Case #1

Diagnosis – Neuropathy

67 year old executive with three year history of ulcers of the left foot

Previous treatment:
• Weekly visits to university centre wound clinic
• Dressing changes several times per week
• Intravenous antibiotics- 6months
• No improvement over three years of continuing care
• Estimated cost of treatments prior to Meditech intervention – $150,000

Course at Meditech
• Treatments on three consecutive days
• Wound left open
• Continuous saline compresses during the night
• Discontinuation of all medications

Result
• Major wound reduced from 0.92cm to 0.18 after three treatments (in essence wound is healed)
• Cost of treatments at Meditech – $500

You might term this “the battle of three years vs. three days”.

Anecdotal or Evidence-based? Judge for yourself!

Case #2

Diagnosis – Gout

69 year old retired professional athlete (NHL) with gout of the right foot

• Acute pain, 2 days in duration
• Right foot inflamed (pain, edema, tenderness)
• Unable to walk

Status after 1 Laser Treatment:
• Zero pain
• Edema, erythema, etc. almost completely relieved
• No medication required
• Fully ambulatory
• Symptom-free

Baseball pitchers are exposed to extremes of stress, imposed in throwing a ball at speeds over 100 km per hour. These movements subject a number of anatomical regions to repetitive motion type injuries, including the shoulder, elbow, cervical and thoracolumbar spine. As might be anticipated, the most common and most serious injuries sustained by pitchers involve the shoulder joint. The reasons for this are quite obvious. From an anatomical perspective, the shoulder joint and the surrounding tissues are structurally complex, highly mobile and involved in most upper body movements.

Initially, the pitcher complains of pain and subsequently undergoes examination and treatment by the trainer. Ultrasound studies, X-rays, MRIs and PET Scans follow, often on an all too frequent basis and clearly without any significant clinical benefit. Therapy almost invariably consists of a combination of treatments designed to alleviate the symptoms. These include exercise, interferential current, ultrasound, massage and the inevitable application of ice.

Essentially, ice is a counter-irritant and is not beneficial with regard to cellular function or structure. It should be noted that these therapies modulate symptoms in contradistinction to Laser Therapy which is designed to heal tissue at the cellular level, thereby restoring normal cell structure and function. In essence, this technology cures the existing pathology and thereby achieves the desired result.

Generally, conventional therapies relieve symptoms temporarily and as the inflammation subsides, the pitcher resumes throwing. In my experience, rest, gentle stretching and the application of some heat accomplishes the same objective, probably more rapidly. Subsequent to the institution of modulation therapies, pitchers undergo a course of rehabilitation, primarily based on exercise, which may be counter-productive with regard to the healing process.

The institution of surgery following unsuccessful rehabilitation almost invariably results in permanent failure. For surgical repair to be successful, at least from a theoretical perspective, complete immobilization of the shoulder for six weeks or more would be required. This measure is seldom observed, therefore the repair is subject to technical breakdown.

At Meditech, we feel a more rational and elegant therapy would be to adopt the following strategy:
• Rest (during early phase of injury)

• The administration of Laser Therapy daily

• Massage as indicated

• The initiation of gentle stretching 1-2 weeks post injury

The incorporation of this relatively simple approach to all shoulder injuries sustained by baseball pitchers would lead to a cure in over 90% of all cases; a player’s career would therefore be extended. For example Duane Ward and a host of other pitchers that have labored for the Toronto Blue Jays and other baseball organizations in the past, are prime examples of the results produced utilizing the surgical approach for shoulder injuries. All too frequently, subsequent to surgery, pitchers will seldom throw the ball again – certainly not at the professional level.

Combining the healing potential of laser, nature (i.e. time) and other conservative measures, over 90% of all pitchers post injury could be returned to a normal functional levels, if the Meditech strategy is followed.

Fred Kahn, MD, FRCS(C)

Read the article on the Financial Post web site

In the practice of laser medicine, it has come to our attention that on occasion, patients that should respond to Laser Therapy are either slow to do so or do not improve to the degree anticipated.

We have reviewed a representative number of cases with respect to this issue and have found that in almost all instances the lack of success can be ascribed to the patient self-directing the frequency of treatment sessions, duration and other aspects of treatment. This is counter-productive for everyone concerned.

Accordingly, we make available this directive, to be distributed to each patient on the institution of therapy.

Patient Compliance – Therapeutic Implications

At this time, we wish to emphasize a number of factors regarding the administration of Laser Therapy.

The therapy team that attends to your medical problems will advise you regarding the frequency and duration of treatments. This may vary from one patient to another and also with respect to the condition being treated.

