RESEARCHUPDATE.MCCOYPRESS.NET

ICPA's Freedom for Family Wellness Summit

2010-03-10T00:14:00Z

The ICPA's Freedom for Family Wellness Summit is scheduled for October 21-24, 2010 in Washington DC. I want to encourage you to submit an abstract for this conference. To assist you in preparing your research for this conference, the ICPA is offering you an opportunity to submit your abstracts for review.

The ICPA is well aware that doctors in practice often see the submission of research to be daunting, and they wish to encourage all interested doctors to submit a request for help if they wish to participate.

The ICPA is ready to assist your process of presenting your research at this conference and with thier assistance this year, is hoping that next year you will be in a position to help others who may be in a similar position to you at this time.

The instructions for preparing and submitting abstracts are available here.

When you have reviewed these guidelines, please submit your abstract using the online form here.

The deadline for submitting your abstracts is June 30, 2010.

If you have any questions, please feel free to contact Charles L. Blum, DC, ICPA Freedom for Family Wellness Summit Abstracts Coordinator at drcblum@aol.com

If you have any difficulties with submission, do not hesitate to contact pbrn@icpa4kids.com with any questions.

As always I look forward to your feedback ,comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

Tiering or Tearing of the Profession?

2010-02-12T15:19:00Z

By now you must have heard of what’s going on in New Mexico. Our brethren in the Southwest have decided they are “Advanced” chiropractic physicians. And just what’s so advanced about them – why they can inject stuff and have a limited pharmacopeia.

Some in the profession are shocked by this and mistakenly think that:

1. Its something new and
2. That the majority of the profession does not support such a move into allopathy.

Unfortunately both beliefs are false.

The whole tiering thing has a long history in the profession but the most recent drive for this started in the late 90’s and early part of 2000 with the launch of the Journal of Chiropractic Medicine. One particular issue worth reading to bring you up to speed on where the profession is headed is the:

Volume 1(4); Fall 2002 issue.

The whole issue is worth reading if you want to understand where this fringe group wants to take the profession but one article in particular sort of lays it all out.

Strength in diversity: Professional and legislative opportunities in primary care by the recognition, defining and promotion of the licensure of chiropractic medical education, competencies and skills
Reiner G. Kremer
J Chiropr Med. 2002 Fall; 1(4): 139–148. Published online 2002. doi: 10.1016/S0899-3467(07)60028-7.

So, this is not a new thing.

Secondly, the belief that the rank and file of our profession wants to remain drug free is not consistent with the facts. In the study completed at Ohio Northern nearly half the respondents stated they wanted to be able to prescribe drugs.

So the folks in New Mexico are just pioneers in what will probably be copied in one way, shape or form throughout the country. Of course each state is different so there will have to be multiple approaches but no doubt they’ll work it out.

There is certainly no one standing in their way – have you heard an outcry from the profession about this? I haven't.

In fact the ACA endorses it and the NBCE is developing exams for such a purpose:

Yes, now student’s money is being used to pay for bringing drugs into our drugless profession. That loud rumbling you just heard was all those chiropractors who went to jail for this profession rolling over in their graves.

Some have spoken out – The Foundation for Vertebral Subluxation issued a statement on it.

Foundation for Vertebral Subluxation Statement on Tiering

Dr. Christopher Kent just wrote an as usual insightful article about it.

Drugs, Chiropractic and Boiled Frogs

The ICA has set up a Working Group to look into it:

Chiropractic Advanced Practice law Raises Questions of National Significance

And Dr. Don Harrison has also just released an article about it.

Tiering of the Chiropractic Profession - Geuss Who's Behind This?

Now - what are YOU going to do or say about it?

Here's some additional links on the topic:

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

David, Goliath, Benjamins and the Death of a Movement

2010-02-08T22:41:00Z

2009 was quite a year with the health care reform debacle and the Swine flu fiasco taking up so much of the public discussion on health care. As we sink deeper into 2010, Swine flu seems to be an after thought now and Obama vows he’s not done with health care. We’ll see…

According to the Center for Responsive Politics, health care and insurance company lobbyists spent more than $648 million in 2009. A spokesman for the Center stated that the money spent last year on health care dwarfs the amount spent on any other single issue in a single year. In fact, he said, it was the most money ever spent by a business sector for federal lobbying.

