Abstract – Case History – Cerebral Concussion

This 28-year-old bank employee sustained at least three concussions and injuries to the cervical spine, the first one occurring at age 10 years. The concussions were invariably activity/sports related and were not accompanied by any episodes of loss of consciousness.

As the number of traumatic episodes increased, she began to develop symptoms which early on were sometimes relieved by craniosacral massage but as symptoms progressed, they became chronic.

Over the years, she developed the following symptoms: severe long term memory loss and fronto-temporal headaches characterized by extreme pressure sensations, which could be quite debilitating. Sleep became increasingly problematic, she began to suffer from light sensitivity, anxiety, depression, fatigue, tinnitus and an inability to concentrate. From the sixth grade on, she also developed a learning disability, which proved to be a significant impediment.

Symptoms prior to attending the Meditech Laser Therapy Clinic in January 2018 had limited both physical and mental activities and diminished her quality of life.

The patient’s testimonial included in this abstract clearly relates her story subsequent to undergoing a course of BioFlex Laser Therapy.

During the course of this year at Meditech, the clinic will treat approximately one thousand similar cases. Once again, this patient demonstrates the high level of effectiveness of Laser Technology in treating the majority of patients suffering from this disease entity.

Clinical Abstract

Purpose of Article – to Demonstrate the Efficacy of Laser Therapy in the Treatment of Neurological Problems.

The case presented is that of a 62-year-old Firefighter. The patient began to experience unilateral sensorineural hearing loss in the left ear, along with vertigo and severe headaches in April, 2016. An MRI of the brain was performed a week later and revealed that a grade 2 ependymoma was present in the 4th ventricle. This was impinging on the dorsal medulla.

The patient was subjected to a craniotomy in order to remove the tumour on June 7, 2016, followed by a course of radiation therapy.

During his recovery, he developed paralysis of the left lateral rectus muscle leading to diplopia. In addition, he was experiencing a lack of balance, nystagmus, severe headaches, slurred speech, difficulty swallowing and fatigue.
Prism glasses were prescribed to alleviate the visual problem, but no improvement was noted. He was told to wait 18 months in the hope that the diplopia, etc. would improve. 15 months post-surgery, his symptoms persisted and some additional symptoms had developed. These included sleep disturbances, memory loss, irritability, depression, anxiety, loss of taste and tinnitus. He presented at the Meditech Rehabilitation Clinic on January 9, 2018.

Physical Examination:

The patient was noted to be right-handed. The right grip was 105 lbs. and the left was 100 lbs.
Range of motion of the cervical spine with regard to flexion, extension, lateral rotation and lateral flexion was 50% of normal.
There was a loss of the normal curvature of the cervical spine and moderate tenderness, C1-C6.

There was limited abduction of the left lateral rectus muscle with bilateral nystagmus on gazing to the left.

Initial Diagnosis:
Post-Surgical Resection of Malignant Ependymoma
4th Ventricle with Multiple Neurological Sequelae.

TREATMENT AND PROGRESS:

The patient initiated treatment using Laser Therapy at the Meditech clinic on January 9, 2018. Initially, treatment was confined to the occiput, cervical and upper thoracic spine. Irradiation of the brainstem and cerebellum were included with the cervical treatments. Following 5 treatments of these areas over 5 days, treatments were extended to the cerebral hemispheres, initially targeting the occipital lobe. Over several additional days, treatment of the cranial hemispheres was extended to include the temporo-parietal and the frontal lobes. These targeted the motor, sensory and speech centres of the brain.

After 3 sessions of daily treatment at our clinic, including the cerebral hemispheres, the patient noted that his horizontal gaze was more balanced, and the diplopia from which he suffered was disappearing. After an additional week, there was marked improvement in the lateral abduction of his left eye and the double vision had disappeared. His energy levels were elevated and he was able to be more active physically. At this point, his caregiver had been trained to utilize the equipment preset for treatment at home and this is continuing.

RELEVANT DATA:

Ependymomas are a type of tumour of the glial cells (supporting cells of the brain) that starts in the ependyma. The ependyma lines the fluid-filled spaces in the ventricles (cavities) of the brain and the centre of the spinal cord. Ependymomas spread to the cerebrospinal fluid more often than other gliomas. They do not spread outside the brain or spinal cord. Based on the World Health Organization (WHO) grading system, ependymomas are classified as low to high grade (grades 1–3). Low-grade tumours (grade 1) are more common in the spine while grade 2 tumours are more common in the brain.

Symptoms depend on the tumor location. The most frequent symptoms include:
• Headache and intracranial pressure
• Nausea and/or vomiting
• Blurred vision
• Weakness or numbness and tingling
The cause is not known. It rarely occurs in multiple family members, although does occur in people with Neurofibromatosis type 21.

Treatment is usually based on the size of the tumour and the symptoms that occur. Surgery may be performed to remove all of the tumour or as much of the mass as possible. Low-grade tumours may not need further treatment if the entire tumour can be removed. Radiation therapy may be given after surgery for grade 1 and 2 tumours if the tumours can’t be completely removed. Radiation therapy is given after surgery for anaplastic tumours. It may also be used to treat tumours that return after treatment (called recurrent ependymomas) if radiation therapy was not given previously. It may be given to the entire brain and spinal cord if tests show that the cancer has spread through the cerebrospinal fluid2.