For travel and work reasons deviations from the treatment schedule are permissible. Generally, however, patients are advised to follow the course of treatment outlined, in order to produce optimal clinical outcomes. Significant deviation from that course can impede the healing process.

Our experience over the course of almost twenty years has proven conclusively that patients who comply with their prescribed therapeutic schedule achieve their objectives more rapidly than those who do not.

Once again, in order to achieve maximum benefit, patients must be encouraged to follow the treatment schedule outlined by the healthcare professional managing their case.

•  Allowances with regard to frequency of treatments may be made depending on geographic considerations and the time factor involved. For best outcomes however, a relatively structured therapeutic programme is essential.

•  In some patients, improvement may be evident after only 1-2 treatment sessions, in others however, secondary to genetic factors, chronicity, etc. 8-12 treatments may be required before significant improvement is experienced.

•  It is always stressed that patients should adhere to the programme recommended, in order to achieve the desired objective.

•  Adverse effects resulting from Laser Therapy are negligible and are not significant in our extensive experience. Nevertheless, if any should occur bring them to the immediate attention of the medical staff in order that the therapy may be modified accordingly.

•  It is essential that patients be reassessed by the healthcare professional directing their therapeutic programme every 2-4 visits, to effect protocol changes that will advance the healing process.

•  Customization of the protocols for each individual patient is an important aspect of Laser Therapy.

•  If patients need to be seen more frequently by the supervising clinician, they should so indicate when registering or notify the attending therapist, prior to the initiation of treatment.

Fred Kahn, M.D., F.R.C.S.(C)

Enclosed is a Bulletin Board communication that demonstrates what is possible.

When I first received this inquiry, I was caught in a dilemma whether to treat or let nature take its course. Fortunately, I made the right decision which is what we attempt to do at all times. The results speak for themselves.

We have seen a number of similar cases of this type in the past, however this one is somewhat special, particularly in view of the result.

At the same time, we offer our congratulations and thanks to therapist Donna Rasplica, MSc., R.Ac., Dr. TCM, who made it all happen. It is highly probable that this patient will continue to improve over a prolonged period of time.

The lesson to be learned from this case is – “that you cannot succeed unless you try.” In addition, the healing potential of Laser Therapy is once again emphasized.

THE TREATMENT OF CHOICE FOR DEGENERATIVE OSTEOARTHRITIS
OF THE KNEES

October 2, 2009, Fred Kahn MD, FRCS(C)

I recently read the enclosed article in the Financial Post September 30, 2009. Whereas the article in its context
is largely correct and points out a significant number of alternative therapies for the treatment of degenerative
osteoarthritis of the knees, it misses out on the most important option of all.

Before I proceed with this commentary, I should state that degenerative osteoarthritis of the knees affects over
30%of the adult population over 50 years in age. It is particularly prevalent in athletes who have played contact
sports both at the amateur and professional level. In those instances, the process is accelerated and often
becomes symptomatic in the early and mid 40’s.

With all due respect, medications both oral and injectable have not provided a solution nor as the enclosed
article indicates, has surgery. Knee replacements, when they work, are more than satisfactory but in a significant
percentage of cases, they result in failure. (I.e. pain, inflammation and the ability to be ambulatory). Sometimes,
this is followed by the insertion of a replacement prosthesis, again with less than desirable results.
At our clinics, these unfortunate patients present, not infrequently and unfortunately it is not possible for them to
return to their pre-surgical state.

From the therapeutic perspective, we have been utilizing Laser Therapy over the past 15 years and out of over
200 knees treated on an average annualized basis, less than 3% have required replacement surgery. Often, we
see patients who are already scheduled for surgery and are allowed 3 to 4 weeks to prove the effectiveness of
Laser Therapy. Almost invariably, we succeed. Why this approach should not be more widely used is therefore
difficult to understand.

Several years ago, I circulated a letter to every provincial health minister in Canada requesting that their ministry
permit us to treat 100 knees waiting for knee replacement. I indicated that these could be rehabilitated at a cost
of less than $2,000.00 per patient, significantly less than continuing procrastination or pursuing the surgical
route. Not one health minister responded. Despite this, we continue to treat individuals suffering from this entity
on a daily basis and achieve consistent, outstanding results. Whereas I am exasperated with this current state
of affairs, I wonder what can be done to rectify this situation in a constructive manner.

In conclusion, I can state unequivocally that the treatment of choice for degenerative osteoarthritis of the knees
is Low Intensity Laser Therapy. Surgery, if required on rare occasions, can always be performed at a later date.

