Chances are we all have experienced the aches and pains of a preventable injury at some time on our life. But, what do we do now that we have the tendonitis, the bursitis, the muscle spasms that just seem to hang around to interfere with our tennis, golf, horseback riding? Many patients come in when the ibuprofen, the muscle relaxers, and /or the OTC (over the counter medications) seem to lose their effectiveness. What started as an acute injury may in fact now have become a chronic injury, with the chronic inflammation, pain, decreased ranges of motion, and with potential long term damaging side effects.

First, get a diagnosis. Have a health care professional examine and diagnose the injury at the onset. What may feel like a muscle spasm in the low back may in fact be a herniated disc. Or vice versa. What may feel like excruciating “nerve” pain may be due to a muscle spasm.

Secondly, check out all your treatment options. In some cases, medications such as temporary use of anti-inflammatories, and analgesics may be indicated. Other options may include acupuncture, ultrasound, physiotherapy modalities, specific exercises, and surgery. These therapies can be extremely helpful in decreasing pain, and inflammation, and restoring normal ranges of motion in the joints and muscles. Often these methods when used at the same time improve healing time.

Third, set up and follow a treatment plan. Patients often ask how long will it take to heal? How many treatments of acupuncture and/or ultrasound do I need? How long do I have to take the medicine? It depends on how long you have had the pain. What the diagnosis is? And what have you been doing/and or taking to relieve it or to aggravate it. Unfortunately most people seek medical care only after nothing THEY do helps it. The recovery of an injury most often can be determined by a few things, including the medical attention within the first 24-48 hours, and the person’s ability to heal. For example, patient after patient has come in complaining that at first the “hot tub” felt great, and the next morning they couldn’t get out of bed. This treatment is rarely successful in an acute sprain/strain type injury.

Following a treatment plan from a trusted health care professional often results in the fastest recovery with the least amount of residual pain, and other symptoms. I know from personal experience it is very difficult to hear, “no skiing, biking, golf etc. for the next x amount of weeks.” However difficult it is to avoid favorite past-times, isn’t it more difficult to be injured? Compliance of a treatment plan, especially when it involves doing, or not doing something we do not want to hear is difficult.

Lastly, being preventative does pay off. Let this be part of the plan following treatment. Preventative measures may include specific exercise, protein supplementation, glucosamine sulphate, chondroitin sulphate, calcium/magnesium, MSM, and other vitamin and mineral supplementation. Regular acupuncture, chiropractic, physiotherapy, and/or massage may also be indicated. Also, rest
from physical exertion allows the body to heal and recover.

We only have one body. Let us take care of it as we enjoy our lives and our journey.

This is one of the most frequently asked questions in my practice. It is nice to answer this question rather than “Does acupuncture work?”.

We all probably know someone who has had acupuncture treatment for one reason or another, and they testify how great it worked. The fact of the matter is that acupuncture works for some people some of the time. Now back to the initial question of how it works. Basically the technique of inserting very fine needles into specific points results in a specific physiological response.

The outcome is dependent on the combination of points chosen, the clinical ability and experience of the acupuncturist in treating specific conditions, and the individual’s response to a specific treatment. The analogy I like to use is this:

Take a computer. Often here in Bend, we experience an electrical surge, disruption in our service, or maybe even a computer virus. So, we restart, restore or reboot our computers. Injury, illness, stress or trauma to our body is similar.

There is a disruption in, for example, the hormonal or neurological function in our body. By choosing specific acupuncture points, a specific message is sent to the brain. The brain receives this message and responds via the body’s many systems to heal and restore health.

The results may be a decrease in pain and inflammation, regulation of hormones, improved sleep, energy, etc. The difficulty is assessing at the onset of an acupuncture series how many treatments it will take for a specific symptom or illness to improve.

A general rule is a series of 12 visits, usually starting at a frequency of 2-3 per week. The longer the illness, and/or severe, the longer
the duration of therapy. We do occasionally have patients who respond very quickly to few treatments we call them our acupuncture “miracles.”

We also have patients who choose to come in once a month for their “tune-up.” Most of these patients have a philosophy of preventative medicine and are committed to a preventive approach when dealing with their health.

You may be wondering what conditions is acupuncture good for. Acupuncture is indicated in all pain syndromes, acute (sudden onset) or chronic, pre op, and post op. It may also be indicated in stress, insomnia, fatigue, nausea in pregnancy or chemotherapy induced, some cases of infertility, woman’s gynecological conditions, stroke, and decreased immunity.

There has been much confusion as to the differences/similarities between various primary healthcare providers. In the United States, allopathic (MD), osteopathic (DO) and naturopathic (ND) physicians are licensed to provide primary care medical services. Each profession has a rich history, and distinguishing philosophical characteristics.

