Author Archives: Fred Kahn, M.D, FRCS(C)

ADVISORY RE THE INGESTION OF VITAMINS, MINERALS AND SUPPLEMENTS

This topic should be addressed like everything else in life, relying on intelligent reflection, interpreting what is available in the scientific literature and using common sense. These must be the pillars upon which decisions should be made. Moreover the topic is similar to all cycles that exist, such as the change in fashion so common in the clothing industry where periodically the shift is from narrow ties, to those so wide they can almost be used as shirts, lapels of jackets that are so narrow as to be almost invisible, to those almost covering the shoulders. The utilization of ingredients ingested, like fashion, is often an item of what is being promoted at any particular time by multi-media sources.

Additionally, the climate that dictates use varies according to regulations, public health department proclamations of appropriate dosages and the overwhelming influence of vested interests. Suppression of the knowledge-base and scientific research, unfortunately may govern the advisories that all too often are the promulgators of change.

The industry includes scientists, compounders, manufacturers, distributors, health food stores and pharmacies and they all have one item in common and that is that they all possess varying degrees of self-interest. In the final analysis, therefore, one makes the decision to ingest these compounds, quite often based on a variety of unsubstantiated guidelines. In the end your intuition, coupled with reliable evidence, are the components upon which you should be able to make the most appropriate decisions.

The reason that I am formulating this commentary is that tonight while driving home, I listened to a long-winded discussion on the radio “that stated that no one requires vitamins, minerals or supplements at all”. That may indeed be true but on the other hand all diets, no matter who concocted them, climactic factors, a sprinkling of scientific fact and again, that old common denominator “common sense”, do provide some valid facts and foundations.

Clear-cut evidence has been presented in the past that many areas, geographically speaking, are deficient in certain minerals, therefore small amounts of manganese, magnesium and zinc should be ingested 2-3 times per week, depending on your geographic location. No evidence exists that they are harmful and on balance, they probably extend life to a significant degree.
To summarize, no one has all the answers with regard to the indications for the utilization of vitamins, minerals and supplements. At the same time, a solid base of research indicates that Vitamins D, B-complex, Coenzyme Q-10, Vitamin C, lysine and omega oil should probably be utilized on a daily basis.

Now we come to the great dilemma – what else should we take?

Clearly in iodine deficient areas this substance should be added either to salt or several drops added to the daily fluid intake. Arginine, levo-citrulline, potassium and many other components have been recommended to limit or even promote the regression of atherosclerosis, particularly in the coronary arteries and there may be some significant benefit resulting from the ingestion of these compounds. Whereas the evidence is not conclusive, again, broad-based research provides some valid guidance with regard to the ingestion of these substances. In addition, many have recommended the use of lycopene, curcumin and acta-resveratrol for cancer prevention.

Conclusive evidence is not yet available supporting the ingestion of beta-carotene, folic acid, Vitamin A and a number of other vitamins to improve vision and prevent macular degenerative disease, however small amounts taken infrequently, perhaps 2-3 times per week, may bring some benefit without causing harm.
In summation, I can simply state that a well-balanced diet, consisting of organically grown fruits, vegetables, wild fish, lean meats, etc. should be the basis of a comprehensive diet. Portion control to avoid obesity should also be kept in mind, although on the diet suggested, this should not be a factor. Foods that are adulterated, processed and suffused with preservatives should be rigidly avoided, along with refined sugar, flour and most condiments.

At least one half hour daily of vigorous exercise is beneficial for the maintenance of the health of all tissues. Swimming, stretching and brisk walking on soft ground are certainly exercises that should be added to your wellness program. In addition, avoiding tobacco completely and ingesting alcohol in moderation are guidelines in the maintenance of good health.

Sufficient hours of sleep are beneficial, allowing tissues to recuperate and the body to eliminate toxins. Another significant factor, as scientifically documented by Hans Selye, is the tremendous importance of the avoidance of stress at all levels. Should you find it problematic to deal with stressful situations, resolve the condition or distance yourself from it. Either course is effective and highly recommended. Do not harbor or continue with stressful situations, as they are extremely detrimental to both your mental and physical status and detract significantly with regard to your longevity and quality of life.
Clearly there are no absolutes for what you should and shouldn’t do, however the above recommendations could extend your life by ten to thirty years. Some additional considerations might be gene typing to determine the probability of cancerous lesions developing, however, frequently it is better not to know.

Dietary recommendations vary from time to time. Whereas 15-20 years ago “fat was bad”, now some fats are good and highly recommended. Sugars appear to have taken the place of fats and are deemed correctly to be highly detrimental to good health. Glucose, which is known to be hidden in virtually all processed foods, may bind with proteins in the brain producing significant dysfunction of that organ and may be an etiological factor in the development of dementias, Parkinson’s and other dysfunctional neurological states.

Summary of Guidelines

1. Balanced Diet
2. Supplements, Minerals & Vitamins (as indicated)
3. Vigorous Exercise – 30 minute daily minimum
4. No Smoking
5. Moderate Ingestion of Alcohol
6. Eliminate Neurotoxins
7. Avoid Stress
8. Adequate Sleep for Revitalization

In conclusion I believe that these matters integrated into your individual daily programmes should prolong your life and again should be ingested with a modicum of “common sense”.

Commentary:

If you as a practitioner have the objective to get your patient well, don’t rub, push, pull, manipulate or sedate the injured cells. Heal the cell utilizing the BioFlex Laser Therapy System. It is simple, easily applied, pain free and will produce the desired result in a relatively short period of time.

The Unravelling of Obama

Another example of the outcome of poor leadership. As I always say, everything that goes wrong or right begins at the top. Unfortunately most of the time it goes wrong.

For concision and precision in describing Barack Obama’s suddenly ambivalent relationship with his singular — actually, his single — achievement, the laurels go to Rep. Steve Scalise (R-La.).

After Obama’s semi-demi-apology for millions of canceled insurance policies — an intended and predictable consequence of his crusade to liberate Americans from their childish choices of “substandard” policies sold by “bad apple” insurers — Scalise said Obama is like someone who burns down your house. Then shows up with an empty water bucket. Then lectures you about how defective the house was.
What is now inexplicably called Obama’s “fix” for the chaos he has created is surreal. He gives you permission to reoccupy your house — if you can get someone to rebuild it — but for only another year.
At least he has banished boredom from millions of lives. Although probably not from his.

