Monthly Archives: June 2018

Guidelines for Patients To Explain the Progress of Healing With Laser Therapy

06/6/18

As most of us know, disease entities follow many different paths. The clinical picture may be chronic or acute and in most cases lies somewhere in between. Periodically, symptoms may be severe and may even constitute an emergency.

Rate of Healing
Surprisingly, a significant percentage of patients will feel markedly improved or even be asymptomatic after as few as 2 to 5 treatments. On the other hand, cases with similar diagnoses may take up to 15 or more treatments to cure the same condition. This relates to the severity of the disease process, the genetic makeup of the patient’s individual cells and their inherent preponderance to healing.

In the majority of cases, the rate of healing cannot be predicted in advance; however, it generally becomes apparent after the first 3 to 4 therapeutic sessions. Excessive degrees of physical activity however, may aggravate the disease process; therefore this is a factor which should be controlled during the course of treatment. The level of compliance with the physician’s directives are also of significant importance and should be carefully followed.

In the course of our daily activities at the clinic, I frequently see patients who state that they are relatively asymptomatic, again following only 2 to 3 treatment sessions and others with similar problems who have improved only minimally after as many as 8 to 9 treatments. In the latter situation, we find that resolution may often be only 1 or 2 treatments away. This demonstrates the many pathways of healing in individual patients.

Cooperation in order to accelerate the healing process is required by the patient, the therapist and the diagnostician. As you may appreciate, healing is not a direct or instant process as the enclosed testimonial indicates (see page 6). This patient was treated with many manual therapies, a number of conventional modalities and medications over a period of 3 to 4 years. Despite this, prior to the application of laser therapy, minimal improvement had only occurred at infrequent intervals. Many similar records of this type of healing endeavor are contained in our files and serve to reinforce my comments.

To reiterate, the following factors are of paramount importance in the production of a satisfactory healing process:
1.) Compliance with the physician’s directives – When the patient carefully follows the clinical dictates prescribed and pursues the course of treatment indicated, healing is generally more rapid than if the patient presents only on occasions of convenience.
2.) Activity levels – When symptoms are acute, rest should be prescribed by your attending clinician or as dictated by the severity of symptoms. Generally, it is important to reduce activities involving the injured area to a minimum. Frequently, one may enlist the use of aids such as crutches, canes and walkers, etc., depending on which area of the body is most severely affected. Bedrest along with the utilization of specific medications may be beneficial concomitant with the utilization of laser therapy, particularly when associated with arthritis and injuries of the spine.
3.) Analgesics and other complementary modalities – These may be utilized as indicated and advised by your personal physician. The patient should disregard the simultaneous advice of multiple healthcare advisors as this may be confusing and counterproductive. Laser therapy, rest and medications as required generally provide a relatively rapid and satisfactory course of resolution of the pathologies encountered.
4.) Common sense is always applicable – Do not engage in activities that increase symptoms including pain, etc. If it is painful to walk or engage in any activities, avoid those activities until symptoms have largely disappeared. Some factors that exist cannot always be controlled and therefore require persistence in continuing Laser Therapy. Do not cease treatment too early as a cure may be only a few treatments away. Laser Therapy is cumulative and in the majority of instances, coupled with rest and time, the healing process can be completed effectively. Progress can often be measured by serial measurement of the dimensions of the joint, the circumference of a limb, the range of motion of the spine or a computerized assessment of the three-dimensional wound.

Your physician should always takes a positive approach. If you follow this lead, complete healing in over 90% of cases can be achieved. As someone once commented, patience can be a virtue, particularly when applied to the process of tissue healing. Laser therapy, properly utilized, can speed the resolution of your particular problem and restore the normal standard of health and quality of life expeditiously.

LASER THERAPY AND OTHER TERMINOLOGIES

06/6/18

Laser Technology, from the descriptive perspective, is also identified by a variety of alternative terminologies. These include – photobiostimulation, phototherapy, light therapy, low level laser therapy, cold laser and the list, depending on the origin of the therapeutic culture, is literally endless. I think the time has come to describe the technology more simply and accurately. This should resolve any existing confusion and its accompanying inaccuracies.

A considerable number of years ago, during the course of a two-day focus seminar at Meditech International, several experts attending the meeting decided to coin the term, “Low Intensity Laser Therapy,” which was generally felt to be the most correct by definition.

High intensity laser diodes, which can cut steel and other materials in the course of utilization will inevitably destroy cells if used in their environment. This can be useful during the process of cauterizing veins and arteries while performing surgical procedures and the ablation of many types of tissues, including moles, polyps, tumors, dermolysis and other situations where a localized destructive process is required.

For the purpose of simplification, we have shortened the most accurate descriptive terminology to “Laser Therapy”. Whereas this process is sufficiently potent from the power perspective to initiate a cascade of positive or constructive physiological reactions within the cell, it is distinguished from the extensive number of higher powered lasers, which are generally utilized in the controlled destruction of tissue. For the purpose of tissue healing, the process works according to the dictates of the Arndt-Schulz Law.

In recent years therefore, as indicated, we have abandoned all previously utilized terminologies in favor of the term “Laser Therapy.” This description is simple, accurate and more widely inclusive. It should be noted that the technology is constructive with regard to the restoration of the normal morphology and function of the cells. Moreover, it is used to stimulate the replacement of cells that are functioning suboptimally or not at all. It is athermal, rather than thermal – another common belief that is erroneous. Ambient temperatures should not be elevated by more than 4 to 5 degrees at the treatment site.

I believe that this explanation, although brief, should clarify the concept of the BioFlex Laser Therapy System and most Class III Devices.