All three types of medical schools require 4 years of medical education to complete there respective degrees. Instruction includes preclinical and clinical phases. Perhaps the most historically philosophical difference was concerning the use of drugs, and therefore the number of hours of instruction in pharmacology. The number of hours of instruction currently is similar in all three types of school. Emphasis is placed on musculoskeletal manipulation in osteopathic and naturopathic medicine, and these professions pride themselves in their “holistic” approach to health care. This orientation to healthcare in these schools require hours of naturopathic philosophy, and osteopathic principles and practices including manipulative therapy, in the first two years of school respectively.

All three types of medical schools rely on mostly PH.D’s to deliver the basic science instruction. As the training progresses to more applied medical subjects the involvement of faculty with clinical degrees increases. Because of the philosophical differences of the three medical professions, there has been a tendency to rely on members of the same professions for clinically related instructions. Allopathic schools use M.D.s, osteopathic schools use D.O.s, and naturopathic schools use N.D.s for the majority of clinical instruction.

It is in the clinical instruction that naturopathic medicine education departs most significantly from the common path of medical education. Clinical instruction relies most exclusively on outpatient clinics and classroom/laboratory demonstrations under the supervision of licensed N.D.s. It typically contains little or no inpatient exposure. The most significant departure from the common path of clinical instruction is exposure to alternative and complementary medical modalities. This includes training in herbal medicine, nutritional medicine, homeopathy, hydrotherapy, massage, mind-body medicine, and natural childbirth.

The large and growing public demand for alternative and complementary medicine has prompted some allopathic medical schools to introduce such modalities into their clinical instruction. Such integrated clinical education settings are expected to strengthen the common paths of clinical instruction.

The philosophies and practices of allopathic, osteopathic and naturopathic physicians cause each to be distinguishable from the others. I believe it is the common characteristics and the differences that contribute to the high quality of medical care available in the United States. We are able to experience the best of each type of medical modality, and experience an integrative medical approach to meet our health care needs.

Many of us have experienced acute inflammation for example from a sports injury or trauma. A couple of days of drug therapy in the form of antiinflammatory OTC (over the counter) is inexpensive and convenient, or by prescription only Celebrex or Voixx may be indicated.

However, many people are self-prescribing and taking Ibuprofen, Aleve, aspirin, or any number of OTC (over the counter) NSAIDS (non-steroidal antiinflammatory drugs) daily, for either acute or chronic inflammation. These medications have side efects. The purpose of this article is to present ideas and options for people who want long term anti-inflammatory options.

Recent research has shown how the omega 3 fatty acids found in significant amounts in fish oils, especially salmon, sardines, and herring effect the inflammatory pathways in our body resulting in decreased inflammation.

In countries such as Japan and Greenland and the areas bordering the Mediterranean Sea, the population cunsumes considerably higher portions of omega 3 fatty acids than in areas where there is little fish consumption, and the measured risk for death by cardiovascular diseases is decreased. This indicates that years of eating such a diet may reduce vasoconstriction, platelet aggregation, arterial inflammation that leads to heart attack and stroke.

Similairly, it is believed that such diets decrease the incidence of certain cancers for example prostate and colon.

Acute inflammatory manifestations such as asthma, and arteritis are much more difficult to control via diet alone. It is very difficult to get adequate quantities of omege 3 fatty acids to resolve acute conditions, excessive quantities of omega 3 fatty acids, via supplementation may have adverse effects. At high levels, there may be immuno-suppression, and they may serve as pro-oxidants.

In order to achieve a therapeutic anti-inflammatory effect, not only is an increase in the PUFA (polyunsaturated fatty acids) needed, but the ratio of omega 3 to omega 6 fatty acids needs to go up. Therefore, with an dietary increase in dietary omega 3, there must be a corresponding decrease in other oils. For example, decreasing sunflower, palm, corn, cottonseed and safflower oils. Olive oil is unique in that although it has a high amount of omega 3 fatty acids, it also contains a relatively large amount of oleanolic acid which biochemically has an indirect anti-inflammary effect. In order to achieve the therapeutic goal of decreased inflammation, supplemental fish oil would be required and should be only done under the supervision of a physician.

Other options for reducing inflammation in the body is by ingesting herbs that block the inflammatory enzymes. These include drinking tea, consuming garlic, tumeric, quercitin (apples, fruit juices) boswellic acid (frankincense). Many fruits and vegetables also provide flavonoids which may be indirect inhibitors of the inflammatory pathways in the body.

A completely natural regime for a reduction in inflammation may be possible via dietary changes and the use of supplements including fish oils and herb extracts.

One of the oldest functional foods available to mammals is milk. In human newborns, mothers milk has been the relied upon for nutrition. We often hear about the role of mothers milk in building the immune system in infants. There is much controversy about the role of milk (and thus, diary) as a source of nutrition. This series of articles aims to explain and clarify milk as a source of nutrition and its role physiologically in our body.