Drug companies spent more than $245 million on lobbying last year alone with Pfizer contributing $22 million. $245 million is more than the combined budgets of all chiropractic institutions in the United States. The money spent by drug companies was more than any other single industry has ever spent on lobbying on behalf of any issue. One report stated this was $90 million more than the oil and gas industry spent on lobbying last year.

In addition to this $648 million another $210 million was spent on television advertising, according to Campaign Media Analysis Group. This amount also set a record for money spent on a single issue in a single calendar year.

The Pharmaceutical Research and Manufacturers of America spent $26 million on lobbying and another $130 million for a television campaign and the American Hospital Association spent $16.3 million on lobbying.

The United States Chamber of Commerce spent $144 million on lobbying and an additional $50 million on commercials.

Just to put this all in perspective, the chiropractic profession spent a whopping $525,000.00 on lobbying in 2009. Yes siree - half a million bucks. Here’s a breakdown of who spent what:

The David and Goliath story of chiropractic versus the medical pharmaceutical industrial complex was true 100 years ago and it’s still true today. Though the spirit of the profession seems crushed and we’ve gone from a movement to a bunch of old white guys making sure their golden years remain – well, golden. All the while the profession as a whole remains stuck in the lower levels of Maslow’s hierarchy of needs just trying to survive.

It would be nice to know what this half a million was spent on so we could see what the priorities of the profession really are but given the fact that a “United Profession” put forth the document The Path to Change in the US HealthCare System: The Chiropractic Perspective. A Joint Policy Statement on Healthcare Reform Presented by a United Chiropractic Profession as our two cents in the health care reform debate, its pretty clear where the cartel is taking us. For more on this see: Please Sir, I Want Some More.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH

matthewmccoy@comcast.net

Editor – Journal of Pediatric, Maternal & Family Health – Chiropractic

http://www.chiropracticpediatricresearch.net

Had your Swine Flu Shot yet?

2010-01-29T16:07:00Z

Not too long ago I officially declared swine flu a fiasco. And while I did get some hate mail suggesting this meant I didn't care about those who did actually die from the disease, most agreed it was indeed a fiasco. In fact, at this point the agreement out there on just how mild it was is so widespread that anyone suggesting otherwise has not only drunk the Kool Aid but is mixing up batches of their own.

Nevertheless, I'll continue to post updates on swine flu happenings since Walgreens, CVS and a host of other doc in the boxes are now trying to unload their stockpiles of vaccines that finally arrived AFTER the worst was over. Interesting to me that these for profit companies can charge people for the vaccines considering that our tax doallrs paid for them to begin with - I suppose its a needle sticking fee?

Yes, from a governmental bailout of vaccine production and distribution to the dissolution of personal autonomy brought on by changes in federal and state laws - it is quite shocking and quite encouraging how people both functioned as automatons on the one hand and resisted the government and pharmaceutical propaganda on the other.

But we'll see. Flu season is not over and there's always next year - and with a re-tooled and re-energized vaccination industry.

Click here for recent headlines related to the flu and vaccines.

As always I look forward to your feedback, comments and suggestions.

Regards,
Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

Swine Flu is Officially a Fiasco

2009-12-10T03:15:00Z

Its official and I’m declaring it. The 2009 Swine flu “pandemic” is a bonafide fiasco. A fiasco is a complete failure - an ignominious, humiliating and disgraceful failure. All the evidence at this point clearly shows that from the government to public health to the pharmaceutical industry - nothing panned out the way they predicted it would.

In a recently released report:

Presanis AM, De Angelis D, Hagy A, Reed C, Riley S, et al. 2009 The Severity of Pandemic H1N1 Influenza in the United States, from April to July 2009: A Bayesian Analysis. PLoS Med 6(12): e1000207. doi:10.1371/journal.pmed.1000207

According to these researchers (which include scientists from Harvard, the UK Medical Research Council and the Centers for Disease Control and Prevention) H1N1 swine flu won't be as severe as was feared and when the fall and winter wave of H1N1 swine flu is over, it will have been no more severe than an average flu season.

In fact, according to one of the researchers - Dr. Lipsitch “The good news is that ... the severity of the H1N1 flu may be less than initially feared."