The place to begin understanding the unraveling of his presidency is page 274 of “The Bridge: The Life and Rise of Barack Obama.” The author, David Remnick, editor of the New Yorker, quotes Valerie Jarrett, perhaps Obama’s closest and longest-serving adviser, on her hero’s amazingness:

“He knows exactly how smart he is. . . . I think that he has never really been challenged intellectually. . . . He’s been bored to death his whole life. He’s just too talented to do what ordinary people do. He would never be satisfied with what ordinary people do.”

Leave aside the question of whether someone so smitten can be in any meaningful sense an adviser. About what can such a paragon as Obama need advice? (Although he did recently say, “What we’re also discovering is that insurance is complicated to buy.” Just to buy.) It is, however, fair to note that what ordinary people ordinarily do is their jobs, competently. Obama’s inability to be satisfied with anything so banal has plunged him into Jimmy Carter territory.

Carter’s presidency crumbled when people decided they still liked his character but had no confidence in his competence. Obamacare’s misadventures, and Obama’s response to them, have caused people to doubt both his character and his competence.

The White House, disoriented by adoration — including the self-adoration — of its principal occupant, sits in a city that has become addicted to its own adrenaline. It is in a perpetual swivet stoked by media for which every inter-institutional dust-up is a crisis.

This year began with the “fiscal cliff” crisis. (You may have forgotten, there having been so many supposedly epochal events to keep track of: All the Bush tax cuts were set to expire; the “crisis” ended when only those cuts for the wealthy were allowed to lapse.)

Then came spring and the “sequester crisis,” meaning discretionary spending “slashed” by “draconian” cuts of . . . 2.3 percent. Autumn brought the crisis of the shutdown of (part of) the government and the crisis surrounding the inevitable raising of the debt ceiling. The ostensible crisis was that the Obama administration might choose to default on the nation’s debt even though government revenues were 10 times larger than required to service the debt.

Good grief. The 1854 passage of the Kansas-Nebraska Act was a crisis. As was the 1857 Dred Scott decision, the Great Depression and Pearl Harbor. But as for 2013’s blizzard of supposed crises: Arguments between the houses of Congress, or between the executive and legislative branches, about money should not be called crises; they should be called politics. The separation of powers that is the essence of the constitutional system assumes rivalrous institutions. When, however, the conflict is not about money but about the nation’s constitutional architecture, perhaps the language of crisis is apposite.

The New York Times reports that last March Henry Chao of the Centers for Medicare and Medicaid Services, which superintended creation of the HealthCare.gov Web site, told a conference that he had worries: “Let’s just make sure it’s not a third-world experience.” When such an embarrassing experience occurred, Obama responded like a ruler of a banana republic unfettered by constitutionalism and the rule of law. Although no president has even a line-item veto power (which 44 governors have), this president asserts the power to revise the language of laws by “enforcement discretion,” and suggests no limiting principle.

But even this is a crisis only if Congress makes it so by supine acquiescence. Congressional Democrats are White House poodles. They also are progressives and therefore disposed to favor unfettered executive power. Republicans are supposed to be different.

Abstract – Wound Healing using The Meditech Technology.

As “case of the week” at our clinic we have selected. Mr. AF, an 88 year old retired banker who first presented on October 14, 2013. His chief complaint was a dermal ulcer of the left lower extremity which had been present over several months. During that period he had been undergoing conventional treatment at a wound clinic, consisting of daily dressing changes, the use of topicals, analgesics and periodic surgical debridement.

Following assessment at the Meditech clinic, the patient underwent ten therapy sessions, extending from October 14, 2013 to October 25, 2013. On that date the wound appeared to be completely epithelialized (see photograph) and the patient was relatively asymptomatic.

When dealing with these lesions, aside from patient compliance, one must evaluate other factors that contribute to the outcome. These include nutrition, supplements, correlating protocols with tissue response and local therapy.

Application of Treatment

We begin treatment with the gentle application of dilute hydrogen peroxide, poured over gauze placed on the wound and in the early stages this is utilized prior to instituting laser treatment. No other therapies are required with our method, which relies largely on natural debridement as Laser Therapy progresses. In brief the tissues are never mechanically traumatized.

The patient was asked to compress the wound at night utilizing warm saline, a directive with which he complied most of the time. In addition he was encouraged to exercise the limb using flexion and extension exercises involving the knee, ankle and small joints of the foot, along with quadriceps extensions, twenty times every two hours during the course of the day. He followed this advice religiously and the significant degree of edema originally present was completely gone after the first two weeks of treatment.

The use of antibiotics and aggressive surgical debridement, used prior to his treatment at our clinic, often prevents epithelialization and the formation of granulation tissue in the wound bed. At our institution these are rigidly avoided. Our philosophy is to support and work in conjunction with the body’s natural healing proclivities and the application of Laser Therapy.

Over many years of experience gained in the treatment of these types of lesions, we have found that the optimal debridement is accomplished by Laser Therapy, hydrogen peroxide and saline. It should be emphasized that the traditional approach to wound healing applied prior to presenting at the Meditech clinic was totally unsuccessful and gradually increased the dimensions of the wound.  Undoubtedly, if this prolonged approach had been continued, amputation of the limb would have resulted.

Conclusion

This particular example of wound healing, using a technique which is both simple and effective, should be utilized in clinics that deal with these lesions, in hospitals, dermatological offices and specialized wound clinics, on a global basis. The method should also be taught in educational institutions.

From at least the theoretical perspective, all limbs can be salvaged at a fraction of the cost incurred by the conventional therapies so widely prescribed at this time.  All therapists involved in wound care, no matter what their professional designation, should adopt the Meditech Wound Healing Technology.

For additional information, please contact Fred Kahn, MD, FRCSC(C) at info@bioflexlaser.com.

