Heart Disease Myths

This month being national Heart Health month, I'll be doing a series of articles on heart disease and how to avoid it. I mean, how to really avoid it, as opposed to the have-this-scan take-this-pill approach to prevention. In fact, it is just that approach to health that has got most of the population walking straight toward the heart attack guillotine. In 20 paragraphs or less, I'm going to show you how to reverse that death march.

The problem is that mainstream medicine has failed miserably at reducing the rate heart disease. After billions of dollars and a half-century of research, heart disease remains this country's number one killer, causing 36% of all deaths.  The claim is often made, based off of a CDC report, that there are fewer people dying from heart disease, and that is true; but that's not because fewer people have heart disease, it's because we can keep people alive longer after heart attacks. They still have heart disease, and are usually very sick, but at least they're not dead. Which is wonderful for those people who are living with heart disease, but honestly, wouldn't it be far better to stop the disaster from happening in the first place?

A more honest method of measuring our ability to prevent heart disease is to measure it's prevalence, or what percentage of the population has heart disease.  In terms of the percentage of the population that has heart disease, "Among adults 18 years and older, the prevalence of heart disease and stroke between 1997 and 2009 has remained essentially the same," according to this report. So, in fact, we aren't really winning the war against heart disease. Instead, mainstream medicine is simply propping up the corpses and declaring victory.

While mainstream medicine pats itself on the back for its "success," the science-based skeptics among us can plainly see that they have been an utter failure at preventing heart disease. The heart of the problem, if you'll forgive the allusion, is that mainstream medicine has built its "prevention" approach on a shaky therapeutic foundation, one predicated more on profitability than on true prevention. These heart disease myths, while they are making lots of money for high-cost, high-tech clinics, surgeons, and pharmaceutical companies, are ignoring the scientific research which conflicts with the profit imperative. The sooner we recognize these myths for what they are, and discard them in favor of evidence-based prevention, the sooner we can reduce the number of Americans dying from heart disease. At the current rate, one American dies from heart disease every 40 seconds. I think we can do better than that.

Heart Disease Is Not A Disease

This may sound spectacularly absurd, but the fact of the matter is, most heart disease does not begin as a pathological process. Heart disease is not a disease in the same way that multiple sclerosis, thyroid disorders or many forms of cancer are diseases. What we call heart disease is actually an unholy conglomeration of lifestyle choices. Stop, for a second, and think about how evolution has molded our bodies. We are designed to live in physically-demanding environments where energy is obtained only with significant energy output. Our ancestors of only a few thousand years ago lived in places where the energy balance between alive and dead was as thin as the edge of a stone blade. Nutrition varied tremendously, from place to place and from season to season. Our bodies developed to adapt to them all. Our systems were honed to provide the best possible performance in those circumstances.

Simultaneously, historical evidence shows that heart disease was not prevalent in pre-industrial societies, from the medieval English to nomadic Ethiopians. What these unlettered, unhygenic people did that we do not is make use of one of the basic premises of medicine, Davis' Law. In non-technical terms, Davis' Law, and it's logical brother, Wolff's Law, boil down to this: Use it or lose it. The heart is a muscle, and the less you use it, the weaker it becomes. What happens to weak hearts? I don't think I really have to tell you.

The real truth is that heart disease is, first of all, the beginning of the failure of a weak, underused muscle: Your heart. What the research actually shows, as opposed to the faux science you have been handed, is that the number one risk factor for heart disease is cardiopulmonary fitness, or in other words, how strong your heart and circulatory system is. The stronger your heart, the less chance you have of having a heart attack or stroke. This influence is so strong that it overrides genetic influence, smoking history, cholesterol levels and weight. For example, if you smoke and do regular, vigorous cardiac activity, you will have a lower risk of heart disease than an unfit non-smoker. If you've got an extra 25 pounds around the middle, but can pound out 50 miles on a bicycle, you are unlikely to die of a heart attack, even though your BMI would make a cardiologist gasp in fear. Our hearts are designed to be used, and used hard. We are made to chase our food with foot and spear, lift logs, roll stones and dig dirt. And the less we do that, the weaker our hearts become. Once a week on the stationary bike while reading the Sunday funnies doesn't turn the trick. You have to pant, sweat and push on an almost daily basis.

You can do this by going to the gym, or by engaging in a home bodyweight/cardio workout. But that takes a lot of self-discipline, more than most of us have. So my suggestion is to incorporate high levels of physical activity into your everyday activities.

Am I suggesting that this we turn our lives into a daily replay of some Scottish highland games? Well, not completely. But if you do want to actually prevent heart disease, it's time to make some changes. Keep the car in the driveway for any trip less than 1 mile. Chop wood to supplement your normal house heat. Ride a bike to work every day, shovel snow instead of blowing it, rake leaves instead of blowing them, and quit blowing away time in front of the television. In our society, we have made physical activity the special time, the consecrated time of the modern American. It's time to reverse that, by integrating high levels of physical activity in our lives and sitting down for our sacred space.

Diet is another lifestyle choice that contributes to heart disease. The confusion that the mainstream medical community faces is that it has no idea what a healthy diet really is, though it hasn't prevented them from promoting an ersatz "heart healthy diet" that fails to do much for anyone. The research shows that vegetarians have a much lower risk of heart attack; it also shows that people eating a meat-heavy Adkins diet also have a lower risk of heart disease.

So, if you want a healthy heart, what are you supposed to do? Become an omnivorous vegetarian?

The problem with the studies purporting to demonstrate the components of a heart-healthy diet is that they fail in two regards. First, they do not take into account what I call individual biochemical diversity, something that I have seen to be of tremendous importance in the nutritional treatment of disease. Second, they ignore the rather extraordinary fact that we do not absorb only energy and nutrients from our food; we also absorb information.

Individual biochemical diversity simply means that we all process our food differently. Some of those differences are genetic, making an eastern European's nutritive processes significantly different from those of a Maori. As a result, though both may suffer from the same malady, the nutritional therapeutic intervention will be different for both. So, yes, for some people, a heart-healthy diet is a vegetarian diet. For others, avoiding heart disease means lots of protein. The trick is finding out what kind of diet (and there are more than just two) will best prevent heart attacks for you.