Let's not forget that the White House predicted as many as 90,000 dead and such dire predictions set the stage for the rolling back of all sorts of civil liberties along with the spending of billions of dollars of taxpayer money that went directly into the pockets of drug companies that were absolved of any risk from adverse reactions from the vaccines they manufactured.

We are just getting the first reports of those adverse reactions. Of course there have been the multiple reports on the internet of anaphalactic reactions and neurological disorders immediately following vaccination but now we have more “authoritative” reports from the CDC and the Vaccine Adverse Events Reportiong System (VAERS).

According to this report:

CDC and FDA staff members searched the VAERS database to identify all U.S. reports of adverse events after vaccination with H1N1 vaccines and 2009--10 seasonal influenza vaccines during July 1--November 24.
3,783 reports of adverse events were received through the U.S. Vaccine Adverse Event Reporting System through November 24 after receipt of H1N1 vaccine. Of these 204 were categorized as serious. In addition, 4,672 adverse events reports after receipt of seasonal influenza vaccines were received, of which 283 were serious.
VAERS data indicated 82 adverse event reports per 1 million H1N1 vaccine doses distributed, compared with 47 reports per 1 million seasonal influenza vaccine doses distributed.
They excluded 62 reports due to “insufficient” information.
During October 5--November 20, a total of 46.2 million doses of H1N1 vaccines and 98.9 million doses of seasonal influenza vaccines were distributed to U.S states and territories. (The government was originally hoping to vaccinate 100 million Americans with H1N1).
The serious adverse event reporting rates were 4.4 and 2.9 serious adverse events per 1 million doses distributed for H1N1 vaccines and seasonal influenza vaccines, respectively.
VAERS received 13 reports of deaths occurring after receipt of H1N1 vaccine. In nine of these deaths, significant underlying illness was reported.
There were 10 reports of Guillain-Barré syndrome, and two additional reports of possible Guillain-Barré syndrome identified by medical officers reviewing other reports to VAERS describing neurologic events.
VAERS also received 11 reports of anaphylaxis, and an additional eight reports of possible anaphylaxis were identified by medical officers reviewing reports to VAERS of serious allergic events.
Three of the Guillain-Barré syndrome cases and 15 of the anaphylaxis cases were coded as serious adverse events, in accordance with federal regulation.
The remaining 173 nonfatal serious adverse events after vaccination with H1N1 vaccines are under chart review. These reports fall into the following diagnostic categories: neurologic or muscular condition other than Guillain-Barré syndrome (49 [28%]); pneumonia or influenza-like illness (27 [16%]); other noninfectious conditions, including multiple medical symptoms (19 [11%]); respiratory or ear, nose, and throat condition (17 [10%]); allergic conditions other than anaphylaxis (16 [9%]); pregnancy complications** (15 [9%]); other infectious symptoms (10 [6%]); gastrointestinal (eight [5%]); cardiovascular (six [3%]); and psychiatric (six [3%]).

Remember all those news conferences where they told us how safe the vaccine was?

Adding to the evidence that H1N1 fears were overblown can be found in a report just published in the New England Journal of Medicine. Surveillance of the 2009 H1N1 virus in China shows that the majority of those infected had a mild illness.

Adding salt to the wounds is an Editorial in the NEJM on the need for science in the practice of public health. The author states that to date H1N1 has not been as lethal as first feared.

Luckily, for the most part, the public didn’t buy into the fear and manipulation churned out by the media, the government and the drug companies. Thankfully we also have the internet and unconventional forms of information distribution. If all we had were the big three networks, cable news and Sanjay Gupta to rely on to give us the truth, no doubt many more would have died or been permanently injured from this fiasco.

The only thing that’s left to do is to hold the congressional hearings on why this was allowed to happen and which heads need to roll. Considering that they spent taxpayer dollars to investigate baseball players taking steroids, one could assume that something so much bigger, so much more damaging to the public health and trust and something people actually care about could warrant congressional hearings.

Don’t worry – I’m not holding my breath.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net/

Swine Flu - Much Ado About Nothing?

2009-11-19T22:06:00Z

What if you had a pandemic and no one came?

Just change the way you measure those infected. In a remarkable development the CDC has announced that they are going to change the way that Swine flu cases are defined. It seems the grand total of 1200 deaths from H1N1 wasn't sufficiently scaring the hell out of people enough to go out and get vaccinated so why not bump up the numbers to put a chill in the air?