ARTHROSCOPY PROCEDURES – EFFECTIVENESS vs. COMPLICATIONS

At our clinic, we continue to see an inordinate number of post-arthroscopy patients that continue to exhibit symptoms frequently more severe than prior to the performance of the procedure. These include interventions that have been performed from 2 weeks to 2 years prior to presentation at our clinic.
Unquestionably, some patients derive benefit from arthroscopy, however the significant percentage of patients whose symptoms persist or become more severe following this surgical event, provides cause for reflection.
In the past six days alone, I have seen four patients who have had relatively recent arthroscopies but now complain of symptoms that have increased substantially subsequent to the procedure. In view of this, one should consider alternative modes of treatment for these patients.
At our clinics, we treat many knee problems with Laser Therapy and symptoms generally begin to diminish after the 2nd or 3rd treatment. Generally more significant change occurs after 5 treatments and almost invariably after 10-20 therapeutic sessions, patients are asymptomatic. On average, 10 treatments readily achieve a desirable result, administered over a course of 3-4 weeks.
In this article, we do not extensively explore the patient’s status pre-arthroscopy but simply the subjective and objective findings demonstrated at the time of the initial and subsequent assessments, as treatment progresses.

CONCLUSION

Prior to the performance of arthroscopic surgery, all these cases should be subjected to a mandatory course of Laser Therapy consisting of at least 10 sessions. This will determine whether the pathology, consisting of inflammation, structural damage, etc., can be resolved. In my experience by following this course, surgery would seldom be necessary. This commentary should be a stimulus for eliminating the extensive number of arthroscopic procedures routinely performed that may cause complications and even more significantly, may be unnecessary.

Comments: Painful frozen shoulder generally resolves, but return to mobility takes time

“Painful frozen shoulder generally resolves, but return to mobility takes time.”
By Helen Branswell, The Canadian Press − August 12, 2013
Published in: The Ottawa Citizen

The article quoted clearly demonstrates the lack of awareness of the “treatment of choice” for shoulder problems, including “frozen shoulder”, rotator cuff injuries, capsulitis, tenosynovitis, etc.

The shoulder is a highly complicated joint and being more mobile than most other joints, is subject to many injuries.

Conventional therapies today consist of physiotherapy, analgesics, anti-inflammatories and if these are not successful – surgery.  While all these may impart some benefit, they are not ideal by any means.

On the other hand, Laser Therapy is a simple, effective therapy that initiates the healing process during the course of the first treatment and generally, most conditions are completely resolved after an average of ten treatment sessions.  Application is completely safe, has no adverse effects and is almost universally effective.

As the course of therapy progresses, most symptoms including pain disappear, along with an increase in the range of motion.  Treatment can be applied by healthcare providers with a minimum of background, in a completely safe manner.  The suffering described in the article and the extensive processes involved, can be reduced to an average time of 1 to 3 weeks utilizing Laser Therapy.

Why is Laser Therapy hardly known in the health care industry? Because conventional methods have become entrenched, as in “we have always done it this way”, along with the overpowering marketing capabilities of the pharmaceutical ­- industrial complex.  Complacent and uninformed practitioners are also responsible.

It is time that physicians and other providers enhance their knowledge base and apply therapies that are focused, painless, safe and effective.

MEDICAL PRACTICE & LASER THERAPY – REFLECTIONS

Today, it is of the ultimate importance that healthcare professionals have an overview of medicine as practiced internationally − not just as it is practiced in Canada. Around the world, it has been demonstrated that governments and medicine seldom mix. Accordingly, all healthcare professionals, particularly physicians, must be independent practitioners who have only the best interests of the patient at heart and must therefore focus their efforts on this objective.

Unfortunately, system administrators seem to sprout ever enlarging bureaucracies often advised by physicians who are motivated by exercising political clout and their own pecuniary interest, rather than the welfare of patients.

Pharmaceutical companies, with their extensive lobbies and the support of government bureaucracies, are primarily driven to generate profits but nevertheless exert an excessive and unwarranted degree of influence in formulating healthcare policies, extending even to the educational process.

Insurance companies, as is increasingly evident, again are economically oriented and pose one of the most pernicious influences in healthcare today. Claims adjusters and low-level administrators frequently impose incredible hardship on patients desperately in need of funds to pay for both their specialized and routine health care, for which they have contributed premiums over many years.

The combination of gatekeepers consisting of governments, HMOs, Wall Street corporations, etc., further muddy the waters. There is no clarity existing with all the vested economic interests that at this point almost totally control healthcare delivery systems, whether in England, Cuba, Canada or Sweden.

In many instances, unfortunately, no healthcare at all may be preferable to what is actually provided. For example, wounds secondary to diabetes, atherosclerosis, and other etiological factors often show rapid improvement with simple elevation of the extremity and saline compresses to the wound 24/7, as compared to the utilization of multiple dressings, antibiotics and analgesics that are provided in such abundance, accompanied by rising costs. All too often, the latter approach leads to the eventual amputation of the afflicted limb.

Does anyone really care about these issues? Not as long as the care provided is perceived to be ‘free’. And what of the latter fact? A perfect excuse to levy more taxes, to expand the bureaucracy and order more diagnostics and consumables, all excluding the most important item – the correct therapy designed to cure the patient’s problem.

To elaborate on the insurance situation: each day, we see new patients at our clinics and invariably, at least initially, the priority item they wish to discuss is their insurance plight – rather than their medical condition. These patients rant on about how the insurance companies keep reneging on the promise to pay for their care. How can you blame them? This premise, after all, is why they bought insurance in the first place.
I recently uploaded on my blog the story of one particular family which serves as an excellent example of this growing problem. The husband was severely injured in an automobile accident over five years ago and has been unable to work since. The couple went broke paying their medical bills and were recently evicted from their home. Several insurance policies had been purchased by this individual, who owned a number of businesses that were thriving prior to the accident. Financial failure ensued after the trauma as the wife was busy taking care of her husband and two children and could not continue to manage their affairs.

Over five years later, the insurance companies are still fighting about who should pay for what. Anyone familiar with this paradigm knows that it can go on for many years, or at least until the patient expires.

At the same time, insurance companies spend considerable funds on diagnostics and these are seldom questioned, no matter how expensive they may be. They also spend unlimited funds carrying out assessments, investigations, etc., which allow them to renege on claims, aided and abetted by a hoard of assessors, bought and paid for by the carrier. The latter almost invariably find that there is no objective evidence to substantiate the disputed claim.

As for pharmaceuticals, these in many instances confer significant benefit. For example, insulin, thyroxin, cortisone, and analgesics, along with many other drugs, provide viable solutions – primarily in the short term, although often only by masking symptoms. Furthermore, drugs do have limitations and can produce adverse effects. In some instances, the latter may be significant. However, because the pressing need for these medications may override the objection to prolonged use, dependence becomes ‘justifiable’. That is certainly the case with diabetes and insulin, ACTH for adrenal insufficiency, thyroxin for hypothyroidism and a number of similar situations.

