CERVICAL STROKES AND CHIROPRACTIC AND DOCTOR OZ

Recently, a national television program featured a story about a young female who died after a cervical adjustment.  Since then I have been approached by many who have voiced concerns over the safety of having a neck adjustment.

I have always, and will continue to advocate Chiropractic as an effective and highly safe procedure. The probability of a vascular incident is approximately 1 in 1 million. Significantly less than the odds of adverse reaction from simple over the counter drugs Ibuprofen or Tylenol; significantly less than a drive from Klamath to Eugene.

There is essentially no difference in risk for an individual who is experiencing symptoms of a stroke and presents to the medical doctor for prescriptive help, or to the Chiropractor for a cervical adjustment:

The largest medical study to date (1), encompassing 100 million person years, found that strokes occur at a similar increased rate regardless of whether the patient sees a chiropractor for manipulation or their PCP for consultation. The authors found: “no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care.“ Researchers discovered that patients in the developing stage of a stroke are more likely to visit a chiropractor or PCP for complaints of headache and neck pain. The study suggested that the chiropractic or PCP treatment was not the cause of the stroke, but rather a non-contributory mid-point of an undetected developing crisis.

Another study by Kosloff et al. (2) extracted 3 years of commercial insurance and Medicare advantage plan data for approximately 39 million insured patients- representing approximately 5% of the total US population. The study analyzed a potential correlation between chiropractic visits, PCP visits, and stroke. The study found: “No significant association between VBA stroke and chiropractic visits. We conclude that manipulation is an unlikely cause of VBA stroke.” The study did however find “a significant association between PCP visits and VBA stroke. The positive association between PCP visits and VBA stroke is most likely due to patient decisions to seek care for the symptoms (headache and neck pain) of arterial dissection.” Like the Cassidy study, this study strengthens the premise that chiropractic manipulation may not increase the risk of VBAI stroke; rather, impending VBAI stroke patients may have a higher likelihood to seek care from a variety of providers, including chiropractors.

On Feb 16, 2016 another high quality study was been published in the respected online journal Cureus. (3) The authors performed Systematic Review and Meta-analysis of data concerning spinal manipulation and VBAI and concluded:

“There is no convincing evidence to support a causal link between chiropractic manipulation and Cervical Artery Dissection.”

1. Cassidy JD et al. Risk of vertebrobasilar stroke and chiropractic care: results of a population based case-control and case-crossover study. Spine 2008 Feb 15;33(4 Suppl):S176-83 http://www.vtchiro.org/Resources/Documents/Chiro%20Stroke%20Cassidy.pdf
2. Kosloff TM, Elto D, Tao J, Bannister WM. Chiropractic care and the risk of vertebrobasilar stroke: results of a case–control study in U.S. commercial and Medicare Advantage populations. Chiropractic & Manual Therapies (2015) 23:19
3. Church E W, Sieg E P, Zalatimo O, et al. (February 16, 2016) Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation. Cureus 8(2): e498. doi:10.7759/cureus.498

The evidence is incontrovertible; Chiropractic is remarkably safe and highly effective. In contrast, medicine and medical malpractice is the third leading cause of death in the US. ( British Medical Journal, 2016 ; 353:i2139)

I never dismiss the risk of stroke, or any other potential risks that may occur from a chiropractic adjustment, but rather minimize that risk by being thorough in my evaluation, identify high risk patients and refer or treat as appropriate. I apply sound techniques that are demonstrably safe and effective.

Bottom line:  Chiropractic is highly safe and highly effective.  Each individual is evaluated and treated appropriately for their own needs and for the best possible outcome. If you have any questions or concerns, please feel free to stop me and ask. I’ll be more than happy to take the time and make sure your concerns are fully addressed to you satisfaction.

ADMINISTRATIVE NOTES

Our office will be closed on the following dates through the end of the year:

• November 24-25 (Thanksgiving)
• December 1-5 (Continuing Education)
• December 22 thru January 3

School sports physicals

Reminder that we provide physicals for all youth and high school sports

Personal injury, motor vehicle accidents and work related injury

This time of year often sees dramatic increases in injuries from either work or motor vehicle injuries. Even the most minor of injury may cause significant discomfort. Early intervention is key to maximizing your healing. More often than not, pain and dysfunction is delayed – much like the pain of a workout that occurs several days later. The nature of healing is such that the loss of Range of motion, ensuing headaches or pain, all may occur days, weeks and often months after the initial injury. Feel free to schedule for an exam and consult if you’ve experienced any of the above. PIP coverage extends for a year after your accident. The difficulty in navigating all the paper work, attorneys etc is sometimes intimidating and at the very least inconvenient. We have a deep wellspring of experience and expertise in these matters and will make the experience as smooth as possible for you.