Secondly, and perhaps more importantly, is the concept of xenohormesis. Living things produce certain molecules in response to certain stressors. When those organisms become food, we ingest those molecules, and our body recognizes the signal that the food is giving us. For example, an animal produces certain molecules when it is stressed because its food supply is low. When we eat that animal, we are informed that a famine may be on the way. So guess what? We start storing energy. And energy is stored as -- wait for it -- fat. And, just for giggles, guess how stressed out an animal that has spent the last month of its life in the execrable conditions of a feed lot is? Guess what its meat is full of? Yup. All those chemicals that tell us that a famine is coming.

The study of xenohormesis is in its infancy, but its a safe bet that the "food as information" paradigm plays a much larger role than we currently understand. The trick is, if you want to stay healthy, eat healthy foods.That means locally grown, locally raised, and if not FDA-approved organic (which is the worst kind of organic, mind you) at least raised with no help from Monsanto.

Cholesterol Doesn't Matter. At All.

This is the part where all of the pseudo-skeptics start getting the vapours and call up the quackwatch hotline. But the fact is, when it comes to heart disease, cholesterol doesn't matter. 

I have come to that conclusion, in part, after examining the epidemiological data over the past 30 years, which demonstrates that, although we've reduced cholesterol levels on a nationwide basis, the rate of heart disease, as I mentioned above, has not budged. My conclusion has come after reading multiple studies, often cited in the literature as a justification for the creation of a cholesterol panic, and finding that in many cases, the researchers' own data does not support their conclusions. And, in some cases, the data has been fabricated, or massaged, to produce the desired outcomes.

And I'm not the only physician to arrive at that determination. Marcia Angell, former Editor-in-Chief of the New England Journal of Medicine, is among many prominent doctors who have looked behind the cholesterol curtain and found the same thing I have -- biased research, bad science, and a public health policy more interested in your wallet than your health.

I could write entire chapters on the damage that the cholesterol myth has done, and perhaps someday I will. Suffice it to say now that, whatever your medical doctor has told you about cholesterol, just ignore it. And, though I risk bringing the wrath of the FDA on my head for saying this (I would certainly never say this to a patient, as recommending pharmaceuticals is not part of my scope of practice), if you have no heart disease, and your MD has given you pills to bring down your cholesterol levels under the guise of prevention, just chuck them. They are likely to do you no good at all.

So I promised you an effective preventive strategy for heart disease in twenty paragraphs, and this is number 20. So here's the deal. Turn off the TV. Hide the car keys. Whatever it is, pick it up yourself and carry it with your own two feet. Sweat and gasp for breath at least once every day. Sprint to the mailbox like you're waiting for your lover's letter. Quit eating crap. Plant or mammal, if it died more than 60 miles from you, don't eat it. Eat anything that's fresh or unprocessed unless it disagrees with you. And one other thing: Ignore most of what you've been told about how to prevent heart disease.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Before you go get a flu shot, please read this.

The Cochrane Collaboration is considered the "gold standard" in evidence-based medicine. Cochrane researchers analyze the published studies on health and medicine topics and produce sound, objective reports that practicing doctors such as myself use to guide our decision-making.

In 2010, the Cochrane group analyzed "all trials which compared vaccinated people to unvaccinated people." And this is what they concluded:

"Vaccine use did not affect the number of people hospitalised or working days lost but caused one case of Guillian-Barré syndrome (a major neurological condition leading to paralysis) for every one million vaccinations."

In case you missed it, let me repeat that. "Vaccine use did not affect the number of people hospitalized or working days lost."

On the other hand, while flu vaccines are useless at keeping people from getting the flu, vaccines did cause at least one case of paralysis, and presumably more.

The report went on to say that "fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products."

As if that wasn't enough, the authors added "reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies."

Now, if anyone, after reading these conclusions by some of the brightest minds in medicine, wants to get their flu shot, be my guest.

But if you care about your health, listen to the research, not the people who are going to make money by scaring you into getting a demonstrably useless, and proven harmful flu vaccine.

And do your friends a favor. Pass this information along.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Whereabouts Unknown

Even before the tragedy at Sandy Hook had occurred, I was aware this year that my holiday spirit had largely gone wandering for parts unknown. And as I watched the appalling news unfold, scooting into my office to tap the news feed in between seeing patients, what little joy I had in this year's season was entirely squelched by by the horror visited on Newtown.

As one patient had put it just a few days earlier, "Dr. Jenkins, this is the first place I've been to in weeks that isn't all decked out in Christmas." I think he was grateful for the respite, and so, frankly, was I. So the lack of holiday lighting, the absence of festive glitter, the avoidance of celebratory music on the office sound system, were all a part to provide a reprieve for those of us who, for whatever reason, felt overburdened by the season.

My reasons for feeling a little Grinch-like this year have been many. Aside from the obvious sadness of recent events, this year has been one of great struggle.

Having been in practice for nearly two decades now, I'm used to the unavoidable disappointments that come with my profession, one in which great distance between patient and doctor is impossible if one is to get the job done properly. But I was particularly saddened when a couple of my patients were struck by sudden, severe downturns in their health, ones which exceeded my skills or that of any other physician. These are people for whom I'd doctored for many years, and it is hard not to become attached to such people in your life, particularly when they are individuals of great worth.

Normally I am a rather ecumenical friend of religion, regarding religion -- any religion -- as my partner in helping to secure greater health for my patients, and often enlisting it to our mutual advantage. But the events of this year, both in this country and abroad, have highlighted for me the capacity for danger that religion innately possesses. Religion is the nuclear energy of the human spirit. When harnessed appropriately, it can create light and warmth that spreads beyond the individual, enabling him to shelter others in the illumination of his humanity.