On the other hand, alternative therapies can and do provide highly effective solutions in the treatment of a plethora of medical conditions and do not produce adverse effects, either long or short-term, particularly in the treatment of arthritis, back problems and most conditions with the common factor of inflammation, a major component in most disease processes.

I first learned about Laser Therapy in 1988, having injured my right shoulder in a skiing accident in 1986. The injury included a complete tear of the supraspinatus tendon and a fracture of the humeral head generating chronic inflammation of the shoulder joint. Subsequent to this episode, I consulted a number of orthopedic surgeons and the general consensus was to perform an arthrogram to be followed by immediate surgery. Being a trained surgeon, I resisted the temptation to follow this approach, based on past experience, notwithstanding the fact that both orthopedic surgeons I consulted were highly competent and had the best of intentions. My conclusion was that this intervention, fully approved by the regulatory bodies, would not substantially benefit me and I therefore pursued an alternative course. Above all, I did not wish to be subjected to an additional trauma.

Unfortunately, prior to Laser Therapy, from 1986-1989 I was unable to play golf or swim on a regular basis, secondary to the discomfort and pain. Analgesics and anti-inflammatory medications produced undesirable side effects; moreover, I objected to them on basic principles. Periodically, when the symptoms became unbearable, I submitted to cortisone injections which, when properly placed, provided temporary relief. A permanent cure proved elusive.

Finally, I found a therapist equipped with a primitive European Laser device and in a short period of time, my shoulder pain subsided significantly. Inspired by this turn of events, I began my pursuit of self-education in the emerging technology of Laser Therapy. Over the course of two years, I read over 300 articles and 13 texts on this topic and participated in many national and international meetings exploring the subject.

Here are some observations noted on this journey:

• How little was really known about this therapeutic medium at that time.
• How much remained to be learned.
• How we must open our minds to new ideas, thoughts and solutions.
• How we must question tradition and “the way things have always been done”.
• How we must be critical of the massive amount of information and disinformation coursing through the net. This is extremely challenging and reminds me of my mother who often said, “I read the following in the newspaper.” My usual response would be, “I know that this is not true.” Her invariable retort was that “It would not be in the newspaper if it were not true!” She also believed in the infallibility of physicians, with the exclusion of myself. Unfortunately, that was the cause of her demise at the age of 93. Had it not been for a series of hospital blunders, she might still be alive today.
• We must always be aware of how the internet disseminates a mountain of data, all of which is of course documented by humans, many of whom have a vested interest in benefiting the propagator of the information provided.
• Creativity and independent thought must be encouraged. In a civilized world, these qualities inevitably lead to progress.
• Never be afraid to question or criticize authoritarianism in its varied forms.
• Do not permit economic conventions, inappropriate regulations, and other obstructions to get in the way of implementing better therapeutic solutions.

To cite some recent advances, I refer to:
o Stem Cell Therapy
o Genetic Modification (gene splicing)
o Robotic Surgery
o Laser Therapy, etc.

• All healthcare professionals should be encouraged to make the patient’s clinical status the focus of their endeavors.
• Most significant of all, are the advances in Laser Medicine over the past decade and the wide impact this should have on the quality of medical care, now and in the future.

When asked how he conducted research surveys indicating what product the company should build, Steve Jobs, the late departed CEO of Apple, stated, “Surveys of that type have no interest to me. I know what people need and that is what I give them.” To me, this represents a greater wisdom than the many aphorisms espoused daily by the leaders of the corporate world.
Steve Jobs may have been, in the eyes of some, a “son of a bitch” but he is one of the few who had the vision and courage to nurture his original concepts and ideas and translate them into reality. All of us should adopt this type of guidance to a greater degree. Personally, I like to think that in many ways Laser technology is developing along a similar trend.

At our clinics, the most significant results produced are in the treatment of arthritis, musculoskeletal problems, particularly the spine, dermatological conditions including wound healing, along with the all too common soft tissue and sports injuries, many of which have acquired the characteristics of chronicity.

In addition, we have discovered and are learning that Laser Therapy has the potential to treat more complex systemic conditions, particularly in situations where conventional methods have been ineffective.

In the past several years, stimulated by several neurological researchers, we have developed and refined some exciting new applications in the field of neurology, particularly with regard to the following conditions:

• Concussion
• CVAs
• Dementias
• Multiple Sclerosis
• Depression
• Anxiety Disorders
• Nerve Regeneration
• Spinal Cord Injuries
• Demyelinating Diseases (Gene 7 Paresis)

While only a relatively small number of these conditions have been treated, it must be noted that we have achieved a greater degree of success than anticipated. In keeping with the conventional one-line disclaimer so common in academic circles, “more studies are indicated”. At the same time, I must emphasize that we continue to meet, if not exceed, our expectations.

The constant road block? Insurance companies. They may be willing to pay for diagnostic services, but refuse to pay for actual therapy that may not yet be “authorized”. Again, this is one of the regressive forms of behaviour dictated by managed healthcare systems in the interest of economic considerations. While the focus is on diagnostics, there is a clear lack of enthusiasm for selecting and applying therapies designed to actually benefit the patient. This is commonly described as “risk management”.

Another problem I mentioned is that pharmaceuticals are generally paid for by the management systems in place. Whereas prescriptions are often written under the mystique of providing instant benefit, the reality is that an undetermined number of prescriptions are never filled, which may be a blessing in disguise. Two-hundred and ninety patient deaths are reported daily in North America – the result of pharmaceutical utilization. In reality there are probably thousands!

In 1998 an article in the Journal of the American Medical Association concluded that prescriptions legally written by physicians are the 4th leading cause of death.
In his 2012 book, Unaccountable, Dr. M Makary, a Johns Hopkins School of Medicine researcher, shows how “mining sickness for profit” makes everybody “unaccountable” – hence the book’s title. The book illuminates a description of how hospitals are a major cause of death and how at least 30% of conventional “healthcare” is unnecessary and leads to deadly results.

From my personal perspective, effective therapeutic solutions have always been integral to the agenda of any ethical medical practice. Again, instituting immediate treatment when the disease process begins, circumvents the obstructive process of bureaucracies in the treatment of both routine and complex medical conditions, while substantially reducing the cost of healthcare.

