Monthly Archives: November 2017

A Commentary to All Healthcare Providers, Regulatory Bodies & Patients:

Arthritis

There are many forms of arthritis, the most common being degenerative osteoarthritis.

Some facts excerpted from The World Health Organization literature indicate several shocking realities.*

  • Arthritis is considered to be the nation’s number one crippling disease and the most common chronic disease of people over the age of 40.
  • According to the Center for Disease Control and Prevention, an estimated 46 million adults in the United States have been told by a physician that they have some form of arthritis, including degenerative osteoarthritis, rheumatoid arthritis, gout, lupus or psoriatic arthritis.
  • By 2030, a startling 67 million Americans age 18 years or older are projected to have arthritis—a 45% increase from current statistics.
  • The average age that arthritis begins is 47 years, with 1 in 2 Americans over age 65 dealing with some form of arthritis.
  • The cost of arthritis due to lost wages, medical treatment and other related expenses can run an individual over $150,000 in expenses over their lifetime.

These facts are significant–the solutions less so. Physicians are prone to prescribing analgesics, anti-inflammatory medications and muscle relaxants or inject cortisone, xylocaine and a variety of lubricating solutions. All of these mask symptoms temporarily, however they do not provide a permanent solution.

Laser Therapy, a relatively new technology perfected by Meditech International Inc. in Toronto, Canada currently offers up-to-date, professional therapeutic systems along with Home Units for utilization by individuals who have not had their problems resolved by conventional and traditional methods, including surgical procedures. Symptoms generally improve immediately following the institution of Laser Therapy. Applying treatment in a cumulative fashion stimulates the reduction of symptoms over time resulting in the patient’s return to a normal range of activities without the utilization of analgesics or other medications.

Unfortunately Laser Therapy is seldom mentioned as a solution as it is not covered by the codes, insurance programs, national health care systems and other mainstream regulatory bodies. The reasons: medicine is slow to change and vested interests will go to great lengths to provide protection for their products, regardless of the lack of value induced.
At this point in time, it must be clearly understood that the BioFlex Laser Therapy Systems offer ongoing relief of symptoms of arthritis in all areas of the body by restoring the normal morphology and function of the cells.

In addition, the therapy provides a potent anti-inflammatory effect and boosts the immune system while restoring the integrity of the cells. Regeneration of cartilage is also a part of this process, which is administered in a pain-free and completely safe manner.

Comparatively speaking, the cost is minimal and each treatment stimulates the healing process to a higher level, making surgical interventions such as arthroscopy, joint replacements and spinal surgeries in the majority of instances redundant.

As time progresses the patient can discard all pharmaceuticals and focus on a healthy diet and activities such as swimming, stretching and walking to achieve a complete recovery.
The facts regarding the efficacy of Laser Therapy are undeniable. At our Meditech Rehabilitation Clinics, this reality can be seen many times over the course of each day and the changes which patients often describe as “a miracle” have come to be an almost standard outcome.

A recent example of results achievable is the case of Jerome Williams, also known as “J.Y.D.” or Junk Yard Dog, a brand label that he has acquired over a stellar ten year career in the NBA.
Jerome presented for treatment at one of our clinics in April and immediately noted improvement. He acquired a Home System and a month later, a Professional System for stationary therapy at his home in Las Vegas, Nevada. The results achieved have been so dramatic that at the age of 44, he has returned to a professional career in basketball in the newly formed 3D League.

Once again, his play is outstanding and in addition he is continuing his long-standing career with the NBA as a goodwill ambassador of the league. J.Y.D. is also involved in many charitable and educational organizations in his post-NBA career. I am pleased to state that he is a perfect example of what can be accomplished with the intelligent application of BioFlex Laser Therapy, a technology that can replace all current and conventional treatments for arthritis.

For additional information, contact Meditech International Inc., Toronto, Canada 416-251-1055, or review our website www.bioflexlaser.com.

LASER THERAPY IN THE TREATMENT OF NEUROLOGICAL PATHOLOGIES

ABSTRACT

This patient demonstrates the benefits of Laser Therapy in the treatment of the neurological problems that typically present at our clinic. It cannot always be accurately determined how much benefit is obtained secondary to Laser Therapy, but in this case, prior to February 2017, the patient’s status had plateaued completely. Subsequent to the initiation of Laser Therapy in February 2017, his ability to speak and the improvement in his visual fields, in view of the absence of other factors, must therefore be attributed to Laser Therapy.

CASE PROFILE:

  • Chiari Malformation-Left Temporal Lobe with spontaneous intracranial bleeding episode. (December 31, 2015)
  • Emergency Craniotomy. (January 1, 2016)

MEDICAL HISTORY:

The patient is a 22-year-old male, who had been diagnosed with an intracranial arteriovenous malformation in the left temporo-parietal area, diagnosed two years prior to treatment at our facility.

At that time, he had sustained an intracranial hemorrhage with a subsequent rise in intracranial pressure. The situation required an emergency craniotomy in order to evacuate the hematoma in the left posterior temporo-parietal lobe.