Milk contains 2 primary sources of protein, the caseins and whey. Whey components include beta-lactoglobulin, alpha-lactalbumin, bovine serum albumin, lactoferrin, immunoglobulins, lactoperoxidase enzymes, glycomacropeptides, lactose and minerals. Whey from buttermilk also contains the lipid sphingomyelin.

The whey remains in an aqueous environment, while the caseins are responsible for making curds after processing. Today we often see whey used as a dietary supplement. Currently there are a number of various whey finished products available. For example: Whey protein isolate, whey protein concentrate, undenatured whey concentrate, hydrolyzed whey. These products often vary in the amounts of protein, carbohydrates and fats. Whey protein isolate is 90-95% protein. It contains little if any lactose, fat and mineral content. Whey protein concentrate has a protein concentration of approximately 25-89 %. There is usually some fat, lactose and minerals. Hydrolyzed whey protein and undenatured whey concentrate vary in the amount of protein, fat, mineral and lactose content. These variables are important because each component has different therapeutic applications.

Whey proteins are complete proteins. They have all the essential amino acids, and are higher in concentration than those of vegetable protein sources. They are also absorbed and utilized efficiently. Furthermore, whey proteins are rich in sulphur containing amino acids cysteine and methionine, which enhances immune function.

Components good for the immune system-
There are a number of components found in whey protein, one of the two primary proteins found in milk — The second protein being caseinate.

1. The first component, beta lactoglobulin constitutes about 50% of the whey protein. It is the primary source of essential and branched chain amino acids.It also ontains a retinol binding protein and thus is thought to potentiate lymphatic response. Human milk contains no beta-lactoglobulin.

2. Approximately 20-25 % of whey protein is alpha lactalbumin. This component is also a source of a wide variety of essential and branched amino acids. Interestingly, this is purified and most commonly used in infant formulas as it is structurally most similiar to breast milk. These formulas however also contain demineralized beta actogloblins due to cost saving measures. Therefore, ulimately the formulas end up less sililiar to breast milk. The alpha lactalbumin has a direct effect on the immune system. Specifically on the B lymphocytic function, T cells and enhanced antibody response to systemic antigen stimulation. It has also been shown to chelate heavy metals and reduce oxidative stress due to its iron-chelating properties.

3. The third component is immunoglobulins. These make up about 10-15% of whey protein. This is the primary component of colostrum. These function as immune modulating proteins.

4. Lactoferrins make up approximately 1-2% of the whey proteins. These are antioxidant, antiviral, antibacterial and antifungal. These promote growth of benficial bacteria and occur naturally in breast milk, tears, saliva, bile, blood, and mucus. Studies on mice have shown lactoferrin demonstrates anti-inflammatory properties.

5. Lactoperoxidase is an important enzyme in the whey fraction of milk. Although is makes up only 0.5% of the total proteins found in whey, is is a very biologivallay significant component. It has the ability to catalyze (change) certain moleculesand therefore can inhibit or kill various bacterial species.

6. Bovine Serum albumin is a large protein and makes up about 5-10% of whey protein. It is a source of essential amino acids.

7. Glycomacropeptide (GMP)is the final component of whey protein and makes up approximately 10-15% of whey protein. It is also known as casein macropeptide. This component does not contain phenlalanine, tryptophan and tyrosine. Therefore is one of the few naturally occurring proteins safe for people with phenylketonuria (PKU).

Clinical Indications of Whey protein-
We have learned that the individual components of whey are beneficial to the immune system. There are, however, specific conditions in which whey protein may be therapeutically indicated.

1. Cancer: Studies have explored the relationship of glutathione and the primary immune-modulating mechaniam and found the immune precursors to glutathione in whey. Thus there may be a connection between the anti-tumor and anti-carcinogenic potential of whey. Whey also binds iron, perhaps thus contributing to anticancer potential. Iron may act mutagenic in its capacity to cause oxidative damage to tissues. In animal studies in which colon cancer was induced, whey demonstrated significantly lower number of tumors and fewer aberant crypts. To date few clinical trials on whey and cancer have been conducted. However, for cancer patients whey supplementation may be indicated.

2. Hepititis: In an open study of 25 patients with either Hepatitis B or C patients were given 12 g of IMMUNOCAL (whey). The trial showed promise for the use of whey in the treatment of Hepatitis B virus.

3. HIV: Glutathione is a common deficiency in HIV patients. In a study of 30 subjects receiving Protectamin, a whey source, participants had an increase in Glutathione levels. Glutathione is known as a potent intracellular antioxidant. Furthermore, Glutathione as an antioxidant component of whey, is being investigated as an anti-aging agent.