Remember that administrators and other gatekeepers have no real interest in finding the best possible medical solutions but focus instead on cost controls and their primary interest remains the bottom line.

For a good clinician, defining the correct diagnosis does not require a major effort. In most instances, it can be accurately determined by taking a detailed history and performing an equally thorough physical examination. This aspect of medical practice, unfortunately, is no longer de rigeur.

Diagnostic studies, which can be expensive and harmful, should only be employed when the practitioner is unable to arrive at a working diagnosis or to confirm the clinical diagnosis, if this is essential.

All too frequently, prolonged diagnostic studies, the prescription of inappropriate pharmaceuticals, cross consultations, and other non-relevant assessments delay the initiation of therapy and therefore the healing process. This approach is wasteful and one must remember that no pathology can be cured without initiating appropriate treatment, preferably immediately.

It is therefore paramount that Laser Therapy, which can be easily administered by therapists with a modicum of medical training, can and should be more widely implemented, particularly in situations where urgent and effective treatment is essential.

Today, evidence-based medicine is all too often related to double-blind studies, peer reviews and the literature. Sometimes these imply or provide automatic approval of therapies that may have minimal benefit at best. In view of this, one must always ask:
• Who finances these studies?
• How relevant are they?
• Who conducts them?
• And for what purpose?

My personal view is that when a patient presents with a problem and has undergone many studies and treatments without any measurable improvement that is clear evidence of failure. Unfortunately, in healthcare systems today there is no real accountability and supervision of progress may be spurious or even non-existent.
Confusion surrounding terminologies such as “evidence-based”, “scientific”, “double blind”, etc. may often be categorized as time based illusions. Healthcare professionals must adopt therapies that cure the problem rather than focusing on the modulation of symptoms and physician compensation codes. The latter is comparable to following a road leading to nowhere.

In our clinics, the problems that we treat most frequently include multi-level degenerative disc disease and single disc herniations, often accompanied by stenosis, radiculitis, etc. The success rate in these situations is over 90% and no adverse effects are produced. In a select number of cases we have performed follow-up MRIs and were not surprised to see that the problem had been resolved (i.e. the disc herniation could no longer be visualized).

Contrary to current concepts, we frequently encounter young athletes with dysfunctional knees. The basis of these pathologies consists of varying degrees of disruption of the anterior cruciate and/or other ligaments, meniscal tears, contusions, etc. Currently, these are almost invariably treated with surgical intervention, which can lead to complications and permanent dysfunction.

As the number of patients presenting at our clinic with these types of injuries has increased over the past several years, we have again been able to conduct follow-up MRI studies and complete healing has been reported most notably in cases where the original MRI read complete anterior cruciate ligament tear. It is my belief that in these instances, a portion of the anterior cruciate ligament remains intact, perhaps only 10%. Again, further studies are indicated and we are conducting these on an ongoing basis.
Without question, if my knee were injured I would use the conservative Laser Therapy approach and surgery could always be instituted at a later date if necessary; this is rarely the case.

It should be noted that frequently patients are successfully treated with Laser Therapy for conditions that have not improved with traditional therapies. Nevertheless, some physicians will comment that they do not believe in this therapy, and this often repeated statement stimulates some reflection on my part.

I believe that our planet sustains approximately 7 billion people and that over 90% of the entire population, I am informed, believes in some God, religious power or tradition. Without invoking blasphemy at any level, I have never been informed that anyone has actually had a conversation, discussion or meeting with a God. Nevertheless, a God of some form exists in almost everyone’s mind and historically the belief in a Dogma survives, particularly in the face of political repression attempting to dissuade citizens from maintaining this practice.

Obviously some remediation of the medical profession is indicated. It should be noted that in all cultures ignorance and non-believers exist. These have always been a mainstay of the human condition and the effort to maintain this status is sacrosanct to many. It feeds their ego, as they have established an opinion – right or wrong – and free-choice philosophy dictates that individuals can choose to be ignorant and incompetent if they wish and there is really nothing that can be done about that. Eventually, these non-believers may become extinct, hopefully replaced by those with more open and educable minds.

Needless to say, progress will require some leadership from educational institutions and governments. Hopefully this process will stimulate further reflection on our ethical and moral values. And then there is always the matter of mass conditioning. For instance, several years ago when a flu epidemic was rampant in Canada, people dealt with infinite lines to obtain the vaccine. Individuals lined up day and night to receive the shots and information was rapidly circulated about the clinics that had the shortest wait times. This persisted for several weeks. As soon as the flu vaccine became widely available, the lines almost instantly evaporated.

CONCLUDING COMMENTS:

• My vision is to exchange a Laser Therapy Unit for every prescription pad in existence.

• To take control of healthcare away from governments and other vested interests and return it to properly educated and trained healthcare professionals who possess and understand quality medical care.

• All healthcare professionals who review this article should strive to integrate Laser Therapy into their practice.

• Embracing these concepts globally will improve every citizen’s health status immeasurably and wider application will reduce costs of delivery by billions of dollars.

SPORTS MEDICINE – “BULKING UP”

Today success in athletics is all too often related to developing an increase in the core strength of the body and “bulking up the muscles”. This is somewhat similar to the use of ice to relieve pain. Whereas ice acts as a counter-irritant and numbs the sensory nerve endings, it does considerable damage to the cell structure, particularly if left in place for a prolonged period of time. Ice is useful to prevent swelling during the first 24-48 hours post-injury. It does this by inducing vasoconstriction, reducing arterial perfusion of the area and decreasing the extent of extravascular fluid collection (edema).

But to get back to “bulking up” as it is commonly referred to in the sports industry. In golf particularly, becoming stronger does not necessarily equate with getting better. Rory McIlroy, a year ago, was a far superior golfer to the current Rory. Aside from personal factors, a change of clubs, the attention brought by fame and the media focus – these items are of minimal relevance.

What is most significant with regard to Mr. McIlroy is his bulk and in my opinion this has gotten in the way. Muscles that were fluid and highly flexible now have developed a higher coefficient of density and the fluidity has disappeared. The brain previously unencumbered, allowed Rory to trust his swing and with his innate talent, permitted him on most days to shoot whatever score he wanted. Now mentally and physically burdened by the alleged three hours each day that he spends in the gym lifting weights, etc. it would appear that these activities serve only to impede the natural flow of matters, both cerebral and muscular.