At the same time, religion, like nuclear fission, creates waste which can be severely toxic and will last for generations, as it has in Palestine and Israel, Iraq and Afghanistan. And at its worst, religion, like an uncontrolled nuclear reaction, can lay devastation and waste over great swaths of our collective spiritual and political landscape. It is hard not to look at the damage caused to thousands upon thousands of lives by religious leaders, either by taking utterly immoral advantage of their charges or by re-asserting slavery for half of humanity, and not only be appalled at the carnage, but also moved at the enormous loss of potential, the wasted spiritual capital left to spiral down the drain of iniquity.

Finally, I am a man who derives much of his strength from the natural environment around him. Little to me is more uplifting than a sojourn, short or long, in the woods, on the water, along a mountainous path, or even (or perhaps especially) taking in the sights, smells and sounds of the landscape about me as I pedal my way through this world, feeling absolutely sanctified to be able to experience it in that unique way that only another pedestrian or cyclist can understand.

And to this man of science and nature, it is absolutely clear that the environment is in great upheaval, one which has been caused by, and which does not bode well for, our species. Mother Nature is indeed angry, and all too few of us are cognizant of the enormous price our children are about to pay for our willful ignorance.

All of these thoughts weigh heavy on my mind and my spirit this morning, a time in which many throughout the western world celebrate family and friends, revel in the delighted squeals of children opening presents. And the thought of such pleasures does make me smile. Whether you are celebrating the birth of your savior Jesus Christ, or Dies Natalis Solis Invicti, the return of the unconquerable sun, Yule's return of the horned hunter, or the endless light of Hanukkah, this is the time to see the light in the darkness and to bask in the warmth of those around us.

Yet, to borrow from the metaphor of Christianity, within each of us is that part which has not yet arrived at the warmth of the creche. As the wise men struggled through the darkness, seeking purity while bearing the meagre gifts of their imperfection, so does each of us seek the perfect within us with often the dullest of tools and the dimmest of torches.

But if we take care of ourselves and one another, that path may not be as rocky, or as steep, as it might appear. The sun will rise again, and each day -- not just this one -- gives us another opportunity to rise above ourselves and be, not only who we are, but who we could be.

I'm on that road, too, and I'll be looking for you.

26 For 26

Like everybody else across the state and across the country, I have been struggling to find a way to respond to the pure horror of last week's tragedy at Sandy Hook.

My tears are not enough. They do nothing to alter a staggeringly sad reality, a reality so terrible that a seasoned police officer who was one of the first responders to Newtown's call for help, walked away with tears in his eyes, saying "my soul is stained."

Prayers are not enough. Any god capable of hearing and responding to such prayers would never have allowed the events to happen in the first place.

Public policy debates are not enough. Gun control, mental health care...yes, we need to talk about these things. But how does that change the memory of a parent's riven, tear-stained face? It cannot.

As a father, who has always regarded his primary duty to be the defense of his children, I could do nothing to alter those childrens' fates, nor that of their teachers. As a doctor who has always striven to be my patients' SWAT team against disease, I am powerless against the gunman's destruction.

Yet this situation demands some response, some thought, some act that, to the extent that a middle-aged chiropractor in podunk Connecticut can effect any change, will constitute my response to the abyss.

And this, in my very small, very teeny-tiny way, is what it is going to be. I call it the "26 for 26."

Between now and Dec. 14, 2013, I'm going to commit 26 acts of random kindness. They won't necessarily be big things -- I won't be sending any random kids to Harvard -- but they will be, in their own small way, meaningful. They will be acts of opportunity -- if I see a chance to help someone, I will. One act of kindness for each one of the victims, large and small.

I know that this is such a diminutive response in the face of such enormous iniquity. But it's all I've got.

26 for 26.

I hope you will join me.

The Killer

In the early 1980s, I moved to Boston with my girlfriend at the time as did several of our college friends. I remember, after having lived there for some time, going to visit another couple whom we had known in Oxford.

They looked like hell.

They had been spending almost every weekend going to the funerals of yet another friend who had died of what was first known as Gay-Related Immune Deficiency (GRID), what we now know as HIV/AIDS.

Back then, HIV/AIDS was a death sentence. Today, thanks to antiretroviral drugs, young men and women with HIV/AIDS may live nearly as long as their peers, making it a chronic, rather than fatal, disease. Nonetheless, it remains a brutal and murderous disease. Survival after infection without treatment is about 10 years, and survival after diagnosis without subsequent treatment can be a matter of months.

While pharmaceuticals play the dominant role in managing AIDS, the research also shows us that nutrition can have an important influence on people with this disease; not surprising, since nutrition has such a profound impact on the functioning of our immune systems.

Though, scientifically, we have come a long way in understanding AIDS, socially, we have not. Thirty-nine states still criminalize AIDS; just recently, an AIDS-positive Iowa man was sentenced to 25 years for having a one-night stand with another man, despite the fact that he used a condom.

Let's be honest: The majority of AIDS criminal laws exist, not to protect the public, but to extend bigotry against gay men. Criminalizing a disease does nothing to prohibit its spread; indeed, it probably increases exposure, by inhibiting people from seeking testing and treatment, or disclosing their status if it is known.

So, we've come a long way in our relationship with this pandemic since it was recognized 25 years ago, but we've got a long way to go.

Today, my heart goes out to all of those who have lost loved ones to AIDS.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Comment

In which I unwittingly join a movement and realize the parallels between wireless routers and alternative medicine.

A few weeks ago, I upgraded the digital infrastructure at my office, the Center for Alternative Medicine. The new router I installed included the capacity for multiple wireless networks, so I added second wireless network without a password.

The goal was to provide a means for kids, parents, spouses, and other members of our patients' entourage to easily access the internet while waiting in the reception area. I generally don't (or at least try very hard not to) keep patients waiting, but there is usually a coterie of people in the reception room cooling their heels, either waiting for Christine DeCarolis to finish massaging a friend or David Pavlick to help someone understand the inner workings of their psyche, or for me to take the acupuncture needles out of someone. And, inasmuch as the cellphone service at the Center can only be generously described as "spotty," I thought this would be a convenient benefit for the nice people who come to visit us.