An MRI post-surgery revealed a discrete area of encephalomalacia involving the parietal operculum and the posterior temporal lobe extending to the left side of the brain.
As a result of the surgery, the patient continued to have significant visual disturbances, memory loss, cognitive issues and aphasia. His ability to speak was markedly reduced, along with comprehension at many levels. An automated visual field perimetry study performed post-craniotomy revealed a total inferior right homonymous quadrantanopsia, consistent with the cortical damage that had occurred.

PHYSICAL EXAMINATION (February 2017):

Aside from the visual impairment and aphasia, there was a modicum of findings with regard to other abnormalities.
There was a loss of normal curvature of the cervical spine and moderate tenderness over this area.

DIAGNOSIS:

  • Chiari Malformation-Left Temporal Lobe with spontaneous intracranial bleeding episode.
  • Emergency Craniotomy.
  • Visual Field Impairment/Aphasia, along with Moderate Cognitive Impediments
  • DISCUSSION:

    The patient received a total of four Laser Therapy sessions involving the cervical spine, brainstem and cerebellum at the Meditech Rehabilitation Clinic beginning February 21, 2017. As he lived at a distance from the clinic, his caregivers were trained on the utilization of the Home System and continued the treatment subsequently at regular intervals. The areas treated included the cerebral hemispheres and the cervical spine.

    After several weeks of treatment, the patient’s attendance at university was resumed.

    Six months post-initiation of Laser Therapy, the patient had a follow-up appointment with his ophthalmologist. An automated visual field perimetry study was performed and revealed a 10% decrease in scotoma. The quadrantanopsia did not cross the vertical midline.

    Enclosed in this communication are his visual fields prior to starting Laser Therapy and six months after continuing treatment. His ophthalmologist was impressed with the improvement noted considering that the trauma had occurred almost two years prior to initiating Laser Therapy. His initial quadrantanopsia had been considered to be permanent.

    As his improvement in speech and vision are continuing to move forward, the patient was advised to continue with both the cranial and cervical Laser Therapy under our supervision.

    INTRODUCTION:

    For over 30 years, Laser Therapy has been effectively used in the treatment of many medical conditions, including musculoskeletal, dermatological problems, wound healing and more recently, the treatment of neurological conditions.

    The technology has been utilized for over 40 years and over the past two decades, has made significant progress. Laser Therapy is a non-invasive, light-based therapy that applies a combination of red and infrared light sourced from red and infrared LED’s and laser diodes.

    Photon particles are absorbed by the mitochondria through cytochrome c oxidase, causing a photodissociation of nitric oxide from cytochrome c oxidase resulting in increased cellular ATP levels. The dissociated nitric oxide levels also promote vasodilation and improve arterial perfusion.

    Transcranial Laser Therapy has been demonstrated to significantly improve outcomes in patients of all types. Lampl et al wrote that “Although the mechanism of action of infrared laser therapy for stroke may not be completely understood, infrared laser therapy is a physical process that can produce biochemical changes at the tissue level. The putative mechanism involves stimulation of ATP formation by mitochondria and may also involve prevention of apoptosis in the ischemic penumbra and enhancement of neurorecovery mechanisms.”1

    Apart from ischemic heart disease, stroke (CVA) is the leading cause of death worldwide. The current approved treatment is to apply tissue plasminogen activator within 3 hours of onset of a CVA. Although this method is effective in clearing blood clots, the narrow time window that exists for effective treatment limits treatment options for the majority of stroke victims.
    Laser Therapy has been investigated as an alternative treatment for CVA and has been shown to have a neuromodulatory and neuroprotective effect, while regulating many biological processes.

    MECHANISMS OF ACTION

    Photon particles are absorbed by the cerebrospinal fluid and distributed throughout the cranium, including the ventricles. These confer a significant neuromodulation effect. The particles of energy are also absorbed by the arterial, venous and lymphatic systems and are thereby transported to the fluid surrounding the central nervous system and the spinal cord. Additional benefit is transmitted by direct irradiation of the soft tissues and the skeletal system of the area involved.

    1Lampl Y. Zivin J.A. Fisher M. Lew R. Welin L. Dahlof B. Borenstein P. Andersson B. Perez J. Caparo C. Ilic S. Oron U. Infrared laser therapy for ischemic stroke: a new treatment strategy: results of the NeuroThera Effectiveness and Safety Trial-1 (NEST-1) Stroke. 2007; 38:1843–1849

    Automated Goldmann Visual Fields (December 23, 2016)

    • Right Homonymous Inferior Quadrantanopsia
    • This is a typical “pie on the floor” appearance in a visual field that conveys involvement of the optic radiation as it traverses the left temporo-parietal lobe. Note complete scotoma of the left lower quarter visual field.

    Automated Goldmann Visual Fields (August 18, 2018)

    • Right inferior quadrantanopsia
    • Scotoma is not homonymous in this visual field. Note 10% improvement in both visual fields with sparing of the central visual field

Beware Before Swallowing!

The article below is a typical example of the inappropriate dispensing of medications simply for the easy relief of symptoms. The latter may not even be a significant problem and it would be more appropriate for the physician to deal with these matters by assessing the patient more extensively prior to resorting to prescribing. A few minutes of discussion can most often avoid the “instant gratification” provided by writing a prescription.