4. Antimicrobial: In patients diagnosed with H. pylori infection and children suffering from chronic pharyngitis, the addition of the lactoferrin with the antibiotic regime revealed remarkable treatment success rates.. Lactoferrin has also demonstrated antifungal activity towards Candida albicans.

5. Cardiovascular Disease: A small study was done using fermented milk and whey protein supplementationto investgate whether serum lipids and blood pressure would be affected. An increase in HDL, decrease in triglycerides and systolic blood pressure and total cholesterol was seen.

6. Exercise: Whey protein supplementation have been commonplace in the consumer market because of the high protein quality content and high percentage of branch chain amino acids. The BCAA,s are the substrates for synthesizing new proteins. Once again, human studies documenting the use of whey supplementation on muscle size and strength are limited. However, the increase in lean body mass increases with resistance training and with the addition of whey protein. The amino acid content of whey favors protein synthesis and muscle growth. Furthermore, intense athletic training has been shown to stress the immune system due to increased free radical production and increased inflammatory activity. Whey, by donating cysteine ( an amino acid) increases the availability of intracelluler glutathione.

7. Infant formula and infant colic: A climically significant study showed that the infants in the whey formula group had a crying time reduced than was observed in the cow’s milk formula group.

8. Osteoporosis: Increased radial bone density was seen to be increased in a study of 30 women given 40 mg/day of Milk basic protein (MBP) a fractionated component of whey which contains 98 % protein, lactoferrin, lactoperoxidase, and other minor components.

9. Other uses of Whey protein: Due to the wide range of essential amino acids, minerals, biologically active proteins, fats, whey supplementation may play a significant role in clinical nutrition in many conditions and diseases. Adequate protein intake is essential in wound healing, timely, and completely. Trypophan, and amino acid is known to increase brain serotonin levels, perhaps improving cognitive, and coping abilities in highly stressed individuals.

As research continues, the already wide range of therapeutic applications of whey protein will continue to grow.

 Health benefits from dairy products-
Milk is one of the oldest foods available to mammals. In human newborns it is relied upon for nutrition. Scientists are beginning to understand the various components of milk, including whey, and their nutritional and therapeutic applications in health and disease.

In my practice I have seen many individuals eliminate dairy from their diets. In the absence of gastrointestinal symptoms, and/or sensitivities, this may not in fact be clinically indicated. As we have seen, the research in to the therapeutic benefits of whey, and the other components of milk play a significant role in maximizing and maintaining health and wellness. The biological components of whey have the ability to act as antioxidants, anti-hypertensives,
anti-tumor, antivirus and antibacterial, a wide range of immune enhancing properties.

If an individual suspects some sensitivity to milk products, further evaluation may be indicated. The actual sensitivity may in fact be to casein, or lactose. Many people can tolerate whey products if the casein, and/or lactose has been removed. The hydrolyzed whey protein products providing readily available di-and tri- peptide fractions, are low allergenicity and are often favored by athletes.

Many of you by now have heard about the flu vaccine shortage here in the US. Please do not be alarmed. For those of you in the high risk groups, health care providers, very young and elderly, immune compromised etc. there appears to be priority selection. The question is really if the flu vaccine is BEST for you even if you are in these higher risk groups. If you have a concern, please feel free to discuss it with me at your next appointment.

As prevention of getting the flu should be our focus, here is a review of some basic prevention measurements all of us can take as the flu season approaches.

1. Wash hands often.
2. Cover mouths when sneezing, and or coughing.
3. Do not go to work if you are unwell. Please get examined if you have questions about your illness. And if in positions of authority, send
   unwell workers home and/or to the doctors office.
4. Take the immune supporting medications to hasten your recovery and minimize symptoms prescribed by a physician. Do not self diagnose
   and treat.
5. At a minimum, take a daily multi-vitamin/mineral ( and all other supplements prescribed from this office.)
6. Exercise regularly. (Wash hands often at the gym!) The old staying “if it is above your neck it is OK to exercise.” Not necessarily.
7. Stay hydrated with water. The winter months are dryer.
8. Eat a diet high in fruits and veggies, fiber, whole grains, nuts and seeds, and quality proteins.
9. Take prescription medications as prescribed.

For those of you who spend a lot of time in and out of airports here are some additional recommendations:

1. Take 2 droppersful (60 drops) of the BIOSTIM tincture 3 times on the day before, the day of, and the day after your flights, both on the arrival and the return portion of your trip. If you get symptoms take the tincture up to 4 times/day for up to 10 days. (BIOSTIM is available here at the office.)
2. Also wash/clean your hands frequently. Carry hand wipes.
3. Ask to be relocated if someone sitting close to you is coughing, and/or has obvious signs of illness.

Finally, if you or someone you know has the flu, encourage them to be under the supervision of a physician. We have available natural medications that may make the person much more comfortable by minimizing their discomfort and maximizing healing and recovery.