As I booted up the new router, little did I know I was joining a movement. The Open Wireless Movement:

"The Open Wireless Movement is a coalition of Internet freedom advocates, companies, organizations, and technologists working to develop new wireless technologies and to inspire a movement of Internet openness. We are aiming to build technologies that would make it easy for Internet subscribers to portion off their wireless networks for guests and the public while maintaining security, protecting privacy, and preserving quality of access."

It's an interesting idea. The internet has become a pervasive enabler of modern life, the digital road outside everyone's front door. And since I have large amounts of unused bandwidth, why not donate it to the greater good? In terms of security, the open, guest network is entirely isolated from the Center's internal network, so our data remains secure.

As I read more about the Open Wireless Movement, I realized that in many ways it parallels steps I have already taken with the Center's technology. For the past 6 years, all of our software has been based on Open Source software. Instead of Windows or OSX operating systems, all of my computers run Ubuntu. Instead of Microsoft Word, we use LibreOffice. Instead of a $30,000 proprietary Electronic Medical Records system, we use OpenEMR (a choice which allowed me to deploy electronic medical systems comprehensively long before most other doctors, and at very little cost).

All of this software is free. All of the code is open. The only payment I make is by reporting, and assisting in the resolution, of software bugs. Open Software is a community effort, that allows both users and developers to dedicate their time to create highly functional, stable applications.

Without stretching the point, this is also how I view health. We are not isolated entities, encountering and fighting off maurauding species intent on our demise. We are ecosystems. We are walking, talking, thinking conglomerates of living entities, from the bacteria that live in our gut and help us digest our food, to the beneficial prions that protect our nerves. Like whales, we proceed through life surrounded by pilot fish who both live off us and help us to live. Every single one of us is not a single organism but a cooperative collection of organisms. We cannot live without one another.

It's an amazing thought, isn't it? That we, in ourselves, are not one, but many? The recognition of that concept is why alternative medicine succeeds in the locations where traditional medicine fails. In many conditions, it is the balance between ourselves and our environment, or our micro-ecology, that is the culprit.

Mainstream medicine's tools, are blunt and traumatic in this arena. When the problem is not the presence of bad bacteria in the gut, but a lack of commensural bacteria, the big hammer of an antibiotic is a poor choice of tools. Changes in behavior, and even in thought, are more effective here than any antibiotic. There are many similar examples, but you get the idea.

And in the exact same way, alternative medicine and mainstream medicine are complementary. Where the MDs tools are weakest, mine are the strongest; conversely, where I may lack the skills to help someone, my peers in mainstream medicine are often helpful.

Or, as I put it to one of my patients, "I'm not the doctor you want to see when you're having your heart attack; I'm the doctor you should have seen 10 years ago."

So, yeah. Next time you're in our office, enjoy the open wifi. At some very basic level, we're all on the same open network already.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Defeat Depression! New Ways To A New You.

Why You Are Sick

Today, more than ever, we live in a disease-ridden society. But that's not because we lack sanitation, hygiene, abundant foods or opportunities for exercise.

We live in a disease-ridden society because we are creating diseases. Or, more accurately, we are having diseases created for us, and through careful manipulation of our fears, we have come to accept these manufactured diseases as real.

Anyone who watches television or reads a magazine has seen (albeit largely unconsciously) how cleverly marketing first creates a disease, ensures that lots of people come down with it, and then offers a "cure" to get rid of it.

As an example: Until Viagra came along, impotence was either an occasional mishap resulting from emotional causes or secondary to other disorders, such as circulatory problems, nutritional deficiencies, and diseases or trauma interfering with nerve function.

Then Pfizer came along, developed a drug that increases blood flow to the male penis, and needed a market to sell it to. Nevermind that Viagra's ability to improve function is limited to a single mechanism that really only works for a few men (those that are producing insufficient amounts of nitric oxide). That market was too small. What Pfizer needed to do was to create a larger market.

First, they created the need, and that was easy: What man doesn't want to be better in bed? Second, they created the disease, i.e., the reason you're not better in bed. They took the old name -- impotence -- and scotched it, because of its negative connotations. The word "impotence" conjures up images of a skinny-armed teen getting sand kicked in his face by the guy with the rock-hard biceps and bosomy blonde in tow. Or the cuckolded husband coming home from his 9-to-5 only to discover his randy wife in bed with the next door neighbor.

No, those are not images with which any man would associate himself. So Pfizer created a new disease -- Erectile Dysfunction -- with an entirely neutral connotation -- and craftily expanded the boundaries of this  created disease. The really, really important thing to note here is that Pfizer took a symptom of several diseases and made it into a disease by itself so that they could sell a drug to "treat" the disease.

It still hasn't reached the point where a man is going to sit down on the bar stool, look over at his neighbor and say, "Damn, dude, I just got diagnosed with ED. Pass the peanuts, wouldya?"

But the reformation of impotence (the symptom), into ED (the value-neutral disease), mainstreamed the concept to the point where healthy young men are now taking the drug for a perceived extra performance edge.

And Pfizer is putting lots of money in the bank.

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Another excellent example of a manufactured disease is osteopenia.

There was a time when osteopenia was an incidental finding on an x-ray, a way you would describe a bone which had gotten more transparent than others. It was an indicator of the loss of mineral in that bone, and a sign that, as a doctor, you might want to be on the lookout for osteoporosis further on down the line.

Or maybe not. Plenty of people experience temporary osteopenia, which reverses on its own. A number of pharmaceuticals cause osteopenia as a side effect, and as soon as the drug is no longer taken, normal bone is restored.  People living sedentary lifestyles, either due to other health problems or simple neglect,  often develop osteopenia which disappears with a return to activity.

But for several years, I had many a middle-aged woman come to my office with the "diagnosis" of osteopenia, for which they had been prescribed Fosamax or one of the other bisphosphonates.

Again, here we have a symptom, or exam finding, that has been carefully recrafted into a disease.

The rebranding of osteopenia came with the development by Merck of a new drug that could increase the mineralization of bone. But this new drug -- Fosamax -- like, Viagra, had a very limited audience. People with osteoporosis, a true weakening of the bone.

