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!