According to current trends, cannabis may soon be over prescribed and in many situations, unnecessarily so, yet the downside of that approach is less hazardous than the many toxic chemicals so casually dispensed.

Before you swallow beware! Instant gratification in the form of a pill is seldom a permanent solution and in some cases may be a deadly one.

Fred Kahn, MD, FRCS(C)

Antipsychotics, not anti-insomnia

National Post (Latest Edition)16 Jun 2017
Sharon Kirkey

Recently, after morning rounds seeing patients admitted to his hospital through emergency, Dr. David Juurlink tweeted: “Can the next doctor wanting to prescribe Seroquel for sleep, just not?”

Of the roughly 20 patients he had seen that morning, four had been prescribed Seroquel, an antipsychotic, for insomnia.

Seroquel and its generics aren’t approved as sleeping pills. Quetiapine, the active ingredient, has been officially approved in Canada for schizophrenia, bipolar disorder and major depression only.

Yet drug-safety experts are growing increasingly alarmed by the drug’s use as a doctor-prescribed nightcap for insomnia, with a 10- fold increase in quetiapine prescriptions for sleep problems in Canada between 2005 and 2012 alone.

Quetiapine is sedating. Like over- the- counter sleep aids, it makes people drowsy. But it also comes with a multitude of potential side effects, according to experts.

These side effects include an odd sensation of tension and restlessness (akathisia), Parkinson’s- like tremors and movement abnormalities, weight-gain, high blood sugar, new or worsening diabetes and, in rare cases, heart arrhythmia that can cause sudden cardiac death. A recent Health Canada review linked quetiapine and other so- called “atypical” antipsychotics to an increased risk of sleep apnea — breaks in breathing during sleep.

Juurlink, a clinical toxicologist at Sunnybrook Health Sciences Centre in Toronto, said quetiapine can also cause a particularly nasty complication known as neuroleptic malignant syndrome, a rare but potentially life- threatening reaction to antipsychotics or major tranquillizers. “Over the last decade, I have seen several patients who have had quetiapine as part of, or one of the contributing causes to NMS,” said Juurlink, whose frustrated tweet to doctors last week was a repeat of one he has sent before.

“I’ve certainly seen people who have been diagnosed with Parkinson’s disease that I’m confident were from quetiapine,” he added. “It’s getting to the point now where, when I admit a patient with Parkinson’s, I reflexively look at their other medications to see, ‘are they on quetiapine?’ ”

pills
According to drug market research firm IMS Brogan, of the 33 million prescriptions for tranquillizers dispensed by Canadian retail drugstores in 2016, one quarter — 8.3 million — were for quetiapine.

Doctors say the drug is being prescribed in low- dose formulations to people with no underlying psychiatric conditions, the majority for sleep. University of B.C. researchers found that 58 per cent of B.C. quetiapine prescriptions in 2010 were for the 25 mg tablet. The dose range for the approved disorders is 150 to 800 mg per day.

“It’s popping up as a patient’s typical medication for insomnia all the time,” says Kamloops emergency physician Dr. Ian Mitchell. “It’s not well supported by any science for use in sleep, it has significant side effects and yet it’s massively prescribed.”

“Seroquel is not benign,” Dr. David Gardner, a professor of psychiatry and pharmacology at Dalhousie University said in an email. “It may be more dangerous than our standard sleeping pills, but without research we cannot know or quantify its risks.”

It’s not clear how antipsychotics have become such a big thing for sleep. But observers point to aggressive marketing and industryfunded “opinion leaders” who’ve described quetiapine as a “mild, not harmful” drug that seems to help with sleep.

marijuana

Some users swear by it. “Seroquel helps me for sleep when nothing else will,” according to one online reviewer. “The only bad thing is 30 ( minutes) to one hour after taking it, I’m starving!!” Others describe feeling spacey and foggy the next morning.

Juurlink said quetiapine might shorten sleep latency — the time it takes to fully fall asleep — by a few minutes. It can also make people less aware of their “nocturnal awakenings” than they might otherwise have been. It’s a potent antihistamine, like diphenhydramine, the active ingredient in Benadryl and other “nighttime” cold remedies.

“But what’s really driving this is a societal expectation that we should all get eight hours of sleep a night, a pill is a way to go about it, and the willingness of some providers to accede to requests for sleeping pills,” Juurlink said.

While quetiapine has proven safe and effective for approved conditions, and most of the side effects have been reported during highdose treatment, side effects such as tardive dyskinesia — abnormal movements of the face and jaw — have been reported with low-dose regimens as well, according to the UBC Therapeutics Initiative.

Abuse of quetiapine is also a growing problem, with people inhaling or injecting crushed or dissolved tablets.

Mitchell says it’s hard to explain the “inherent hypocrisy” of the massive prescribing of an antipsychotic for insomnia, while medical leaders are warning doctors to be wary of prescribing marijuana for sleep.

“I’m not asking people to smoke a joint in a nursing home for sleep, that’s not what this is about,” he said. “But there may be some alternatives to some of the damaging medications that are out there, or ways to replace them with cannabis.”