Brain surgery and the consequent radiation therapy following the procedure is a major medical event which carries numerous associated risks including an allergic reaction to anesthesia, intracranial bleeding, blood clots, edema, coma, impaired speech, vision, coordination, or balance, infection in the brain or at the wound site, memory problems, seizures and strokes. Aside from some of the side effects mentioned, our patient also sustained nerve damage of the abducens nerve (6th cranial nerve)3.

The sixth nerve leaves the brainstem at the pontomedullary junction and follows an upward and outward path. The long intracranial course of the abducens nerve makes it vulnerable to injuries, most often at the site of the dural entry point and at the petrous apex. Although traumatic palsy of the sixth nerve is usually seen in combination with intracranial hemorrhage, skull fracture, facial fracture or elevated intracranial pressure, it may occur in the absence of such lesions.

The appropriate management of posttraumatic or post-surgical isolated abducens nerve palsy remains a matter of debate. Spontaneous recovery from sixth nerve palsy usually occurs within 6 months, with improvement noted in most cases at 3 months4. Our patient remained symptomatic 15 months post-surgery.

Laser therapy has a favourable prognosis in the regeneration of peripheral nerves in both neurosensory and neuromotor deficits, such as trigeminal neuralgia, neuropathy, low back pain with sciatica, and herpes zoster. Application of laser produces both local and systemic effects that can stimulate the nerve regeneration process. Moreover, laser therapy improves the recovery of the injured peripheral nerve and decreases post-traumatic retrograde degeneration of the neurons in the corresponding segments of the spinal cord. Research studies have shown that Laser therapy increases the functional activity of the injured peripheral nerve, prevents or decreases degeneration in corresponding motor neurons of the spinal cord, and improves axonal growth and myelinisation.

Bernal previously found that Laser Therapy is an excellent complementary medium for the recovery of facial nerve paralysis and provides a painless therapeutic alternative without side effects that can be used on any type of patient, including those who cannot use corticosteroids, such as diabetics and hypertensive patients. In addition, Ladalardo et al. studied the effect of GaAs diode laser in patients with Bell’s palsy and used THE House-Brackman Facial Nerve Grading System (HBS) to assess the outcome. In that study, patients who received the treatment showed a functional improvement ranging between one and three grades on the HBS. One of the possible explanations of the laser effect is through an increase in the activity of enzymes involved in the mitochondrial respiratory chain, such as cytochrome C oxidase and adenosine triphosphatase (ATP), thereby leading to an increase in ATP production in mitochondria. In addition, it increases DNA synthesis as well as collagen and pro-collagen production. The anti-inflammatory effect of laser therapy can be caused by a reduction in the levels of pro-inflammatory cytokines, such as interleukin-1 alpha (IL-1α) and IL-1 beta (IL-1β) as well as an increase in the levels of anti-inflammatory growth factors and cytokines, such as basic fibroblast growth factor (bFGF), platelet-derived growth factor (PDGF), and transforming growth factor-beta (TGF-β). In addition, laser irradiation causes dilatation of blood vessels, which also leads to a reduction in swelling caused by inflammation. It may also have inhibitory effects on the release of prostaglandins, cytokine levels, and cyclooxygenase (Cox) 2, and has been shown to accelerate cell proliferation, collagen synthesis, and tissue repair. Laser Therapy may also have a direct effect on nerve structures, which could increase the speed of recovery of the conduction block or inhibit Aδ and C fiber transmission. Moreover, it was reported that
Laser Therapy significantly widens the arterial and capillary vessels, increases
microcirculation, activates angiogenesis and reduces edema caused by inflammation. It also stimulates the immunological process and nerve regeneration5.

Our experience in the treatment of this patient firmly establishes the positive effects of Laser Therapy. Based on current therapeutic methods, this approach is superior to those being utilized and can therefore be termed the treatment of choice in the resolution of symptoms associated with these neurological conditions. Moreover, application is safe and does not have any of the potential adverse effects of steroids, botulinum toxin injections and unquestionably accelerates the resolution of post-surgical sequelae.


References:

1. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/ependymoma/?region=on

2. http://www.cern-foundation.org/education/ependymoma-basics

3. https://www.healthline.com/health/brain-surgery#followup

4. Asproudis I, Vourda E, Zafeiropoulos P, Katsanos A, and Tzoufi M. Isolated abducens nerve palsy after closed head injury in a child. Oman J Ophthalmol. 2015 Sep-Dec; 8(3): 179–180.

5. Salaheldien M, Alayat M, Elsodany AM, Abdel Raouf El Fiky A. Efficacy of high and low level laser therapy in the treatment of Bell’s palsy: A randomized double blind placebo controlled trial. Lasers Med Sci (2014) 29:335–342

Clinical Abstract

Edit: February 6, 2018

CLINICAL ABSTRACT

Purpose of Article: To demonstrate the efficacy of Laser Therapy in the Treatment of Chronic Cerebral Concussion.

The patient is a 38-year-old individual who presented complaining of multiple cognitive impediments. On careful questioning, he recalled sustaining a severe concussion at age 5, after falling six feet from a fence. Evidently he lost consciousness for an undetermined period of time and was taken to the hospital by his parents. A number of investigative procedures were performed, however no therapy was provided.

From that time on, the patient had a difficult upbringing, experiencing problems with all relationships including his parents, at school working with teachers and subsequent to completing his education, maintaining a job. He had been on Zoloft for depression for many years. He stated that he had been diagnosed with “Obsessive Compulsive Disorder”, has difficulty organizing, is subject to chronic “brain fog” and has severe pain in the cervical spine. These problems had become well established and the patient summarized his status as being unable to get along with anyone, achieve any level of success in his work objectives and generally preferred to live alone as an introverted, problematic recluse.