March 20, 2009

On a recent Saturday morning, the clinic had a visit from Darlene Corkett, the proprietor of the Waldencroft Clinic in Barrie. Darlene purchased her first BioFlex System in May 2006 and a second unit, one month later. Over the past three years, she has developed an extensive practice in which she works on a full-time basis.
In conversing with Darlene, I was impressed with her skills in assessing patients and applying proper treatment. As we often say at Meditech, “she really gets it!”
On the occasion of that visit, I was so intrigued by her comments that I asked her to write an article about her experiences and the nature of her practice.
Her unedited article is being published in the Laser Report to serve as a “beacon” for other BioFlex users and to illustrate the benefits her efforts bring to the community.

My introduction to the Meditech laser machine was actually through my mother, who lives in the Maritimes. She had just finished reading an article about LILT by Dr. Gifford-Jones and she wanted to know if laser would be something she would benefit from. Her doctor was suggesting a total hip replacement due to a thyroid medication induced osteoporosis. I promised I would look into it.

After touring Meditech’s clinic on Horner Avenue, I met with Dr. Fred Kahn and was immediately impressed with what I saw and heard about LILT.

I purchased my first machine in May 2006 and my second machine one month later. It wasn’t long before I was very busy with the large number of senior clientele I was treating with Shiatsu and Acupuncture. I started by asking my patients with osteoarthritis and rheumatoid arthritis if I could treat their conditions with laser. Many, many treatments later with a tremendous amount of great feedback from my clients I felt I was just beginning to know how to customize the machines.

Each patient has their own unique set of problems, and history. Listening to their complaints and symptoms gives me a better idea as to how I can set up the protocols to suit their needs. Listening is the key!

My background as a Certified Shiatsu Therapist and Acupuncturist helps me to evaluate and zero in on their chief complaint. Combining my skills as a therapist with the sheer love I have of the study of the human body and pathologies, I was becoming more and more comfortable with “tweaking” the protocols.

The senior patients who come to my clinic are extremely active and get quite annoyed when they are unable to carry out the activities they had previously been enjoying because of osteoarthritis or rheumatoid arthritis. They also want to get in and out of treatment as quickly as possible.

I explain to them that the protocol for a specific pathology usually requires a certain number of treatments, and since everyone reacts differently to laser, I reassess them at each visit.

Using “Paula”, my life size skeleton, and charts, I also explain the results of their MRIs, x-rays and CT scans in as much detail as possible. This helps them visualize the problem, and gives them some responsibility for healing themselves. I have found that the more a patient knows about their body the greater their empowerment. It also engages them as very compliant clients. Although I could not prevent my mother’s hip replacements, she did come and visit for a while and had post-operative treatments. She is now back to walking and snowshoeing and remains pain free.

Case Study:

Madeline B., age 72, presented with symptoms of osteoarthritis and rheumatoid arthritis in her knees, hands and feet and shoulders.

She was diagnosed with these conditions in 1967 at age 31. For 26 years she had Gold shots. Arthroscopic surgery was done on both knees in 1989. She was taking Methotrexate for 15 years and is presently on a new drug, Arava. As of 2 years ago, she is no longer taking Methotrexate. She is also a controlled diabetic on Metformin. She finds that heat helps to reduce pain.

When Madeline came to the clinic in August 2006 she was in severe pain. Her knees, hands, shoulder joints and feet were all red and swollen. She had been scheduled many times for bilateral knee replacements but was unable to get the surgery done due to low platelet count. (Methotrexate shuts down the immune system.) Because of the severity and the large area of pain, I decided to customize the rheumatoid arthritis protocol to treat the knees first. The results in the next ten days were remarkable with a significant decrease of pain and a decrease in heat and redness in the knees. Her gait, which had been greatly affected by her pain, normalized. She was able to walk much better, with greater stability, and most importantly, she started to sleep again.

Madeline still suffered from the pain of rheumatoid arthritis in her hands, shoulders and feet so I changed the protocol once again to treat the spine.

The results of this treatment were amazing! Ten treatments later, her whole body responded to the treatments. For the first time in several years, she was able to climb the stairs to the arena to watch her grandson play hockey! She now comes in for one treatment every month. This is enough to keep the symptoms of osteoarthritis and rheumatoid arthritis under control.

Her community activities have increased, and she and her friends and family feel that she hasn’t been this terrific in many years.

The majority of my clients are seniors with degenerative diseases, and even though it is sometimes difficult to treat people with such debilitating problems, it is very satisfying and exciting to see what can be done with LILT. Having treated many people like Madeline, I feel that laser therapy is nothing short of miraculous!