A Summary of the Signs and Symptoms of Cerebral Concussion and Guidance – Re: Clinical Management

06/1/18

Etiological factors may vary from a minor blow to the head, often combined with a whiplash-type injury of the cervical spine resulting in a symptom complex that may be minimal in degree. However, when the trauma is more severe, it may render the patient comatose for prolonged periods of time and even result in death. In most instances, symptoms are brief in duration and last for a matter of days to several months.

The Center for Disease Control and Prevention defines concussion as “a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces, secondary to direct or indirect forces applied to the cranium.”

Symptoms can last from minutes to days and in some instances become chronic or permanent. Early symptoms include headaches, pain in the cervical spine, nausea, dizziness, an inability to focus or concentrate, memory loss, visual disturbances and in a small number of cases induce loss of consciousness or even coma.

The Glasgow Coma Scale classifies concussion based upon the level of consciousness of the patient. Mild concussion typically allows complete neurological recovery. Moderate concussion can result in stupor and lethargy. In cases of severe concussion, patients may experience a comatose state, a heightened risk of hypotension, hypoxemia and edema of the brain. Invariably, all forms of concussion result in varying degrees of inflammation of neurological tissue, accompanied by pain and neurological impairment.

It has been determined that MRI, PET scans, EEG studies, etc., generally do not reveal any significant abnormalities in the early phases of the disease. Macroscopic changes of cellular tissues may not accompany the symptoms that exist until a significant period of time has elapsed.

Usually, traumatic episodes that result in concussion include a collision with an opposing player when engaged in sports activities, falls and other incidents sustained in the home, motor vehicle accidents and the numerous traumatic episodes related to military activities. The majority of episodes cause only minor symptoms, which usually disappear over a finite period of time, in most cases without any specific therapy being applied.

It has been calculated that somewhere in the vicinity of 10 to 20% of all cerebral concussions that have been formally diagnosed result in symptoms, which if they persist over a period of time may become chronic. In all of these cases, appropriate therapy should be applied and continued until the patient has been asymptomatic for a period of at least 2 months while engaged in relatively normal activities.

The symptoms most frequently reported consist of headaches which may take many forms. Generally, they are fronto-occipital in location accompanied by pressure sensations, stabbing, aching, throbbing, etc. They may be intermittent or exist on a 24/7 basis. The majority of these patients also complain of pain in the cervical spine with or without radiation to the upper extremities. Insomnia, irregular sleep patterns and cognitive impediments may be minimal to extreme. These include difficulty in finding words, the normal comprehension of reading material, TV content, an inability to focus and concentrate and in essence, mentation is impaired in varying degrees. Memory loss may be short or long term and in some instances both. Often this relates to the duration of the period of loss of consciousness, which however in the majority of cases does not occur. As previously indicated, the injury may induce a prolonged state of coma or even death.

Symptoms may also include a loss of sense of taste, reduced auditory acuity, tinnitus and visual disturbances including blurring, double vision, etc. Both light and sound sensitivity are frequent and may persist. The patient may be unable to attend school, work, lose the ability to socialize and be unable to engage in normal relationships. Irritability with periods of labile mood disorders may be accompanied by loss of anger control. Fatigue, anxiety and depression may be present in both the early and late phase of cerebral concussion. With the development of chronicity however, they may become the most dominant long-term problems.

An increasing number of neuroscientists believe that many years later, neurological diseases such as Parkinson’s disease and the dementias may result from a traumatic episode of the brain experienced much earlier in life and long forgotten.

All patients who have sustained cerebral concussion with persistent symptoms should be monitored until asymptomatic and in most cases based on clinical findings and progress, should be subjected to curative Laser Therapy and in some instances preventative treatment.

Certainly, in patients who remain symptomatic even for a week without improvement, a course of Laser Therapy based on thorough clinical evaluation is advisable. A standardized or individual customized course of treatment for each patient should be administered as clinically indicated.

In conclusion, all patients who have sustained a cerebral concussion should undergo an ongoing course of Laser Therapy, unless symptoms improve rapidly post-trauma spontaneously. The purpose for this is not only to relieve symptoms but to prevent chronic damage to the intracranial tissues. Therapy can be standardized or customized and ideally should be applied every 2 days initially.
• Depending on clinical change, the protocols are changed according to the progression or resolution of the severity of the symptoms.
• This applies particularly for patients who are severely affected and present for an assessment relatively early after the injury.
• In chronic cases where symptoms persist regardless of the time period elapsed since the trauma, curative therapy should continue for at least 2 months subsequent to the resolution of all symptoms. Depending on the nature and duration of the injury and unless symptoms are improving rapidly spontaneously, treatment should be applied as early as possible and continued for a minimum of 8 weeks during which the patient is able to engage in normal activities.
• Each case must be assessed on its own merits and treated accordingly.
• In our experience, Laser Therapy should be considered the treatment of choice and be continued until the patient is asymptomatic, fully active and does not require any other therapy, including medications.

Conclusion: All patients who have sustained a cerebral concussion and continue to demonstrate symptoms receive a course of Laser Therapy tailored to their individual situation. Ideally therapy should be continued every second day until the patient has become asymptomatic for at least 2 months.

Generally, protocol settings are initiated at lower levels and increased in accordance with clinical change. As symptoms diminish in the degree of severity, the frequency of treatment can be gradually reduced, but not during the first 2 to 4 weeks.

All patients require periodic clinical assessment incorporating appropriate measurements to determine improvement as the course of treatment progresses. Symptoms should diminish rapidly in most instances when all appropriate parameters are observed.

The entire process should result in a significant improvement/cure rate in all categories of cases treated. This should be accompanied by the restoration of the patient’s quality of life, normal activity levels, and a total absence of symptoms.