But in 1997, Merck hooked up with the developer of a cheap and easy x-ray machine which purported to measure bone density in a way that would predict risk of fracture.  The DEXA scan immediately multiplied Merck's market by creating a new class of disease sufferers, this time people who had the new disease of "osteopenia."

And the market took off. With the addition of standards manufactured by the drug companies themselves, medical doctors started prescribing Fosamax to a huge number of middle-aged women.

The wheels have since come off that cart, at least a little bit. No so much because subsequent research shows that Fosamax does not create healthier bone, nor because Fosamax has also been shown to actually cause bone death and increase fracture risk in certain bones (true). Nor has the fad decreased because research has also shown that the DEXA scan does not adequately -- or even remotely -- predict bone fracture (true).

No, the fad has passed because the patent on Fosamax ended in 2008, and the horde of no-name drugs has reduced the value of Fosamax considerably. With competition, Fosamax is no longer the money maker that it once was.

But the lesson that Merck learned was a valuable one. No, not the lesson about the consequences of releasing a dangerous and poorly-tested drug onto the market.

The real lesson here was that coupling tests which purport to objectively demonstrate the presence of a "disease" with a drug that cures that "disease" is an extremely potent form of marketing.

Today, consultants of pharmaceutical companies are offering week-long seminars on how to couple drug development with tests that will increase the demand for that drug, and then market them to medical doctors and consumers alike.

This development has gone largely unnoticed, and unreported, and the vast (and unwarranted) trust that Americans have in their medical physicians makes such sales easy to make.

Medical doctors, on their side, are seeing pharmaceutical company payouts, in the form of "consulting fees," as a lucrative sideline to offset the continuing pressure on their income. Medical doctors are also paid ludicrous sums for enrolling patients into research programs, to the extent that some practices have hired specialists to sift through the studies available and determine which will be the most profitable to participate in.

And patients, on their side, are manipulated by the fear spread by pharmaceutical companies that previously unheard-of diseases will dramatically affect their quality of life.

But you know what? Most people aren't sick, and most people don't need prescription drugs -- although 50% of the U.S. population are taking them.

In fact, most of the people taking drugs today are not the victims of disease, they are victims of a lucrative marketing scam no more ethical than an email from a banker in Kenya.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Chiropractic Care and Anxiety

Anxiety is a problem which has afflicted us all at one time or another. Fortunately, our anxiety is usually the result of a specific context or situation, and it resolves as we move to meet the problem or it is otherwise solved. Not so for many, however, who have to deal with anxiety on a day-in, day-out basis. Many people experience panic attacks for no reason, where their heart starts pounding, they get short of breath, and they get a feeling of dread. Generalized anxiety, a free-floating sense of worry that is out of proportion to the cause, can last for weeks or months, and can result in insomnia, hyperactivity, headaches, irritability, abdominal distress and other symptoms.

Mainstream medicine, of course, relies primarily on drugs to treat anxiety disorders, but these drugs can create more problems than they solve. Benzodiazepines, for example, interfere so much with mental functioning that anyone who is taking that class of drug is not permitted to have a commercial drivers license, and they are also highly addictive. A common anxiolytic, Xanax, is one of the most frequently-used drugs to treat this condition, despite the fact that there are no long-term studies confirming either it's effectiveness or it's safety.  Overall, the use of anti-anxiety drugs increases your risk of death from a variety of causes, so with all of this in mind, drugs may not be the best answer for this particular problem.

Fortunately, there are several ways of managing anxiety that do not require drugs. EEG neurofeedback, a technique which uses real-time electrical signals in your brain to alter its patterns, has been used quite successfully to manage anxiety. Fortunately, Litchfield has an excellent clinical therapist who is also highly skilled in EEG neurofeedback. David Pavlick is a clinical social worker with an office at the Center for Alternative Medicine, and has helped many people overcome their anxiety.

Cognitive Behavioral Therapy, or CBT, is the current darling of psychology, and it, too, appears to be  very effective in treating anxiety. In fact, a variety of talk therapy techniques have been shown to help people with anxiety.

But, as is the case for most chronic problems, a multidisciplinary approach usually results in better results. People with chronic problems, especially mental and emotional disturbances, should also be examined by a primary care chiropractor to eliminate underlying physical and nutritional causes for the anxiety.

Multiple studies have confirmed that balancing the essential fatty acids (EFAs) can reduce the symptoms of stress. Back when I started practicing, I used to hand a patient a bottle of EPA or DHA and have them take it for a month to see what kind of response we would get. These days, however, I can order a simple blood test, covered by insurance, which will show me the patients' levels of the various essential fatty acids, eliminating the guesswork. I can tell without trial and error whether or not such an approach is likely to work, and if so, exactly what kind of dosages of which EFAs I need to make my patients better.

The B vitamins, magnesium and calcium also play a role in anxiety states, and adjusting these levels may help as well. Imbalanced hormones will also often play a role, as an over- or underactive adrenal gland, or an imbalance in the hypothalamic-pituitary axis can be primary causes of anxiety symptoms.

Very often, I find, that in order to correct my patient's nutritional status, we have to begin by fixing impaired digestion, one of the most common -- and most overlooked -- causes of mental and emotional issues that I see.

With all of these conditions, once again, instead of guessing, I test, and use objective measures to tell me if these types of intervention will be useful.

Finally, Traditional Chinese Medicine can be successfully employed to help patients with anxiety. From a TCM point of view, there is no separation between mind and body, and the freedom from that false duality gives us the ability to view anxiety from an entirely different angle.

In TCM, anxiety stems primarily from an imbalance in the Spleen organ system. Because the Spleen, in TCM, is responsible for extracting qi from the food, Spleen imbalances result in qi stagnation or depression.

When qi becomes depressed in the middle jiao, then you start to experience the signs and symptoms of panic attacks, as well as other classical signs of anxiety. Thus, from a TCM point of view, restoring normal Spleen functioning is primary to the treatment of anxiety. (As a side note, I find it very interesting that in both TCM as well as Western alternative medicine, the digestive system is found at fault in mental disorders.)