Unquestionably, he is stronger and can hit the ball further but this is not necessarily the ultimate objective in golf. His scores this year are a clear indication of what is happening. First of all, Rory should learn to ignore the many comments by the press, other golfers, etc. and learn to relax and engage in gentle stretching exercise programs permitting a natural swing flow to develop the relevant musculature and his mind. For this type of golfer, the hours in the gym clearly do not provide a benefit, and serve only as an impedement.

George Knudson, a golfer who achieved great success at all levels, particularly for a Canadian, always believed in working on his swing, training the muscles, gentle stretching and calming the mind. In neurological circles, this is almost spiritual and can be referred to as, “neuromodulation”. This brought maximum success, commensurate with his ability and training regimen. Allowing his own intelligence to dictate his career, activities to keep the muscles flexible, particularly as he advanced in age, he combined teaching with a planned programme to return to the Seniors’ Tour. Unfortunately, health issues ended his career far too early, as he would certainly have achieved a high level of success on the Seniors’ Tour.

Weights and repetitive motions in the gym performed thousands if not millions of times, are not necessarily helpful on the road to success. As Don Cherry would say, “To all you kids out there, stop bulking and keep stretching”. Mobility, fluidity, the maintenance of good cardio-respiratory function and keeping the mind both relaxed and focused at the same time, are essential to success in all areas, particularly in sports.

I have always been a firm believer in the dictum – “never lift anything you don’t have to”. I think if this course is adhered to, rather than the opposite extreme, an easier road to a higher level of success can be achieved. Training the muscles by practicing your particular sport is useful and unquestionably some people need it more than others. By practicing and playing your sport frequently or even daily, both power and flexibility will be maintained and the mind will be uncluttered by non-relevant activities that impede both natural physical and mental development.

The 2013 Open Championship currently proves my theories conclusively. At the halfway mark, a 49-year-old Spaniard is in the lead and it is clearly evident that he does not spend much if any time lifting weights, unless it is a glass of wine. Tiger Woods, on the other hand, a devotee of the gym, is an exception that reflects his fierce desire to keep on winning. He has overcome many physical problems and has developed a methodology, which works for him, but probably not for anyone else.

The road to success will be governed by a clear focused mind, the heart and will to win and practicing your sport on a regular basis in order to strengthen the muscles that are important to that particular endeavour and leave the mind free. Logic, as in all things, should prevail, along with specific goals and pursuing a solid path to achieve that end. Keep the mind uncluttered and train the muscles to excel at the activity you have chosen. Don’t beat it to death by excessive and counterproductive activities. At all times stay happy, relaxed and focused.

MEDICAL PRACTICE & LASER THERAPY – REFLECTIONS

Today, it is of the ultimate importance that healthcare professionals have an overview of medicine as practiced internationally − not just as it is practiced in Canada. Around the world, it has been demonstrated that governments and medicine seldom mix. Accordingly, all healthcare professionals, particularly physicians, must be independent practitioners who have only the best interests of the patient at heart and must therefore focus their efforts on this objective.

Unfortunately, system administrators seem to sprout ever enlarging bureaucracies often advised by physicians who are motivated by exercising political clout and their own pecuniary interest, rather than the welfare of patients.

Pharmaceutical companies, with their extensive lobbies and the support of government bureaucracies, are primarily driven to generate profits but nevertheless exert an excessive and unwarranted degree of influence in formulating healthcare policies, extending even to the educational process.

Insurance companies, as is increasingly evident, again are economically oriented and pose one of the most pernicious influences in healthcare today. Claims adjusters and low-level administrators frequently impose incredible hardship on patients desperately in need of funds to pay for both their specialized and routine health care, for which they have contributed premiums over many years.

The combination of gatekeepers consisting of governments, HMOs, Wall Street corporations, etc., further muddy the waters. There is no clarity existing with all the vested economic interests that at this point almost totally control healthcare delivery systems, whether in England, Cuba, Canada or Sweden.

In many instances, unfortunately, no healthcare at all may be preferable to what is actually provided. For example, wounds secondary to diabetes, atherosclerosis, and other etiological factors often show rapid improvement with simple elevation of the extremity and saline compresses to the wound 24/7, as compared to the utilization of multiple dressings, antibiotics and analgesics that are provided in such abundance, accompanied by rising costs. All too often, the latter approach leads to the eventual amputation of the afflicted limb.

Does anyone really care about these issues? Not as long as the care provided is perceived to be ‘free’. And what of the latter fact? A perfect excuse to levy more taxes, to expand the bureaucracy and order more diagnostics and consumables, all excluding the most important item – the correct therapy designed to cure the patient’s problem.

To elaborate on the insurance situation: each day, we see new patients at our clinics and invariably, at least initially, the priority item they wish to discuss is their insurance plight – rather than their medical condition. These patients rant on about how the insurance companies keep reneging on the promise to pay for their care. How can you blame them? This premise, after all, is why they bought insurance in the first place.
I recently uploaded on my blog the story of one particular family which serves as an excellent example of this growing problem. The husband was severely injured in an automobile accident over five years ago and has been unable to work since. The couple went broke paying their medical bills and were recently evicted from their home. Several insurance policies had been purchased by this individual, who owned a number of businesses that were thriving prior to the accident. Financial failure ensued after the trauma as the wife was busy taking care of her husband and two children and could not continue to manage their affairs.

Over five years later, the insurance companies are still fighting about who should pay for what. Anyone familiar with this paradigm knows that it can go on for many years, or at least until the patient expires.

At the same time, insurance companies spend considerable funds on diagnostics and these are seldom questioned, no matter how expensive they may be. They also spend unlimited funds carrying out assessments, investigations, etc., which allow them to renege on claims, aided and abetted by a hoard of assessors, bought and paid for by the carrier. The latter almost invariably find that there is no objective evidence to substantiate the disputed claim.

As for pharmaceuticals, these in many instances confer significant benefit. For example, insulin, thyroxin, cortisone, and analgesics, along with many other drugs, provide viable solutions – primarily in the short term, although often only by masking symptoms. Furthermore, drugs do have limitations and can produce adverse effects. In some instances, the latter may be significant. However, because the pressing need for these medications may override the objection to prolonged use, dependence becomes ‘justifiable’. That is certainly the case with diabetes and insulin, ACTH for adrenal insufficiency, thyroxin for hypothyroidism and a number of similar situations.