PHYSICAL EXAMINATION:
On initial examination on August 18, 2015, the patient was noted to be right-handed. The right grip was 90 lbs and the left was 80 lb. Range of motion of the cervical spine with regard to flexion, extension, lateral rotation and lateral flexion was 60% of normal. A loss of the normal curvature of the cervical spine was noted, along with significant para-cervical muscle spasm and moderate tenderness from the occiput to T1.

The patient’s attitude was extremely negative and with regard to movements and speech, he appeared to be hypoactive. The neurological examination was grossly within normal limits however a bony depression was noted over the left frontal bone, attesting to the initial injury at age 5 years. Generally speaking, the patient was minimally communicative and appeared to be locked in a protective shell.

The initial diagnosis formulated after a prolonged period of questioning, and the physical examination, was–Cerebral Concussion (chronic, severe).

The case clearly represented the clinical picture of a chronic case of Cerebral Concussion and it was somewhat doubtful after the period of time that had elapsed from his initial injury that improvement in his condition could be provided.

COURSE OF TREATMENT: Treatment was initiated using the BioFlex Laser Therapy System on August 22, 2015. Initially, treatment was confined to the cervical spine, including the occiput and upper thoracic spine. Irradiation of the brainstem and cerebellum were included in this process. Following five treatments of this area on consecutive days, treatments were extended to the cerebral hemispheres. Initially only the occipital lobes were targeted but as the course of treatment advanced, treatments were extended to the temporo-parietal and frontal lobes. These focused on the motor, sensory and speech centres of the brain.

After the initial three days of treatment, the patient reported that he was experiencing petit mal seizures at night. He also revealed that the house he grew up in had high lead levels which he was exposed to during his formative years. At this point in the course of treatment, he noted that the chronic “brain fog” was gradually being replaced by clarity and his reading abilities had begun to improve.

At this time, he began to reduce the intake of Zoloft, which had been prescribed for his chronic depression.

As therapy progressed, range of motion of the cervical spine improved to a relatively normal level. After 12 treatments of the cervical spine over a course of three weeks, along with applications to the cerebral hemispheres, he reported that he was able to engage in more physical activities and his mental clarity continued to improve. In addition, he commented that his emotional status was more stable, his energy levels had increased and the periodic petit mal seizures had almost completely disappeared. After six weeks of treatment, the patient felt that he had improved sufficiently on the functional level that he decided to discontinue treatments.

Two years following the completion of treatment, the patient presented with another problem and at that time, we did not recognize him. There was a complete change in his appearance, demeanor and his communicative skills. On questioning, the patient revealed that his lifestyle had improved substantially, although he was still using Zoloft periodically. Conversational levels were relatively normal, the patient was optimistic and there was no evidence of any psychological or behavioural problems.

He indicated that he had been holding a steady job for the past year, had moved to a higher level environment, appeared to be well groomed and communicated with a great deal of self-assurance. Indeed, when I saw him in the waiting room, I had difficulty recognizing him. For the first time since I had known him, he was optimistic with regard to the future and felt that his life was continuing to improve on all levels.

RELEVANT COMMENTS: In the past, there has been minimal progress in developing effective treatments for chronic brain injuries, particularly in cases of multiple cerebral Concussions. This patient illustrated the tremendous benefit that can be induced by appropriate Laser Therapy. The changes in this patient were dramatic from all perspectives, particularly his speech and energy levels. The patient stated that the quality of his life had normalized and looked forward to the future with optimism.

Interview With Femevolve

The article posted below was recently published in a new magazine called FemEvolve. This is a publication founded by Christina Paruag, a graduate of the Department of Journalism at Ryerson University. Christina skillfully highlights the story of her past illnesses and the restoration of her health status using Laser Therapy.

The article also includes a brief interview with me and I feel that her story delineates the benefits that can be obtained with this therapeutic approach.

At the same time, Christina and her associates are to be congratulated for launching this new venture, particularly in these difficult times in the print industry.

I was given the book The Brain’s Way of Healing by Norman Doidge for my 21st birthday. I really wanted this book to help in re-wiring my brain to better manage the daily chronic pain I was experiencing from severe endometriosis. Little did I know how life changing this book would be.

As I sat there reading the book one afternoon, I came across a passage in the chapter Rewiring a Brain with Light. This chapter was quite interesting to me as I had been studying physics at the time. I read until I got to one part about a doctor by the name of Fred Kahn. He was previously a surgeon, going on to specialize in vascular surgery, and was very well-experienced in his field.

I learned through reading that he gave all of this up to pursue a career in laser therapy- in which he would help thousands of patients minimize the chronic pain they were experiencing that was limiting them in living their lives to the fullest. I became intrigued and couldn’t stop reading. I got to a passage about a neuroplastician who had suffered with severe endometriosis. I read and read with such speed, I couldn’t believe my eyes. In this book that I thought would help my endometriosis in one way, there existed a real treatment that could get to the root cause! Norman Doidge explained that Dr. Kahn’s laser therapy system helped the neuroplastician to overcome tremendous pain, bowel obstruction and get rid of scar tissue. My eyes welled up with tears and I felt hope pulse through my body. Could this be the answer? I immediately Googled his clinic, Meditech Rehabilitation Centre and booked a consultation with his receptionist.