So, fortunately, for people experiencing anxiety, there are a number of approaches that can be used to assist them. From nutrition to acupuncture to lifestyle and herbal interventions, a variety of forms of alternative medicine can be used as an adjunct to, or even primary means, of helping people deal with anxiety disorders.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

It's in the Bag.

Cycling -- at least the way I do it -- is all about the bags. Rarely do I take off on a jaunt when I don't feel the need to carry a few extra things. Think of your car. Who would use a car lacking a glove box or a trunk? Nobody, of course. Even if you don't treat your vehicle as a beast of burden, that storage space is a necessity for just your normal motoring activities.

When you use your bicycle as your primary form of transportation, the same rules apply. You still need a glove box. You still need a trunk.

So when I completed the transformation of a 1974 Fuji Sport 10 into a retro/commuting/tweed & vest bicycle, I still needed a couple of finishing touches. I needed some place to keep the detritus of daily life; my wallet, my keys, my phone, a jacket, a multitool; a tablet or netbook, and the odd bottle of wine or baguette that is the primary task for which such a bike is created.

My current pannier/briefcase, an Axiom Legacy, was certainly up to the task functionally -- after all, it weathered the winter of 2010 on the side of the trike with nary a complaint. But the briefcase's 21st-century materials and styling was all out of place on a bike with pretensions to the Golden Age of cycling.

Recalling the testimonials of my UK friends, I next looked at Carradice -- a company that brings cotton canvas and a stiff upper lip to the damp, streaky, misty fog that the British sportingly call "weather." And while Carradice certainly had both the style and the quality I sought, I recalled warnings about it's eccentrically English supply chain, which seems to consist of "we'll get it to you when we send it, and thank you ever so much for your order."

In fact, not a single US dealer could be found which actually had any of the bags in question in stock.

I finished my search where I should have started it, specifically on Etsy, and even more specifically at Anhaica Bag Works. Anhaica, which takes its name from the capital of the Appalachee tribe (today known as Tallahasee, Florida), is the home of a cycling needlewoman who combines her experience on bicycles with considerable skills as a seamstress and designer, using waxed canvas to create waterproof bags of considerable durability.

My first purchase from Marina, Anhaica Bags' proprietress, was a custom handlebar bag with pockets for all of the essentials of a Modern Man. Over a few email messages, Marina and I discussed what I would be using it for, what I would be putting in it, and  the size and type of pockets I would need. Marina had the bag finished and mailed to me in less time than it takes Carradice to return an email, and within four days of use it easily replaced my briefcase. By the second week, it had become indispensable, even on the rare occasions that I hop into a car. By the third week, it had become, God help me, a man purse. I don't leave home without it.

I was so impressed with the workmanship of the handlebar bag that I ordered a rack bag to replace my aged Nashbar rack bag, which was developing holes and looking a little too rickety for the 200 miles I was planning to pedal over my upcoming holiday. Again, I looked to Carradice for inspiration (well, mostly dimensions), and asked Marina to make me something like that. Once again, in record time, I had a canvas rack trunk which matched the handlebar bag and which used re-purposed lightweight coroplast to give it shape. It consisted of a single compartment with a rear pocket on the outside. Like the handlebar bag, it was strapped and closed with durable webbing and strong plastic buckles.

My multi-century vacation is now a note in my journal and pictures on my PC, and I've logged a hundred more miles in about-town riding, and all I can say is that the bags produced by Anhaica Bags simply rock. I had no idea that a rack bag, made so simply, could be so unbelievably useful. The two quick-release buckles make accessing the bag a snap, especially compared to the drill I had to go through with my old rack bag: (1) Fold back the weatherproof flap (2) unzip the bag expander by mistake (3) re-zip the expander (4) find the zipper pulls for the real opening (5) open the bag (6) reach in blindly as the flap falls back down...you get the idea.

With my Anhaica Bags rack bag, all I do is unclip the buckles, flip open the top, and I have full and unfettered access to the entire contents, organized just the way I want it. There is one large pocket in back for tools and a spare tube, and that's it. Opening and closing it was so simple that, while I was touring, I regularly had to stop and double check that I'd actually closed the lid -- it was that simple.

Oh, yeah. What about the weatherproofness of these bags? If you are used to high-tech fabrics like Gore-Tex, the quaint simplicity of waxed canvas might strike you as somewhat backward and unreliable. Let me be the first to tell you that it is not. As luck would have it, the first day I used each bag, I got caught in severe downpours. When I got back home, I found my contents inside utterly dry. I mean bone dry. Marina makes her own waxed canvas, and strategic flaps and design creates a bag that is as waterproof as I could wish for, while avoiding the mold-inducing hermetic sealing of, say, Ortlieb bags.

I know I'm beginning to sound like a shill for Anhaica, but if I do, it is only because I am so enormously impressed by the level of skill that went into the construction of these cycling bags. As I mentioned before, Marina is a cyclist herself, and her knowledge of how to design and make a bag comes from day-in-day-out experience; the kind of experience that you will rarely see reflected in a mass-market product. And if you are worried about the responsiveness of a single-proprietor business, you needn't. At one point, I mangled one of the pockets on the handlebar bag, and I emailed Marina about getting it repaired. She returned my email the same day, while she was on vacation, and had the repaired bag in the mail to me the day after she got it. Service? Yeah, she's got it.

Anhaica offers other bags besides the rack and handlebar bags I bought. She has tool rolls (and will whip up a custom one for you), backpacks, and hip packs, from a variety of materials. Frankly, I'm thinking about trying to talk her into making a set of panniers for me.

Marina's products are not something you come across often these days, being the product of the experience and skill of a single person who obviously takes great pride in her work. The durability is built in the cloth and the stitching, and the attention to detail makes these bags suitably handsome for any bike, not just my moustachioed retro bike. If you are considering adding bags to your bike, I strongly recommend that you check out Anhaica Bags on Etsy.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

25 Things You Didn't Know a Chiropractor Could Do: DOT Medical Exams

Last week, I attended a seminar with a few hundred other doctors to get prepared for the new federal regulations about DOT medical exams. Anyone who has a commercial drivers license (CDL) knows about the medical exam they have to take every 2 years (sometimes more often) in order to keep it. I've been doing these exams for several years, and over this time, the federal Department of Transportation has been reviewing and upgrading their medical exam program.