On the other hand, alternative therapies can and do provide highly effective solutions in the treatment of a plethora of medical conditions and do not produce adverse effects, either long or short-term, particularly in the treatment of arthritis, back problems and most conditions with the common factor of inflammation, a major component in most disease processes.

I first learned about Laser Therapy in 1988, having injured my right shoulder in a skiing accident in 1986. The injury included a complete tear of the supraspinatus tendon and a fracture of the humeral head generating chronic inflammation of the shoulder joint. Subsequent to this episode, I consulted a number of orthopedic surgeons and the general consensus was to perform an arthrogram to be followed by immediate surgery. Being a trained surgeon, I resisted the temptation to follow this approach, based on past experience, notwithstanding the fact that both orthopedic surgeons I consulted were highly competent and had the best of intentions. My conclusion was that this intervention, fully approved by the regulatory bodies, would not substantially benefit me and I therefore pursued an alternative course. Above all, I did not wish to be subjected to an additional trauma.

Unfortunately, prior to Laser Therapy, from 1986-1989 I was unable to play golf or swim on a regular basis, secondary to the discomfort and pain. Analgesics and anti-inflammatory medications produced undesirable side effects; moreover, I objected to them on basic principles. Periodically, when the symptoms became unbearable, I submitted to cortisone injections which, when properly placed, provided temporary relief. A permanent cure proved elusive.

Finally, I found a therapist equipped with a primitive European Laser device and in a short period of time, my shoulder pain subsided significantly. Inspired by this turn of events, I began my pursuit of self-education in the emerging technology of Laser Therapy. Over the course of two years, I read over 300 articles and 13 texts on this topic and participated in many national and international meetings exploring the subject.

Here are some observations noted on this journey:

 How little was really known about this therapeutic medium at that time.
 How much remained to be learned.
 How we must open our minds to new ideas, thoughts and solutions.
 How we must question tradition and “the way things have always been done”.
 How we must be critical of the massive amount of information and disinformation coursing through the net. This is extremely challenging and reminds me of my mother who often said, “I read the following in the newspaper.” My usual response would be, “I know that this is not true.” Her invariable retort was that “It would not be in the newspaper if it were not true!” She also believed in the infallibility of physicians, with the exclusion of myself. Unfortunately, that was the cause of her demise at the age of 93. Had it not been for a series of hospital blunders, she might still be alive today.
 We must always be aware of how the internet disseminates a mountain of data, all of which is of course documented by humans, many of whom have a vested interest in benefiting the propagator of the information provided.
 Creativity and independent thought must be encouraged. In a civilized world, these qualities inevitably lead to progress.
 Never be afraid to question or criticize authoritarianism in its varied forms.
 Do not permit economic conventions, inappropriate regulations, and other obstructions to get in the way of implementing better therapeutic solutions.

To cite some recent advances, I refer to:
o Stem Cell Therapy
o Genetic Modification (gene splicing)
o Robotic Surgery
o Laser Therapy, etc.

 All healthcare professionals should be encouraged to make the patient’s clinical status the focus of their endeavors.
 Most significant of all, are the advances in Laser Medicine over the past decade and the wide impact this should have on the quality of medical care, now and in the future.

When asked how he conducted research surveys indicating what product the company should build, Steve Jobs, the late departed CEO of Apple, stated, “Surveys of that type have no interest to me. I know what people need and that is what I give them.” To me, this represents a greater wisdom than the many aphorisms espoused daily by the leaders of the corporate world.
Steve Jobs may have been, in the eyes of some, a “son of a bitch” but he is one of the few who had the vision and courage to nurture his original concepts and ideas and translate them into reality. All of us should adopt this type of guidance to a greater degree. Personally, I like to think that in many ways Laser technology is developing along a similar trend.

At our clinics, the most significant results produced are in the treatment of arthritis, musculoskeletal problems, particularly the spine, dermatological conditions including wound healing, along with the all too common soft tissue and sports injuries, many of which have acquired the characteristics of chronicity.

In addition, we have discovered and are learning that Laser Therapy has the potential to treat more complex systemic conditions, particularly in situations where conventional methods have been ineffective.

In the past several years, stimulated by several neurological researchers, we have developed and refined some exciting new applications in the field of neurology, particularly with regard to the following conditions:

• Concussion
• CVAs
• Dementias
• Multiple Sclerosis
• Depression
• Anxiety Disorders
• Nerve Regeneration
• Spinal Cord Injuries
• Demyelinating Diseases (Gene 7 Paresis)

While only a relatively small number of these conditions have been treated, it must be noted that we have achieved a greater degree of success than anticipated. In keeping with the conventional one-line disclaimer so common in academic circles, “more studies are indicated”. At the same time, I must emphasize that we continue to meet, if not exceed, our expectations.

The constant road block? Insurance companies. They may be willing to pay for diagnostic services, but refuse to pay for actual therapy that may not yet be “authorized”. Again, this is one of the regressive forms of behaviour dictated by managed healthcare systems in the interest of economic considerations. While the focus is on diagnostics, there is a clear lack of enthusiasm for selecting and applying therapies designed to actually benefit the patient. This is commonly described as “risk management”.

Another problem I mentioned is that pharmaceuticals are generally paid for by the management systems in place. Whereas prescriptions are often written under the mystique of providing instant benefit, the reality is that an undetermined number of prescriptions are never filled, which may be a blessing in disguise. Two-hundred and ninety patient deaths are reported daily in North America – the result of pharmaceutical utilization. In reality there are probably thousands!

In 1998 an article in the Journal of the American Medical Association concluded that prescriptions legally written by physicians are the 4th leading cause of death.
In his 2012 book, Unaccountable, Dr. M Makary, a Johns Hopkins School of Medicine researcher, shows how “mining sickness for profit” makes everybody “unaccountable” – hence the book’s title. The book illuminates a description of how hospitals are a major cause of death and how at least 30% of conventional “healthcare” is unnecessary and leads to deadly results.

From my personal perspective, effective therapeutic solutions have always been integral to the agenda of any ethical medical practice. Again, instituting immediate treatment when the disease process begins, circumvents the obstructive process of bureaucracies in the treatment of both routine and complex medical conditions, while substantially reducing the cost of healthcare.