I found a documentary on CBC about the book and watched the interview with Dr. Kahn in disbelief. This was a real treatment- something that may actually put an end to all my pain and suffering,” I thought. I wanted my life back. I wanted more than anything to feel like a normal 21-year-old, and not have to plan my life around my period or feel restricted from having a job and going to school. I was so excited. I didn’t want to get too hopeful, yet something inside me told me that I had to give this a try. After watching that CBC documentary, I wanted the chance to interview Dr. Kahn. I didn’t know if it would ever happen, but I deeply admired what he was doing. How he gave up what he had worked so hard for and pursued something close to his heart: the chance to put an end to chronic pain, or at the very least, minimize greatly, chronic pain in his patients.

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I can gratefully say that Dr. Kahn’s Bioflex Laser systems have given me my life back. I started treatments in November 2016. After my first treatment, my energy levels peaked. I didn’t feel the same levels of chronic fatigue. When I went to sleep that night, I woke up the next morning astonished. I hadn’t been able to remember my dreams for two years before this point due to my noisy brain (chronic pain generally leads to an increase in neuronal activity as the brain fires too many pain signals to the area where pain is experienced. The brain is in constant fight-or-flight mode and sends numerous pain signals to the area, when there is no cause for concern. This was my experience with endometriosis, and no medication was able to help). The laser therapy enabled me to remember vivid and detailed dreams, putting my brain into a restful state as my body healed. After just three treatments, I went from being in severe pain almost every day to being in manageable pain a few days a month. I went from missing three to four days of school/work to missing none, sometimes only one a month. I started walking
properly, not with a limp. I began to cook and clean more often and became more independent, less reliant on family as I was able to get out of bed. I can now say that I can handle a full-time job, a full-course load,
traveling while on my period, or anything else life throws at me. I’ve used laser therapy not just for my severe endometriosis. I told Dr. Kahn in March 2017 of recurrent kidney infections I’d been experiencing. Every ER doctor I saw gave me antibiotics, until I had taken almost io rounds of antibiotics. The infections got so bad at one point I felt like I was dying. They would keep coming back. Until
one month I had all the same symptoms, but no infection could be detected. This went on for almost five months. Every doctor was puzzled as to how this could happen. Dr. Kahn told me that it was possible that the problem was not my kidney, but rather scar tissue affecting my bladder, and suggested lasering my bladder. After only one treatment, I saw a significant improvement and haven’t been on antibiotics since. In June 2017, I suffered a minor concussion. I just started my first full-time job ever and was terrified of losing it at that point. After three treatments, my concussion symptoms (such as a pounding headache on one side, dizziness and difficulty with speech) started becoming less. I was able to keep going to work every day, while I made sure to rest a lot at night and minimize electronic time. My concussion symptoms went away in two weeks with treatments three times a week. Dr. Kahn has been so supportive throughout the past
year and I truly believe that had I not met him, I would still be suffering from severe endometriosis, on multiple rounds of antibiotics and dealing with post-concussion symptoms. I feel like I have my life back, and this is all thanks to Dr. Kahn, his amazing and hardworking staff, and the life-changing therapy that they deliver.

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In addition to my own success with laser therapy, well-known individuals such as former NBA star Jerome “Junk Yard Dog” Williams and long driving champion Niilo Schonfeld have benefited from Dr. Kahn’s BioFlex Laser systems for pain in the knees, neck and back. The BioFlex Laser systems have enabled these individuals to continue their careers with reduced pain.
Read on below about the powerful effects of laser therapy and Dr. Kahn’s remarkable work that is helping numerous patients on their journey to a pain-free life.

Can you talk a bit about your initial experiences with laser therapy and what drove your passion to start this research?

I had a shoulder problem. I had a ski injury, I had a rotator cuff injury and it wasn’t getting any better. I like to play golf and swim three to four times a week and I wasn’t able to do that. I don’t like utilizing pain medications, so I missed those activities and went looking for a better therapy. I talked to a couple of surgeons and they wanted to operate, and I just felt like surgery was not the solution. Surgery gives you an additional trauma, another injury. I already had an injury, so surgery would be another injury.

Because you’d have to recover just healing from that.

They cut through tissue, they cause bleeding, they do all kinds of things. Not that surgeons are incompetent, but having been a surgeon; I was a general surgeon with a sub-specialty in vascular reconstructive surgery so that route did not appeal to me and I rejected it. In medicine today, it’s important to know how to protect yourself. Particularly as you get older, you’re gonna have some problems, aside from trauma.

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I was looking around for different options. Options, you have to look for them. They won’t come to you. I heard about laser therapy and someone had brought a very primitive Russian device, so I found a guy that had one.

That’s where it started, in Russia?

There were devices built in Japan, in Russia, etc. Poorly engineered devices built all over the world really, but they weren’t good devices. A light source based in some sort of base where you turn on the light and you turn it off.

So it wasn’t LEDs or concentrated laser light?

No, it wasn’t sophisticated. So we use LEDs, red, infrared, lasers. We use all kinds of different lights because all of them have different physiological effects. By adjusting the light source, we manipulate the frequency, the duty cycle, the wavelength, the waveform. There are about six things that we modulate. It’s fairly complex and it’s scientifically-based.

That goes into the protocol that you create for a patient?

Yes. Literally, manufacturers have no idea what I’m talking about when I say these things because they take a light source or a diode, turn it on and turn it off. Then they add all kinds of hype, which is untrue and has no basis in reality, never mind science and they try to sell that light. Their mantra is, “it’s bigger, it penetrates more deeply, etc.” A great deal of advertising hype which is generally not true.