Family dinners

Winter comfort food -Winter time poses all kinds of challenges for busy families; Sports, after school activities, meal preparation, and trying to fit family meal time in the middle of all that. Here are 5 suggestions for healthy winter time family friendly comfort meals that are easy and efficient for a working family to prepare. Good luck!!!

In health,

Scott Wallace DC

P.S. Have questions?  Feel free to contact Dawn at officemanager@pinetreechiro.org.

Slow-Cooker Root Vegetable Pot Roast

Prep Time25 min
Total Time8 hr 25 min
Servings

Come home to a delicious dinner with this simple slow-cooker roast made with beef and basic root vegetables.

Ingredients

• 1 lb parsnips, peeled, cut into 2-inch pieces
• 1 lb turnips, peeled, cut into wedges
• 1 lb carrots, cut into 2-inch pieces
• 1 medium red onion, cut into wedges
• 3 cloves garlic, finely chopped
• 1 tablespoon olive oil
• 1 boneless beef chuck roast (3 to 4 lb)
• 1 1/2 teaspoons salt
• 1/2 teaspoon freshly ground pepper 1
•  1 cup Progresso™ beef-flavored broth (from 32-oz carton)
• 1/2 cup dry red wine or additional beef-flavored broth
• 1/4 cup tomato paste
• Chopped fresh parsley, if desired

Directions

• Spray 5- to 6-quart slow cooker with cooking spray. In slow cooker, stir together parsnips, turnips, carrots, onion and garlic.
• In 12-inch skillet, heat oil over medium-high heat. Sprinkle beef with salt and pepper; add to skillet. Cook until browned on all sides. Place beef on vegetables in slow cooker.
• In medium bowl, stir together broth, wine and tomato paste with whisk. Pour over beef.
• Cover; cook on Low heat setting 8 to 10 hours or until beef is very tender. Serve beef with vegetables and cooking liquid. Garnish with parsley.

Slow-Cooker Beef Roast with Onions and Potatoes

Prep Time15 min
Total Time9 hr 30 min

Onion and potatoes add Old-World flavor to a family favorite beef roast.

Ingredients

• 1 large sweet onion, cut in half, then cut into thin slices
• 3-lb boneless beef bottom round roast
• 3 baking potatoes, cut into 1 1/2- to 2-inch cubes
• 2 cloves garlic, finely chopped
• 1 3/4 cups Progresso™ beef flavored broth (from 32-oz carton)
• 1 package (1 oz) onion soup mix (from 2-oz box)
• 1/4 cup Gold Medal™ all-purpose flour

Directions

• In 5- to 6-quart slow cooker, place onion. If beef roast comes in netting or is tied, remove netting or strings. Place beef on onion. Place potatoes and garlic around beef. In small bowl, mix 1 1/4 cups of the broth and the dry soup mix; pour over beef. (Refrigerate remaining broth.)
• Cover; cook on Low heat setting 9 to 10 hours.
• Remove beef and vegetables from cooker; place on serving platter. Cover to keep warm.
• In small bowl, mix remaining 1/2 cup broth and the flour; gradually stir into juices in cooker. Increase heat setting to High. Cover; cook about 15 minutes, stirring occasionally, until sauce has thickened. Serve sauce over beef and vegetables.

Slow-Cooker Family-Favorite Pot Roast

Prep Time25 min
Total Time10 hr 40 min
Servings 6

Slow cooker pot roast features tender beef and vegetables in a robust tomato sauce.

Ingredients

• 2 teaspoons olive or vegetable oil
• 2- to 2 1/2-pound beef bottom round roast
• 6 medium potatoes, cut into 2-inch pieces (about 4 cups)
• 2 1/2 cups baby-cut carrots
• 2 cups sliced fresh mushrooms (about 5 ounces)
• 1 medium stalk celery, sliced (1/2 cup)
• 1 medium onion, chopped (1/2 cup)
• 1 teaspoon salt
• 1/2 teaspoon pepper
• 1/2 teaspoon dried thyme leaves
• 1 can (14.5 ounces) diced tomatoes, undrained
• 1 can (10.5 ounces) condensed beef consommé or broth
• 1 can (5.5 ounces) eight-vegetable juice (2/3 cup)
• 1/4 cup Gold Medal™ all-purpose flour