The result is that, in 2014, any doctor providing DOT medical exams will have to pass a test and be certified by the agency before they will be allowed to issue medical certificates to drivers. Always one for being on the bleeding edge, I'm one of the first physicians in the country to have undergone the new DOT training, and I will be among the first wave of doctors to be taking the test later this year. The regulations have gotten complex enough so that this has become a bit of a speciality, and can no longer be adequately performed by most primary care physicians.

In order to make it easier for drivers, I've developed my 65-15-24 Guarantee.

65 -- The full cost of the exam is $65. Unlike others, I will not charge for reviewing medical histories, consultant reports, or additional visits that might be required by DOT regulations.

15 -- Once you have completed your paperwork, you will not wait more than 15 minutes to see me. If you do, your exam will be provided at no cost.

24 -- You can get in to see me for your exam within 1 business day.

If you've ever read my previous post on my core principles, you will see how this service fits, and why I've chosen to incorporate this guarantee.

Check your paperwork. If you need to re-up your medical exam, or you know someone who does, have them give me a call at 860-567-5727. Or, go to www.dot-exams.com for more information.

The Ten Deadliest Mythical Diseases, Part 2

The second half of my top 10 mythical disease list is sure to stir up some contention, as I will be taking on some sacred cows of both the mainstream and alternative medical communities. Regardless of the controversy that it might cause, addressing these myths directly will help us -- both doctor and patient -- to arrive at more accurate understandings of the health problems that we encounter and struggle with.

Why do I call these "mythical" diseases? Because they exist only to wrongly describe a phenomenon which we insufficiently understand. Sort of like Zeus chucking thunderbolts about the heavens until we discovered that lightning is only an electrical discharge. Once we knew of lightning's true origins, we became more able to protect ourselves from it, rather than scurrying about in fear of an unhappy god.

The same thing applies with these diseases. So long as we ascribe them to poorly-fitting taxonomies, we will be unable to create effective solutions. If we throw away our distorting glasses, seeing them anew, we can investigate and apply new solutions. My first item on the second half of my top 10 is a perfect example. (I've waited for years to write that sentence.)

6. Chronic Lyme disease. If I ever met a disease that wasn't, this is it. Chronic Lyme has as many possible symptoms as fibromyalgia. What makes it particularly difficult to uproot is that chronic Lyme is bolstered, in the opinion of many, by the fact that the sufferer has already experienced a documented illness. The argument that the the Lyme bacteria hides itself within its host is derived from the same argument in the 1980s which postulated that HIV was actually a form of syphillis, a chronic spirochete infection eventually invading the host's brain and nervous system. However, with syphillis, the patient continues to show signs of active infection, whereas none are found in the chronic Lyme patient.

What better fits the available evidence is that many of the symptoms of chronic Lyme can be traced to gastrointestinal dysfunction induced by the antibiotics used to treat acute Lyme. It is not unusual for a GI tract, denuded by an antibiotic of its beneficial bacteria, to create a constellation of symptoms difficult for many doctors to categorize, from neurological to immunological alterations. This theory does not fit all of the cases of chronic Lyme, but many of those cases that I have seen have been resolved by restoring normal gut function.

7. Celiac disease. Speaking of gut dysfunction, if I had a nickel for every patient who walked in my door having been told that they have celiac disease by their mainstream primary care doctor, I'd be a rich man. The fact of the matter is that what is often mistakenly diagnosed as celiac disease is usually simple gut dysfunction or leaky gut syndrome. There's no need for a life spent in fear of wheat. Simply fix the underlying problem and move on.

8. Osteopenia. This isn't a disease, and never has been. It is only a radiological finding indicating mild decreased density of the  bone. That decreased density does not indicate that the individual is in any imminent risk of a fracture; it only means that the person may, at some point down the road, and not necessarily, develop osteoporosis.

Osteopenia is a normal feature of aging. It did not become a disease until the bisphosphonates like Fosamax hit the market, and they tried to enlarge the population of potential Fosamax recipients by reclassifying osteopenia as a disease that needed to be treated.

Fortunately, since all of the lawsuits hit as a result of Fosamax & Friends causing bone death instead of bone strength, I've been seeing a lot fewer patients in my office carrying the weight of this imaginary disease.

9. Chronic Fatigue Syndrome. This is just another way of a doctor saying "I don't know what's wrong with you except you appear to be very, very tired." Like fibromyalgia, it's a wastebasket diagnosis that stands in place for many other disorders, from subclinical hypothyroidism to hypothalamic-pituitary-adrenal axis dysfunction to Vit. B deficiency. If a doctor tells you that you suffer from CFS, just go find another doctor who is willing to dig a little deeper. I really dislike this diagnosis, because it unnecessarily burdens people with what they believe to be an incurable disease.

10. Gastro Esophageal Reflux Disorder. The only reason we have GERD on such a wide scale is because of that little purple pill. Until then, it was heartburn, and readily fixed by not eating junk, not eating too late, not drinking too much alcohol and keeping your gut healthy. And before the purple pill, cider vinegar and baking soda seemed to take care of most cases of GERD. Yes, there are a few people with valves in their GI tract that aren't working properly; however, the vast majority of GERD is not GERD at all but just crummy eating habits.

Frankly, it says everything to me that the medical "cure" for this "disease" is to inhibit the proper functioning of the stomach, impairing both your digestion and your immune system in the process. If you have to fix a problem by breaking something else, you probably don't know what you're doing.

I could go on, and I may do so in another post. But I hope that in reading this list over, you've recognized the common denominator in all of them. These "diseases" are actually dysfunctions that stem from either improper medical intervention or inappropriate lifestyle choices. And that concept is what lies at the heart of much of my approach to treatment. The sooner we learn that we control our diseases -- not the other way around -- the sooner we can become healthy.

Cycling Renaissance

In a previous post, I mentioned the Golden Age of Cycling, which occurred at the beginning of the 20th century. And from the most current numbers, it looks as if we might be poised for a second Golden Age.