Right. The size of the light has nothing to do with it, it’s the modulation.

From day one I always like to do better than other people.

(Laughs) Well it’s clearly paying off!
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Whatever revenue we generate goes right into research, design, manufacturing and educating.

Right. I like that it’s not just the therapy, you take everything into account. You have the clinic, the engineering side.

Health care professionals.

Yes, I had the chance to see that too today.

It’s based on understanding of clinical problems. Understanding of how to put together devices that can treat those problems, and then customizing those devices appropriately. So, design and development of equipment and teaching people how to use it properly are extremely important.

How does laser lead to cellular repair and tissue healing?

Through a series of complex physiological interactions between the light and the intracellular organelles or molecules and it also involves the cell membrane. The process results in the restoration of normal structure and function of the cell.

Laser therapy has been shown to increase oxygenated blood flow to the diseased tissue which accelerates healing. It also promotes the production of collagen (a protein fibre that helps to form connective tissue in the body), while reducing internal scar formation and enhancing tissue elasticity. It repairs damaged muscle fibres and activates myogenic satellite cells which repairs muscle tissue. It also increases inflammatory mediators such as macrophages (which break down foreign and injured cells, and protect the body against infection), neutrophils (which ingest bacteria and help fight infections) and lymphocytes (which regulate the immune system), reducing both inflammation and edema.

So the cells become damaged when the patient has inflammation?

Yes, systemic diseases, local diseases, any kind of disease process. Usually with a disease process, you have an inflammatory change or deterioration of the tissues, like in arthritis it’s inflammation and degeneration. The vast combination of different etiological factors.

Can you explain for our readers, the difference between high intensity and low intensity lasers? Why are low intensity lasers safe?

It’s low intensity because it deals in milliwatts. High intensity is watts. With a high intensity laser, you can cut through steel, through cement, through anything. With low intensity laser therapy, it’s more gentle and lower power settings are used. It’s controlled and ours are designed so that they can’t burn or harm tissue. Some manufactures use high powered lasers and then put a thick piece of glass or plastic between the light and the tissue and you do not know what intensity actually interfaces with tissue, which defeats the purpose of constructive radiation.

What health conditions do you regularly treat with laser therapy?

We have four treatment platforms.

Treatment of musculoskeletal problems: spinal pathologies, soft tissue and sports injuries, arthritis, etc.

Treatment of wounds/dermal ulcers: such as diabetic lesions, and those that occur due to compression, surgery or trauma. This is a highly effective treatment that leads to rapid healing of the lesions.

Treatment of dermatological conditions: eczema/dermatitis, psoriasis, acne, etc.

Treatment of neurological conditions: cerebral concussion (traumatic brain injuries-TBIs), early application for Dementias, Parkinson’s and other neurological conditions.

How do you use laser to treat concussions?

All concussions have neck injuries. Most of the injuries are focused on the junction of the neck and the brain. It involves the central nervous system (CNS), the neck, and the spinal cord. We always start by treating the neck. So we treat the tissues directly, the neck, CNS, etc. and we irradiate structures using photon particles. These are absorbed by the cerebrospinal fluid, which circulates through the spinal canal and around the brain and ventricles. We treat through the vascular and lymphatic systems. Cerebrospinal fluid and direct treatment of the tissues- neurological, skeletal and soft tissues

Some patients also get treated on top of their heads, right? What’s the difference between that treatment and treating concussions with lasers used on the neck only?

Okay, so 70% of patients are cured without treating the hemispheres. If we don’t need to go to the hemispheres, we don’t. If it’s i00% effective treating the neck, we don’t need to do that, if it isn’t then we go to the hemispheres. It’s very elaborate and sometimes the auditory mechanisms are affected so we treat those as well.

Because you get the ringing in your ears and that sort of thing

Right. The ringing of the ears often disappears just when you treat the neck. When you’re treating the neck, you’re treating the spinal cord, the brain stem and the cerebellum. So that’s your basic treatment.

That’s so incredible.

I’ve also categorized concussions into acute stable, acute labile, chronic stable, etc. So there are different categories. Then they fall into different age groups, degrees of severity of concussion. We use all that information and we have a number of protocols developed for each of those. It’s quite sophisticated. It’s like you feed all the material into a computer and you come up with different combinations, permutations, algorithms, protocols that enable you to effectively treat those conditions.

That’s great! Moving towards the women’s health side and lasers: Can it be used to treat or diminish ovarian cysts?

Ovarian cysts are usually benign lesions, all women have them.

You’ve never shrunk them?

Ovarian cysts will do what they will do. I used to do a lot of abdominal surgery, so every woman has them. Can you do anything about them? No. The ones that are huge, they’re gonna burst. When inside the peritoneal cavity, we might prick it like a balloon and suck up the fluid and they’re gone. They relate to ovulation. Malignancy is rare but might be considered.

Okay, that’s good to know. In my experience, before I started laser therapy, I was getting ruptured cysts every three months. Since I started, I’ve only had one. So I was curious if it shrinks them or stops them from forming the same way.

Basically, when you have endometriosis, you have a lot of irregularities, many cysts bursting and enlarging, etc. Only rarely are they malignant.

Can it be used for fibroids?