Remember that administrators and other gatekeepers have no real interest in finding the best possible medical solutions but focus instead on cost controls and their primary interest remains the bottom line.

For a good clinician, defining the correct diagnosis does not require a major effort. In most instances, it can be accurately determined by taking a detailed history and performing an equally thorough physical examination. This aspect of medical practice, unfortunately, is no longer de rigeur.

Diagnostic studies, which can be expensive and harmful, should only be employed when the practitioner is unable to arrive at a working diagnosis or to confirm the clinical diagnosis, if this is essential.

All too frequently, prolonged diagnostic studies, the prescription of inappropriate pharmaceuticals, cross consultations, and other non-relevant assessments delay the initiation of therapy and therefore the healing process. This approach is wasteful and one must remember that no pathology can be cured without initiating appropriate treatment, preferably immediately.

It is therefore paramount that Laser Therapy, which can be easily administered by therapists with a modicum of medical training, can and should be more widely implemented, particularly in situations where urgent and effective treatment is essential.

Today, evidence-based medicine is all too often related to double-blind studies, peer reviews and the literature. Sometimes these imply or provide automatic approval of therapies that may have minimal benefit at best. In view of this, one must always ask:
• Who finances these studies?
• How relevant are they?
• Who conducts them?
• And for what purpose?

My personal view is that when a patient presents with a problem and has undergone many studies and treatments without any measurable improvement that is clear evidence of failure. Unfortunately, in healthcare systems today there is no real accountability and supervision of progress may be spurious or even non-existent.
Confusion surrounding terminologies such as “evidence-based”, “scientific”, “double blind”, etc. may often be categorized as time based illusions. Healthcare professionals must adopt therapies that cure the problem rather than focusing on the modulation of symptoms and physician compensation codes. The latter is comparable to following a road leading to nowhere.

In our clinics, the problems that we treat most frequently include multi-level degenerative disc disease and single disc herniations, often accompanied by stenosis, radiculitis, etc. The success rate in these situations is over 90% and no adverse effects are produced. In a select number of cases we have performed follow-up MRIs and were not surprised to see that the problem had been resolved (i.e. the disc herniation could no longer be visualized).

Contrary to current concepts, we frequently encounter young athletes with dysfunctional knees. The basis of these pathologies consists of varying degrees of disruption of the anterior cruciate and/or other ligaments, meniscal tears, contusions, etc. Currently, these are almost invariably treated with surgical intervention, which can lead to complications and permanent dysfunction.

As the number of patients presenting at our clinic with these types of injuries has increased over the past several years, we have again been able to conduct follow-up MRI studies and complete healing has been reported most notably in cases where the original MRI read complete anterior cruciate ligament tear. It is my belief that in these instances, a portion of the anterior cruciate ligament remains intact, perhaps only 10%. Again, further studies are indicated and we are conducting these on an ongoing basis.
Without question, if my knee were injured I would use the conservative Laser Therapy approach and surgery could always be instituted at a later date if necessary; this is rarely the case.

It should be noted that frequently patients are successfully treated with Laser Therapy for conditions that have not improved with traditional therapies. Nevertheless, some physicians will comment that they do not believe in this therapy, and this often repeated statement stimulates some reflection on my part.

I believe that our planet sustains approximately 7 billion people and that over 90% of the entire population, I am informed, believes in some God, religious power or tradition. Without invoking blasphemy at any level, I have never been informed that anyone has actually had a conversation, discussion or meeting with a God. Nevertheless, a God of some form exists in almost everyone’s mind and historically the belief in a Dogma survives, particularly in the face of political repression attempting to dissuade citizens from maintaining this practice.

Obviously some remediation of the medical profession is indicated. It should be noted that in all cultures ignorance and non-believers exist. These have always been a mainstay of the human condition and the effort to maintain this status is sacrosanct to many. It feeds their ego, as they have established an opinion – right or wrong – and free-choice philosophy dictates that individuals can choose to be ignorant and incompetent if they wish and there is really nothing that can be done about that. Eventually, these non-believers may become extinct, hopefully replaced by those with more open and educable minds.

Needless to say, progress will require some leadership from educational institutions and governments. Hopefully this process will stimulate further reflection on our ethical and moral values. And then there is always the matter of mass conditioning. For instance, several years ago when a flu epidemic was rampant in Canada, people dealt with infinite lines to obtain the vaccine. Individuals lined up day and night to receive the shots and information was rapidly circulated about the clinics that had the shortest wait times. This persisted for several weeks. As soon as the flu vaccine became widely available, the lines almost instantly evaporated.

CONCLUDING COMMENTS:

• My vision is to exchange a Laser Therapy Unit for every prescription pad in existence.

• To take control of healthcare away from governments and other vested interests and return it to properly educated and trained healthcare professionals who possess an understanding of quality healthcare.

• Everyone reviewing this article should strive to become a creative and effective Laser Therapist.

• Embracing these concepts will improve every citizen’s healthcare immeasurably and wide application can reduce costs of delivery by billions of dollars.

LASER THERAPY

Pain is the most frequent symptom that brings patients to doctor’s offices. At the same time, the majority of therapeutic solutions for the treatment of pain consists of modulators, counterirritants and a variety of pharmaceuticals designed to suppress or mask symptoms. Essentially none of these address the causative factors or the existing pathology responsible for the pain, along with other symptoms. At Meditech we have always been aware of this problem and our efforts are directed to cure the pathology causing the pain. Once again, it must be clearly understood that pain is merely a symptom, not a disease, and in order to eliminate it, the causative factors must be resolved.

BioFlex Laser Therapy Systems present a non-invasive, therapeutic solution that has been approved by Health Canada, the FDA and the European Economic Union for the treatment of many conditions, including musculoskeletal problems, arthritis, sports, soft tissue injuries, etc. Over the past decade particularly, we have expanded the applications to other diseases, providing effective clinical solutions when conventional therapies are ineffective.

Our educational opportunities based on scientific research and clinical applications address the advantages of Laser Therapy and more recently we have expanded the number of conditions to the list of diseases that can be effectively treated.

If you require information regarding our technology, please request the information pertinent to your needs. Many thanks for your interest in the BioFlex Laser Therapy Systems.

Fred Kahn, MD, FRCS(C)