed your summer experience.  Michelle and I took Townson to the pediatrician today and he weighed in at a whopping 12 lbs.He is growing (and eating) very nicely.

We just love him so much.

Regards,

Dr. Green

Townson is 41 days old today.  The cliche is for real.  It really does pass so quickly.  He is growing so much. 

Can you believe it's already September?!?!  School is back in and we've been doing a lot of school and sports physicals....primarily for those Estero Mustangs.  Get out there and support your local youth athletes...they are the future. 

Just a head's up...October is National Chiropractic Month.  We will be offering a special or two during October so stay posted.

In closing, on a sad note, Lynette has informed us she is retiring at the end of this week.  She has done so for personal reasons. She will be missed.  In light of this, we have hired two new LMTs.  One, Mary, has a whole bunch of experience, and the other, Brenda, is just starting out, but is quite accomplished in her previous work.  She went out to Colorado this weekend to take some injury and trauma massage courses.  Both will work all five days of the week...so no more just monday, wed, friday.  Phone us or stop in and make an appt today!

In the words of Lynette......go out and make it a great day!!!!!!!!!!!!!!!!!!

Dr. G

Natalies, our Registed Chiropractic Assistant, also attended.  It was her first ever chiropractic event. She attended all her classes and had a great time. She seemed quite enthused and was happy to learn as much as she did. 

Chiropractic truly is a growing, vibrant community.  It's lifestyle fosters health and happiness.  Sure there are a few bad apples out there, but Chiropractic Care and Rehab of Estero will not allow them to spoil the bunch.

We are coming up on 3 years of practice in Estero and want to thank all of our family, patients, friends and supporters.

Go Estero Mustangs!  Get out there and watch them perform!

Christopher M. Green, DC, of Chiropractic Care and Rehab Center, Corkscrew Road, Estero, has recently earned a PES or Performance Enhancement Specialist Certification from NASM, The National Academy of Sports Medicine.  The 12 module course focuses on integrative, functional training for athletes, weekend warriors, persons in chronic pain and persons post-surgical.  Dr. Green can be reached at 495-1166 or chirocareandrehab@gmail.com

On Friday, August 15, from 9 to 5, we are having our Children's Day.  Parents of established patients or parents of children who are not patients (and sign a consent form) and would like health questions answered, are free to bring your children in for question and answers regarding health topics such as

*neck and back pain

*chronic ear infections

*asthma or respiratory problems

*weight gain or weight issues

*headaches

*scoliosis

Phone 495-1166 to set a time. cg

Welcome to the first ever blog entry for Chiropractic Care and Rehab Center.  These are exciting times around here!

First off, my wife, Dr. Giroux, and I are expecting our first child very soon.  Our midwife informed us yesterday Michelle is already 2cm dilated and 80% effaced.  We may have the baby a week prior to the given 'due' date.  We are very happy and excited.  We are also trying to get as much sleep as possible.

Also, we have a new website. This site has more video applications for patients to watch and educate themselves.  We also have this blog format.  In the future, I will add sites for links to different spine literature and exercise sites.

Last but not least, we are proud to welcome our new front desk manager, Michelle Tisch, to the practice.  Michelle is originally from Brooklyn, NY.  She lives in Naples with her husband, Michael, and two daughters, Brandy 14 and Nicki 12. Myself, Dr. Giroux, Lynette and Natalie are also still here. Stop in and say hello.

Go out and make it a great day!

Mom and baby are resting and recovering.

If you'd like to see some pictures, go to

www.naplesbirthcenter.com/ShowPicture.asp?id=300

We couldn't be happier.

Chris

She was strong and beautiful throughout.

We welcome Townson Michael Green into the world.

Mom and baby are healthy, happy and resting.

Wanted to let you know I am quite close to completing some advanced studies online.  I have two more modules before I earn a PES or Performance Enhancement Specialist Certification.  The course is throught NASM or The National Academy of Sports Medicine.  This PES Cert is similar to an athletic training cert however it not only focuses on injury treatment but more importantly or injury prevention, stabilization, strength, and power building for today's athlete. I have already taken some of this knowledge and applied it to my normal treatment routines for some of you, my patients. If anyone is interested in building a training regimen for sports, golf, running, weight training or contact sports, I am all the more willing to help.  I'll let you know when I finish the course.

Lastly, with some of the changes taking place with the Obama Administration, namely the mobilization toward a national health care initiative, it is all the more imperative chiropratic supporters and patients voice their support for inclusion and expansion of covered services in all national health care reform.  This office has taken steps to act on our patients behalf.  We are asking anyone interested in standing up for chiropractic to go to www.ChiroVoice.com or www.AdjusttheVote.com for information about how you can stand up and be counted for chiropractic.

All the Best,

Dr. Green

In other, more clinical news, after a major evidence review, the UK's National Institute of Health and Clinical Excellence (NICE) has issued a new guidline on early management of persistent non-specific low back pain.  It recommends several treatment approaches.  According to the guideline, your health care provider should recommend one of three main therapeutic paths: 1) a structured exercise program; 2) a course of manual (hands-on) therapy, either chiropractic, PT or massage: or 3) accupuncture.  The guides are appropriate for persons symptomatic more than six weeks but less than a year.  The guides recommends an intensive physical and psychological treatment program for those who have completed the less intensive treatment, or all 3 treatments, and yet still have high levels of diability and significant psychological distress over their pain. See

www.nice.org.uk/guidance/CG88

First, Eugene Carragee, MD and colleagues from Stanford found that discography speeds disc degeneration over a 7 to 10 follow up period...(discograph) "resulted in accelerated disc degeneration, disc herniation, loss of disc heigth...".  Discography is both radiography and a pain provoking procedure where a contrast medium is injected into the disc to see it better while taking a picture and to see if this injection reproduces pain.  It is usually done to identify candidates for surgery.  This new studysuffests that puncturing the disc has far greater risks than previously thought.

Two, THE OVERUSE OF SPINAL IMAGING HAS LITTLE TO DO WITH PATIENT'S CLINICAL CHARACTERISTICS

H.H. Pham, MD and colleagues analyzed Medicare claims from 2000 to 2002 and 2004 to 2006 assessing the appropriateness of imaging based on National Committee on Quality Assurance (NCQA) protocols. They found significant overuse of imaging in the Medicare population with 88% getting xrays and 11% getting CT or MR scans.  Of interest, large group practices were more likely to order early imaging than small group practices.  It was pointed out by Richard Deyo, MD, that 'giving into patient demands for imaging may send the wrong message' for example in a 1987 study, Deyo, et al. it was found that when xrays were performed for low-risk patients with back pain, it heightened patients' expectations that imaging should be a standard part of the back care process.

Of note, one month ago I wrote a paper about this exact same topic, how Xrays and MRs should not always be the first thing your doctor does because MANY times, there are false positives or no disctinct pain generator shows up on the picture.

Happy Fourth.  Happy Birthday America!