Fibroids again, are generally asymptomatic. Most therapies, pain medications, anti-inflammatories are used to treat symptoms. I’ve thought about this for a long time. Symptoms are the result of a disease process. Whether it’s organic, systemic, local, generalized, etc. Most medicine is directed to treat the symptoms because that’s profitable. A lot of people encourage symptoms to persist, so the patient comes for more visits, gets more treatments, more analgesics, etc. We’re different as we treat the condition causing the symptoms. We try to figure out what’s causing the symptoms. It’s like the fire and smoke -most people treat the smoke, but the fire will continue to burn.

Right, just like the problematic cysts are a symptom of endometriosis and ovulation. How does it work in eliminating scar tissue in endometriosis?

Enough penetration into the peritoneal cavity which is lined with a very delicate lining com¬posed of cells, it’s very sensitive to increased pressure, inflammation, all those things. It reduces the inflammation essentially. It has a calming effect on the tissues and gets rid of the inflammation. It stimulates the absorption of follicles bursting, fluid in the peritoneal cavity, it gets rid of all those.

What factors are considered when you create a protocol for a patient?

The patient’s weight, padding, how much skin pigmentation. There are about 10-12 factors that come into play. What the problem is, how severe it is. Is it acute? Is it chronic? So there are many factors that we take into consideration. Each case is individualized. No two cases are treated the same way. You can but it’s better if you don’t. There are many common factors, however.

A great advantage of laser therapy is that it is not painful and there are no harmful side effects. Are there any known long¬term effects of laser therapy?

I’ve been using it personally for 20 years and nothing adverse has ever occurred. There may be some, but if so they haven’t become noticeable.

Or you’re just superhuman.

No, I’m definitely not!

(Laughs) I’ve never had a bad experience with it either so that’s good. What factors would lead to laser not being effective for a patient?

We don’t use it on the abdomen during the first or second trimester of pregnancy. That’s the main one. Some people demonstrate photosensitivity, so you might restrict them, or you might start at really low settings and let the tissues/cells adapt.

What countries is laser therapy currently offered in?

Our systems are in 52 countries worldwide.

That’s just the BioFlex itself?

The system, yes.

Wow.

But medicine is very slow to change. It’s very traditional and conventional and it’s fixed. In our system, the people who get the best care are those who are not salvageable or dying unfortunately.

It’s not about prevention, that’s what bothers me.

Prevention should be a major item in all medical school curriculae.

It’s not, it’s just the band-aid options. What does success mean to you?

If I’m helping people, that’s success. If I make money, I will give it away anyway eventually
or use it for research. Money is security against society. I’ve coined a phrase, “It’s easier to be happy when you’re rich than when you’re poor. You may not be happy, but you have the opportunity to rectify that, you can do what you like, you can pay for it.”

What are some things you do that contribute to a healthier life?

If I’m helping people, that’s success. If I make money, I will give it away anyway eventually
or use it for research. Money is security against society. I’ve coined a phrase, “It’s easier to be happy when you’re rich than when you’re poor. You may not be happy, but you have the opportunity to rectify that, you can do what you like, you can pay for it.”

What are some things you do that contribute to a healthier life?

I try to exercise everyday. Something, even a half an hour or an hour walk, stretching, golf, swimming. Being active. I read a lot. I think a great deal. Being active, being involved. Being engaged. Diet also is extremely important.

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Definitely. That’s great. Can you name someone that has inspired you on your journey in helping others use laser therapy?

There are a lot of people I’ve looked up to during the course of my life. I had a grade school teacher, she was very good to me and I think she helped to guide me. Then I had an English high school teacher who was a big
influence. Taught me how to read and write. I worked for a guy at a golf course for several summers. He had wonderful integrity and business principles. One of the people I admire is Frank Stronach, he’s the president of Magna. I like the things he stands for and the way he conducts himself, along with what he has accomplished.

You feel that it’s aligned with your values?

Yes, exactly. Then I’ve worked with some surgeons that I thought were outstanding. Denton Cooley in Houston, Texas who is the father of vascular surgery.

These are some of the people who have had a positive influence on me.

That’s great! What advice would you give to prospective patients considering laser therapy?

It can’t cause any harm and it may do you a lot of good. In medicine there are no guarantees. I don’t want to sell people anything that they don’t think is going to help them and most of all I want to cure their condition.

To learn more about laser therapy and to discover how Dr. Kahn’s incredible Bioflex systems can help you, visit: http://bioflexlaser.com/

CLINICAL ABSTRACT –
Fred Kahn, MD, FRCS(C), Ronaldo Santiago, MD

PURPOSE OF ARTICLE
To Illustrate The Efficacy Of Light Therapy In The Treatment Of Neurological Pathologies.

PATIENT PROFILE:

Currently he is under the care of his family physician, a neurologist, urologist, etc.

He sustained his initial concussion as a child when he fell out of a tree and lost consciousness for an undetermined period of time. A severe whiplash injury occurred in his 20s, accompanied by trauma to the cranium and three years ago, he had another concussion (moderate/severe) when he sustained a blow to the head at work.

He has been on Acyclovir for the past six months, presumably for treatment of Epstein-Barr Syndrome. Symptoms over the past two years persist without relief and include severe dizziness, headaches, insomnia, fatigue and a complete inability to function at all levels. The patient has been unable to work, is relatively immobile, unable to speak and relates a host of additional cognitive symptoms. He has been subjected to ongoing physiotherapy, occupational therapy, speech therapy, numerous specialist consultants and the employment of an extensive variety of therapeutic options, none of which have improved his status.