Darlene Corkett CST, D.Ac
Waldencroft Shiatsu Clinic
Laser Therapy

The treatment of wounds continues to be a controversial subject in the medical community. Generally a variety of dressings are utilized along with an overwhelming number of medications.

At Meditech, we continue to see an increasing number of these sometimes challenging problems that fail to respond to conventional therapies.

Utilizing the Meditech regimen, we are able to achieve consistent positive results, particularly as our experience in this area increases.

Our treatment approach consists of the following:

• the removal of dressings

• discontinuation of the majority or all pharmaceuticals

• instituting a programme of laser therapy

• saline compresses as indicated

A useful adjunct when available is the hyperbaric chamber.

On this programme, we have developed the ability to heal an extensive variety of wounds in a relatively short period of time.

Our goal is to establish this method of healing more widely.

The 7 cases illustrated in this monograph clearly corroborate the effectiveness of laser therapy, the basic platform in this healing methodology.

CASE #1

Patient#: 5230

Age: 50/F

Diagnosis: Pre-gangrenous foot – Multiple ulcers secondary to Diabetes Mellitus

This diabetic ulcer presented for follow-up several months post-cessation of laser treatment. There has been no recurrence of the ulcer previously treated with the BioFlex System. The patient is asymptomatic, fully functional and the photograph indicates significant remodeling of the soft tissues.

CASE #2

Patient#: 5094

Age: 77/M

Diagnosis: Ulcer – left foot

This patient demonstrates complete healing of an ulcer after 5 treatments administered over the course of 1 week. Etiology is peripheral arterial occlusive disease. At this time, the patient is asymptomatic, walking normally and does not require any medication.

CASE #3

Patient#: 4840

Age: 72/F

Diagnosis: Infected ulcer – secondary to inadequate arterial circulation

This patient lives over 4 hours away from our clinic and is therefore only being treated sporadically with the Home Unit II. Despite the self-administration, healing is progressing slowly and complete epithelization of the ulcer bed should be complete over the next 6 weeks. Notably, the dimensions of the ulcer have been reduced from 111 cm² to 7.87 cm² and there is healing both at the base and the ulcer margins.

CASE #4

Patient#: 3183

Age: 79/M

Diagnosis: Dermal Ulcer – right heel

This patient’s ulcer developed while being treated in the hospital for a CVA. Following the conventional therapeutic approach, the ulcer continued to increase in dimension. The patient utilized oral and topical antibiotics and dressing changes on alternate days over several months.

On our wound care program, the wound was left open and antibiotics were discontinued. In addition, laser therapy was instituted along with saline compresses at home. Complete healing has occurred and remodeling is evident post-cessation of laser therapy.

CASE #5

Patient#: 6329

Age: 90/F

Diagnosis: Ulcers – right foot, great & 2nd toes

One can visualize the improvement in the appearance of the foot following 6 treatments. Cyanosis is no longer present and the edema and erythema are minimal. Mobility of the toes has been completely restored and the ulcers demonstrate good peripheral healing.

CASE #6

Patient#: 6198

Age: 58/M

Diagnosis: Peripheral arterial occlusive disease with multiple ulcers – left foot

Patient presented with an extremely inflamed forefoot (diameter 42 cm), discolouration, ulcerations and fissuring in several areas and unable to bear weight. After several treatments diameter reduced to 32 cm, all signs of inflammation have disappeared and patient is able to bear weight without discomfort (note distance between 1st and 2nd toes).

Copyright © 2008 Meditech International Incorporated. ALL RIGHTS RESERVED.

Last Friday, we had a surprise visit from an old patient, Gerard Mol, a farmer from Prince Edward Island (PEI). Farming today has become more of a corporate venture and Gerard represents that form of endeavour, managing several hundred acres of various crops, including those wonderful potatoes, famous throughout the world.
Mr. Mol originally came to us in June 2006 with a long-standing history of back pain, subsequent to an injury 8 years earlier. His symptoms had been acute, present in excess of one year and were relatively incapacitating. There was “sciatic pain” and all meaningful physical activities were totally restricted. After many different therapies and consultations with a number of specialists, his condition had not improved. He had come to the conclusion that if Laser Therapy were not effective, he would be forced to “sell the farm.”
Radiological findings revealed herniated discs at L4,5 and L5-S1 levels. In addition there was extensive degenerative osteoarthritis, secondary to the heavy lifting the patient had performed over the years. A highly competent neurosurgeon had previously reviewed his situation and the decision to operate was reserved, in view of the extensive pathology.
Clinical examination when he presented at Meditech revealed a minimal range of motion of the thoracolumbar spine. There was a reverse scoliosis, flattening of the lumbar lordosis and the patient was in such acute pain that he had to be treated daily at a hotel near the clinic, initially. After three to four days, he was able to come to the clinic and at the end of two weeks, his symptoms were markedly reduced.
To maintain his status, Gerard with the assistance of a nurse he brought from PEI were trained to use the Professional System at home, in order to continue the healing process and prevent recurrence. This has been completely successful. Indeed, at this time, his spine is normal in appearance, he continues to be completely asymptomatic and he has regained total functionality with regard to range of motion of the spine and activity levels.
Mr. Mol, being a responsible citizen, used his business talents to establish the first Laser Therapy clinic in Prince Edward Island and he is in the process of enlarging this clinic with the addition of more systems to serve the population of his island. Meditech salutes Gerard for his perceptiveness in choosing the right treatment, leading by example and establishing an institution that will be a benefit to the people of PEI.