Rutgers University professor John Purcher has crunched the most recently available cycling data, and his numbers are pointing to a renaissance in cycling. Here are the highlights:

• Bike commuters doubled between 1990 and 2009.
• Transportation cycling (going to work, shopping, running errands) is outpacing sport cycling (fast guys in lycra). 54% of all cycling trips in 2009 were for transportation, an increase of 11% in 8 years.
• Cycling fatalities fell 21% between 1998 and 2008 (Remember my post about cycling safety?)

(Source: "Bicycling Renaissance in North America?," Pucher, J., et al., 2011, Transportation Research A, Vol. 45)

What does this mean to you? Well, if you are thinking about jumping into cycling -- particularly transporation cycling -- it means that you are beginning to see a variety of bicycles and gear designed for this purpose. When first lived car-free, as a dazzling young urbanite in Boston, there was no such thing as a "commuter bike." I had to make do with a faux-racing bike with its drop handlebars and uncomfortable-but-speedy design.  Now there are dozens of brands that make commuters, from Jamis to this fine selection, including a very classy Pashley.

It also means that your safety, which is already pretty good, will get even better. Because multiple studies have shown that the more cyclists there are on the road, the safer it is for all cyclists (there is also some evidence that suggests that more cyclists make the roads safer for motorists as well).

For me, cycling makes a wonderful transition from work to home. Instead of remaining compressed and tense behind the wheel of my automobile, my ride home is now filled with sunsets, stars, the smells of the seasons and the gentle hiss of my tires on the road.

And that is what makes my daily commute a daily pleasure.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

I *Would* Ride, Except It's Too Dangerous!

This is the most common reason I hear from people who otherwise might take my advice, dust off their bikes, and go for a spin.

While it might seem dangerous -- being on the road next to the 2,000-lb behemoths that can crush us like a bug on tile -- in fact, the opposite is true. Cycling is *so* safe that the average cyclist actually lives several years longer than a non-cyclist.

Let me repeat that, with flair: Cycling is so safe that the average cyclist lives several years longer than a non-cyclist.

Sure, lots of cyclists (in this country, at least) wear those silly foam hats, and talk about all of their close calls with motorists, potholes and dogs, but these should be viewed for what they are -- campfire goosebump stories. The fact that the cyclist in question is around to tell the story should give you a clue that perhaps, just perhaps, the danger value has been cranked up a notch or two.

So let's look at some cold, hard (and rather pleasant) facts about cycling:

• According to several studies, cyclists live longer than non-cyclists; in one study, the cycling lifespan advantage was almost 10 years.
• Motorists are *far* more likely than cyclists to suffer from serious head injuries.
• Cycling is safer than: Fishing, horseback riding, swimming, athletic training, football and tennis.
• Cycling is safer than riding in an automobile.

Let's compare lifetime risks. Your risk of dying from:

• Heart disease              1 in 5
• Automobile accident    1 in 84
• Pedestrian accident     1 in 626
• Bicycle accident           1 in 4,919

The simple fact is this: Cycling is a very safe activity. It is safer than every other form of transportation except flying, and orders of magnitude safer than riding in a car.

The problem with cycling safety is one of perception, not reality, so fear not, hop on your freedom machine and roll down the road.

Don't forget to wave at the folks in the gas station. I always do.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

This Road Belongs To The Bicycle

In today's installment of Bicycle Month posts, I am going to ever-so-briefly mutate from being a physician and bon vivant to (very) amateur historian.

You know that road out in front of your house? The (probably) paved road that takes you and your resource-hogging, squirrel-killing automobile to work, to school, and to the grocery store?

Well, you can thank this country's cyclists for that road.

You see, back during the turn of the century, cycling was an enormously popular activity. By the 1880s, the "safety bicycle" design, essentially the same shape as the modern bicycle, had replaced the dangerous penny-farthing, and John Dunlop had invented the air-filled tire. These two advances converted the bicycle from a silly toy for the young, adventurous and rich, to a useful transportation and recreational device for the masses. The use of the bicycle exploded among the middle class, and what is now known as the Golden Age of Cycling began.

(I cannot go further without noting that the bicycle was an enabler of the nascent feminist and suffrage movement in the U.S. In fact, Susan B. Anthony called the modern bicycle the "freedom machine." But we'll get back to that later this month).

As the American populace became truly mobile for the first time, they found the conditions of our dirt roads somewhat less than adequate for their speedy new machines. And, as Americans tend to do, they banded together to advocate for improved cycling conditions. The most prominent face of this social force was the League of American Wheelmen (which continues to be the largest voice for cyclists today as the updated League of American Bicyclists). The League successfully lobbied both local, state and federal government to engage in a massive upgrade of the nation's rutted roads.

Thus, the paving of American roads began long before the mass-produced automobile was even a gleam in Henry Ford's eye. The paved road that you drive on today exists because the cyclists of the early 20th century demanded the infrastructure needed for middle-class mobility.

Next time you get angry at some bicycle who is blocking "your" road, remember this. It was originally his road. And in law, custom and practice, the cyclist has the same rights to use the road as you do.

In fact, instead of honking at him, you should thank him, for making your passage possible.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Welcome to National Bike Month!

Welcome to National Bike Month! To celebrate this most worthy steed and its versatility, economy and pure fun as a transportation device, I will, each day in the month of May, post a useful tip or fun fact about biking.

Here's today's tip: We all know that bike riding saves money and improves health. But all too often, we find it difficult to find a way to work cycling into our daily routine.

So try doing this. Pull out a map of where you live. draw a one mile diameter circle with your house at the center. Then, just one day per week, use your bike to run any errand that falls within that circle.

For me, that circle will include the grocery market, post office, library and several stores where I regularly purchase goods. You'll be surprised at the number of places that will fall within your circle. Try it and see!

If you follow this program while we have comfortable cycling weather -- just one day per week for 4 months -- you will have saved about $60 simply by leaving your car in the driveway for those trips.

If you want to, you can use that $60 to take yourself out to dinner. Your waistline can certainly afford it, because you will have burned an extra 2,000 kcal.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.