PHYSICAL EXAMINATION NOVEMBER 19, 2017:

  • The patient moves slowly and has a shuffling gait.
  • His facial expressions are relatively rigid.
  • Despite his current age of 52 years, his appearance and movements resemble someone in their 80s.
  • The patient is right-handed. The right grip is 50 lbs and the left 40 lbs.
  • Lateral abduction of both shoulders is to 90° only and all movements of both shoulders are restricted in varying degrees.
  • Range of motion of the cervical spine with regard to flexion, extension, lateral rotation and lateral flexion is less than 20% of normal and a similar range of motion of the thoracolumbar spine is 25% of normal.
  • Straight leg raising is 50° bilaterally.
  • Range of motion of both hips is minimal.
  • A reverse thoracolumbar scoliosis with the lumbar apex to the right is noted to be present.
  • Varying degrees of tenderness exist over the cervical, thoracic and lumbar spine.
  • The patient speaks slowly and his voice demonstrates minimal volume.
  • He lacks any affect.
  • His speech is hesitant and the sounds are almost unintelligible.
  • His wife acts as an interpreter which is helpful.

INITIAL DIAGNOSIS:

  1. Neurodegenerative Disorder (Multiple System Atrophy)
  2. Parkinson’s Disease.

TREATMENT AT MEDITECH CLINIC:

The patient commenced treatment with Laser Therapy at our clinic, and this was applied over the cervical, thoracic and lumbar spine, along with both shoulder joints. After five treatments to these areas, therapy was extended to the cerebral hemispheres, initially targeting the occipital lobe and eventually including the temporo-parietal and the frontal lobe

After seven days of daily treatment, there was noticeable improvement in his gait. The patient was able to rise from the seated position without help and recovered a relatively normal gait. His sleep problem was completely resolved and he was able to smile and speak in a normal fashion. Comprehension of all verbal communications had been largely restored.

DISCUSSION:

Multiple system atrophy (MSA) is a rare, progressive neurodegenerative disorder characterized by a combination of symptoms that affect both the autonomic nervous system (the part of the nervous system that controls involuntary action such as blood pressure or digestion) and movement. The symptoms reflect the progressive loss of function and apoptosis of nerve cells in the central nervous system.

Autonomic failure symptoms include fainting spells and problems with heart rate, erectile dysfunction and bladder control. Motor impairments (loss of or limited muscle control or movement, or limited mobility) may include tremor, rigidity, and/or loss of muscle coordination as well as difficulties with speech and gait. As these features are similar to Parkinson’s disease, it may be difficult to distinguish these disorders early in the course of the disease.

MSA can be divided into two different types:

  1. the Parkinsonian type (MSA-P), with primary characteristics similar to Parkinson’s disease (such as moving slowly, stiffness, and tremor) along with problems of balance, coordination, and autonomic nervous system dysfunction, and;
  2. the Cerebellar type (MSA-C), with primary symptoms featuring ataxia (problems with balance and coordination), difficulty swallowing, speech abnormalities or a quavering voice, and abnormal eye movements (“cerebellar” reflects a part of the brain involved with coordination)

The cause of MSA is unknown. There is noted accumulation of the protein alpha-synuclein in glial cells that support nerve cells in the brain, primarily oligodendroglia which produces myelin in the central nervous system. The same protein also accumulates in Parkinson’s disease, but within the nerve cells itself as opposed to the supporting glial cells in MSA1.

There are no known treatments to delay the progressive neurodegeneration associated with MSA and at this time there is no known cure. Current treatments are mostly supportive and convey minimal clinical benefit. In this case, the patient was referred to physiotherapists, occupational therapists, acupuncture practitioners, and an integrative medicine practitioner who detected the Epstein-Barr viral (EBV) antigen in his system. Presumably this is the reason he was placed on Acyclovir, which he felt did not convey any benefit.

Currently there are no studies that mention a connection between MSA and EBV, however the latter has been linked to an increased potential to develop Multiple Sclerosis (MS). For some individuals, Levodopa may improve motor function, however improvement is minimal and diminishes as the disease progresses.

Using cell models of MSA, scientists were able to show that both damage to the mitochondria (cellular “power plants”) and the generation of abnormal alpha-synuclein aggregates may contribute to the development of MSA. In a study conducted by Blin, et al, a significant age-related decrease in the activity of mitochondrial respiratory chain complex I was observed, supporting the hypothesis of a wide-spread mitochondrial complex I deficiency in PD and MSA as compared to age-matched controls, who only showed age-related deficiency. Deficits in complex III and IV activity (which includes cytochrome c oxidase) was also observed, but which was restricted to a few patients2.

Many investigators believe that Laser Therapy for brain disorders is one of the most important medical applications of Light Therapy. It is well accepted that with the overall aging of the general population, together with ever lengthening life spans, that Dementia, Alzheimer’s, and Parkinson’s disease will become a global health problem and even after many years of research, no drug has been developed to benefit these neurodegenerative disorders3. Laser Therapy is a non-invasive, light-based therapy that utilizes a combination of red and infrared light sourced from red and infrared LED’s and laser diodes and for over 30 years has been effectively used in the treatment of many medical conditions, including musculoskeletal, dermatological problems, wound healing and more recently, the treatment of neurological conditions.