As previously stated over the past two years, we are continuing with a number of studies focusing on protocols for the treatment of dermal lesions and as we find exciting new applications we will pass them on to you periodically.

Two weeks ago, a patient presented with a large keloid malformation over the anterior chest wall. This problem began several years ago with an infection and the subsequent development of a scar. Two years ago, this lesion was excised by a plastic surgeon, however within a year the lesion returned with significantly increased dimensions both in diameter and elevation. (Transverse dimension 8cm, vertical 4.5cm and elevation 5mm)

Subsequently, there were a number of cortisone injections and application of various topical medications, all of which failed to diminish the size of the keloid.

The patient first presented at Meditech on July 23, 2007. The initial protocol utilized was red continuous for 10 minutes, infrared 50/70 for 10 minutes and the 75mW infrared probe continuous wave for 5 minutes, as well as the 100mW red probe continuous wave for 5 minutes. The patient has had a total of six treatments since then and on August 1st, quite remarkably, the lesion was barely visible and in total dimensions, elevation, etc. has been reduced over 90%.

After the two initial treatments, red was utilized at 100/90 for 8 minutes, infrared 250/80 for 8 minutes and the 100mW red probe continuous for 3 minutes, plus the 200mW infrared probe continuous wave for 3 minutes. 

Again, after two treatments, further protocol changes were instituted utilizing the 75mW infrared probe and the 100mW red probe for 4 minutes each. The other protocols were unchanged.

Lessons to be learned from this approach indicate that one must be acutely aware of physical change and correlate it with protocol settings. We started with relatively low levels and went to higher levels fairly rapidly, as this appeared to be the appropriate course. The success we achieved was dramatic to say the least.

At this time, we are also treating ten or more psoriatic lesions with a significant degree of success. Some are highly successful, some slower to improve, but in all instances improvement is noticed either shortly after initiating treatment or after five plus treatments. These results are extremely encouraging and we hope to correlate them in a more definitive manner by the end of this year. In the meantime, we will keep you informed. (Initial & final pictures will be forthcoming.)

On an additional note, I had the opportunity to review Jan Tunér’s article, “Is the Blue Cross Meta Analysis Reliable?” As usual, Dr. Tunér’s articles are incisive, knowledgeable and to the point. Furthermore, the article points out the lack of reliability in many assessments, much as his recent article with regard to advertising in the laser industry. My interpretation of Dr. Tunér’s message is – always state the facts as they exist. Through this process, education and integrity will be enhanced.

The application of our technology continues to bring satisfaction to patients and staff alike. Last Friday, I had the opportunity to see a patient with a pre-gangrenous left foot, an extensive ulcer of the first toe and in a great deal of pain. She had seen seven specialists over two years and had undergone many hyperbaric chamber treatments which incidentally, I feel are always helpful but often difficult to obtain.

Last week, she had been told that her toe and possibly the foot might require amputation in the near future. After only two successive treatments, the patient is pain-free, the foot is warm and pink in colour and the ulcer is beginning to heal. Cases of this type indicate the tremendous need for the work that we are doing.

A recent article by Dr Gifford-Jones , a syndicated medical columnist, reaffirms the existence of the multitude of patients suffering from dermatological conditions, wounds and ulcers of various types, that have been resistant to conventional therapies over many years. In almost all instances after only a few treatment sessions utilizing laser therapy , the positive change is quite dramatic.

We continue to interface with many interested physicians, chiropractors, physiotherapists, etc, around the globe and provide educational opportunities for all who demonstrate interest. Currently, we are completing the topics and speaker's list for the seminar on October 27, which will focus on Laser Therapy in Sports Medicine and the Science of Low Intensity Laser Therapy .