Directions

• Heat oil in 10-inch skillet over medium-high heat. If beef roast comes in netting or is tied, do not remove. Cook beef in oil about 10 minutes, turning occasionally, until brown on all sides.
• Place potatoes, carrots, mushrooms, celery and onion in 4- to 5-quart slow cooker. Sprinkle with salt, pepper and thyme. Place beef on vegetables. Pour tomatoes, consommé and vegetable juice over beef.
• Cover and cook on Low heat setting 8 to 10 hours.
• Remove beef and vegetables from cooker, using slotted spoon; place on serving platter and cover to keep warm. Skim fat from beef juices in cooker if desired. Remove 1/2 cup of the juices from cooker; mix with flour in small bowl, using wire whisk, until smooth. Gradually stir flour mixture into remaining juices in cooker. Increase heat setting to High. Cover and cook about 15 minutes or until thickened. Remove netting or strings from beef. Serve sauce with beef and vegetables.

Slow-Cooker Meatball Stone Soup

Prep Time10 min
Total Time10 hr 10 min

Simmer this hearty main-course meatball soup in the slow cooker, and make it a fuss-free, delicious dinner.
 

Ingredients

• 1 bag (16 oz) frozen cooked Italian-style meatballs
• 1 carton (32 oz) Progresso™ beef flavored broth
• 2 cans (14.5 oz each) diced tomatoes with Italian herbs, undrained
• 1 medium potato, chopped (1 cup)
• 1 medium onion, chopped (1/2 cup)
• 1/4 teaspoon garlic-pepper blend
• 1 bag (1 lb) frozen mixed vegetables

Directions

• In 3 1/2- to 4-quart slow cooker, mix frozen meatballs, broth, tomatoes, potato, onion and garlic-pepper blend.
• Cover; cook on Low heat setting 9 to 11 hours or until vegetables are tender.
• Stir in frozen mixed vegetables. Cover; cook on High heat setting 1 hour.

Shepherd’s Pie

Prep Time30 min
Total Time50 min

Need a classic comfort food recipe? Look no further than this traditional shepherd’s pie filled with beef sirloin, mixed vegetables and topped with warm, creamy mashed potatoes. In under an hour, the shepherd’s pie is ready to serve for a weeknight meal that’s sure to please.

Ingredients

• 1 teaspoon olive oil
• 1 small onion, finely chopped (1/3 cup)
• 1 1/2
• lb ground beef sirloin
• 2 cups frozen mixed vegetables (from 12-oz bag)
• 3 tablespoons tomato paste
• 1/2 teaspoon salt
• 1/4 teaspoon pepper
• 1 3/4 cups Progresso™ beef-flavored broth (from 32-oz carton)
• 2 tablespoons all-purpose flour
• 1 package (20 oz) refrigerated mashed potatoes

Directions

• Heat oven to 375°F. Spray 11x7-inch (2-quart) glass baking dish with cooking spray.
• In 12-inch skillet, heat oil over medium- high heat. Cook onion in oil 5 minutes, stirring occasionally, until soft. Add beef; cook 5 to 7 minutes, stirring occasionally, until thoroughly cooked. Drain.
• Add mixed vegetables, tomato paste, salt and pepper; cook over medium heat 5 minutes, stirring frequently, until vegetables are hot. In small bowl, mix broth and flour with whisk. Add broth mixture to beef mixture. Heat to boiling; cook 3 minutes, stirring constantly, until thick. Spoon beef mixture into baking dish. Spread mashed potatoes over beef mixture; fluff with fork.
• Bake 20 minutes or until golden brown.

Slow-Cooker Beef Stroganoff

Prep Time15 min
Total Time5 hr 15 min
Servings8

Stroganoff, once only a weekend special, can now be served weeknights thanks to slow cooking.

Ingredients

• 1/4 cup butter
• 2 lb boneless beef sirloin steak, cut into 3x1/2x1/4-inch strips
• 1 cup chopped onion
• 2 cloves garlic, finely chopped
• 1 can (10 3/4 oz) condensed golden mushroom soup
• 1 carton (8 oz) sliced fresh mushrooms
• 1/2 teaspoon salt
• 1/4 teaspoon pepper
• 4 oz cream cheese, cubed (from 8-oz package)
• 1 container (8 oz) sour cream
• 6 cups hot cooked noodles or rice

Directions

• In 12-inch skillet, melt butter over medium-high heat. Add beef strips, onion and garlic; cook 7 to 9 minutes or until beef is browned.
• In 3 1/2- to 4 1/2-quart slow cooker, mix beef mixture, soup, mushrooms, salt and pepper.
• Cover; cook on low heat setting 5 to 6 hours or until beef is tender.
• Stir cream cheese into beef mixture until melted. Stir in sour cream until well blended. Serve over noodles.