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

Given that previous studies show mitochondrial involvement in both PD and MSA, there would be several key advantages for the use of Laser therapy for PD and MSA. Although in its infancy, with the bulk of results still at the pre-clinical “proof of concept” stage, Laser Therapy has the potential to develop into a safe and effective neuroprotective treatment for patients with Parkinson’s disease and other neurodegenerative diseases such as MSA. If Laser Therapy was applied at an early stage of the disease process it could without doubt stop progression of the disease and begin healing of the cells, along with the regenerative process based on its neuromodulation and neuroprotective effects. Over time this should achieve the objective of restoring the function and morphology of the neurons and other intracranial tissue resulting in significant improvement with regard to all clinical signs and symptoms4. Moreover, Laser therapy, with the accompanying lack of adverse side-effects, is amenable to use in conjunction with other treatments when available. Laser Therapy, as a specific treatment for MSA and other neurological conditions, is completely safe, simple to apply and in the context of a bleak future, for MSA patients in particular, offers a safe and specific therapeutic approach. This will not only extend the affected individual’s life span but also improve the quality of life for these patients and hopefully a return to normal activity levels.

CONCLUSION:

This patient’s level of improvement after one week of daily treatments including November 19-24, was in excess of 70%. He was walking and communicating in a relatively normal fashion and required no assistance to accomplish this.

For logistical reasons, he returned to his home in Florida where his wife will continue to treat him on alternate days according to the protocols developed at the Meditech Rehabilitation Centre. He will return in four weeks for re-evaluation and continuing treatment under our direct supervision for an additional two weeks.

This case demonstrates the dramatic effect of Laser Therapy in the treatment of neurological conditions. It should be noted that the patient stated that he expects to return to work in March 2018.

REFERENCES:

  1. Multiple System Atrophy Fact Sheet | National Institute of Neurological Disorders and Stroke.https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Multiple-System-Atrophy
  2. Blin O, Desnuelle C, Rascol O, Borg M, Peyro Saint Paul H, Azulay JP, Billé F, Figarella D, Coulom F, Pellissier JF, et al. Mitochondrial respiratory failure in skeletal muscle from patients with Parkinson’s disease and multiple system atrophy. J Neurol Sci. 1994 Aug;125(1):95-101.
  3. Michael R. Hamblin. Shining light on the head: Photobiomodulation for brain disorders. BBA Clinical 6 (2016) 113–124
  4. Johnstone DM, Moro C, Stone J, Benabid AL, Mitrofanis J, Turning On Lights to Stop Neurodegeneration: The Potential of Near Infrared Light Therapy in Alzheimer’s and Parkinson’s Disease. Front Neurosci. 2015; 9: 500.

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

Arthritis

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

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

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

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

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

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

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

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

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

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

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

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

LASER THERAPY IN THE TREATMENT OF NEUROLOGICAL PATHOLOGIES

ABSTRACT

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

CASE PROFILE:

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

MEDICAL HISTORY:

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

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

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

PHYSICAL EXAMINATION (February 2017):

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

DIAGNOSIS:

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

DISCUSSION:

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

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

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

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

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

INTRODUCTION:

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

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

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

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

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

MECHANISMS OF ACTION

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

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

Automated Goldmann Visual Fields (December 23, 2016)

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

Automated Goldmann Visual Fields (August 18, 2018)

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

Beware Before Swallowing!

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

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

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

Fred Kahn, MD, FRCS(C)

Antipsychotics, not anti-insomnia

National Post (Latest Edition)16 Jun 2017
Sharon Kirkey

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

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

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

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

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

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

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

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

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

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

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

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

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

marijuana

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

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

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

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

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

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

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

PROFILE: NIILO SCHONFELD

October 3, 2017

Niilo is a Toronto-born international Long Driving Competitor who has established a world-wide reputation. He has won a number of international competitions including Mexico, South Africa, etc. His strengths are his work ethic, competitive drive and discipline. Since his first long drive competition six years ago he now ranks among the best long drive golfers internationally.
nilo_sm
Niilo spends countless hours training in the gym and at the range. At all times he keeps sight of his goal to become the World Long Driving Champion. He possesses great natural athletic ability and this has been enhanced by many hours in the gymnasium and improving his psychological focus.

Niilo’s efforts have been facilitated over the past 10 years by the ongoing use of the BioFlex Laser Therapy System. He is now using his third device and states unequivocally it has been helpful in keeping his joints, neck and back, pain-free. This is a great asset in an endeavor where injuries invariably end the careers of most competitors at an early age.

At Meditech we take great pride in supporting Niilo’s endeavors and will continue to maintain his health status at an optimal level in order that he may achieve his final objective: a World Championship in International Golf Ball Distance Driving.

Some Statistics
• Club Head Speed: 140mph
• Ball Speed: 210mph
• Longest drive: 435 yds.
• Equipment utilized: Heads – Geek Golf, No Brainer
Shafts – Execution, Triple X Flex

A Passing Thought

Simple Solutions Are Best – the reason!

− not only because they are simple but logical. Generally, they have a scientific basis and are effective − and so it is with the treatment of pain. Conventional methods of managing pain consist of modulating symptoms, much like venting smoke from a burning fire. Usually, pharmaceuticals in varying doses are utilized to achieve this objective, which is only temporary at best and not devoid of adverse effects.

With the utilization of Laser Therapy, one treats the cause of the pain or the existing pathological condition. The logical sequence – the pain disappears, much as smoke will vanish when you put out the fire.

Many people simply defy logic and as scientific solutions evolve, it is sometimes absurd how simple the process can be. Subsequently, people will state, “Why didn’t I think of that?”. The fact is, they didn’t and therein lies the problem.

In our society, independent thought and creativity are stifled by an overwhelming number of factors including excessive regulations, the challenges of technology and expanding governments, not to mention a flawed educational system. All these matters will need to change if our civilization is to survive.