While the news media is widely reporting long lines at clinics for the vaccine other sources suggest a different story. In New York last week officials were prepared to administer 31,500 vaccinations a day at seven free clinics throughout the city. The total vaccinations administered on Saturday was 1,701. The New York Times reported vaccine workers standing around with nothing to do and officials perplexed by the low turnout.

Meanwhile government officials and vaccine manufacturers were hauled before Congress which was investigating why so little vaccine had made it to the public and here we are dead in the middle of the season. Everyone blamed those slow virus growing chicken eggs, the public’s fear of vaccines and regulatory hurdles that won’t allow them to use adjuvants. Only 49 million doses had been delivered by this week.

All of this doesn’t seem so much a mystery to me. The drug companies were paid ahead of time to produce the vaccines, surveys of your average earthling revealed that more than half would not get the vaccine, low turnouts materialized so why would the vaccine manufacturers spend any more money to produce more vaccine when they probably won’t be able to get what they will produce off their shelves by the end of the season?

$1.5 billion was paid by the US government for Swine flu vaccine – that’s $600 per taxpayer. In what seems incredible Glaxo won’t tell what they are getting from the UK government for its H1N1 concoction and Baxter settled out of court after accusations of fraud for overcharging for their Swine flu vaccine. Despite this Britain still went ahead and contracted with them for 132 million doses!

Its like getting vaccine out of the back of a panel van in the alley from your local neighborhood criminal.

And these are the people we are supposed to trust when they tell us to just roll up our sleeve and get in line? I'm sure such criminal behavior would never spill over into the science or manufacturing of the vaccine - right?

Despite the changes in definitions to bump up the numbers some experts don’t seem to think there is anything to worry about. Ira M. Longini Jr., a flu epidemiologist at the University of Washington and Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, both said the new figure doesn’t come close to the 90,000 people Obama said would drop dead this flu season.

In fact according to Dr. Longini deaths were likely to be in the 30,000-to-40,000 range, and Osterholm said they would “have a long way to go to even get there.”

Sounds like a typical flu season to me.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

Swine Flu Vaccine & Pregnant Women

2009-11-13T16:27:00Z

There is no doubt a great deal of information being thrown at us every day in regards to the Swine flu. Just deciding what is important to focus on takes a great deal of time and effort. For this update I am going to focus on the news widely reported in the media that results from a clinical trial indicates that the vaccine is safe in pregnant women. As soon as this came out the media were all over it and public health officials were once again making a mockery out of those women who were choosing not to vaccinate themselves out of concern for the untested vaccine.

Let’s walk slowly through the data as reported by the National Institutes for Allergy and Infectious Disease.

1. This clinical trial is studying only 120 women
2. There are two groups with only 60 subjects in each group
3. They are getting two doses of the vaccine with one group getting a larger dose than the other.
4. They are 18 to 39 years of age
5. They are in their second or third trimester (14 to 34 weeks) of pregnancy
6. The vaccine is a candidate 2009 H1N1 influenza vaccine manufactured by Sanofi Pasteur.

In order to be in this study these women must be in good health. They determine good health as follows:

By vital signs (heart rate 100 beats per minute; blood pressure: systolic 140 mm Hg; diastolic less than or equal to 90 mm Hg; oral temperature 100 degrees Fahrenheit), medical history to ensure any existing medical diagnoses or conditions are stable and not considered clinically significant, and targeted physical examination based on medical history. A stable medical condition is defined as health outcomes of the specific disease are considered to be within acceptable limits in the last 3 months.

Here is a list of all the women EXCLUDED from the study:

• Has a known allergy to eggs or other components in the vaccines (these may include, but are not limited to: gelatin, formaldehyde, octoxinol and chicken protein).
• Has a history of severe reactions following previous immunization with influenza virus vaccines.
• Has participated in a novel influenza H1N1 2009 vaccine study in the past 2 years or has history of novel influenza H1N1 2009 infection prior to enrollment.
• Has received any other live licensed vaccines within 4 weeks or inactivated licensed vaccines within 2 weeks prior to vaccination in this study prior to vaccination or plan receipt of such vaccines within 21 days following the last vaccination (except for seasonal inactivated influenza vaccine which may be received 2 weeks post either vaccination). Measles, mumps, and rubella vaccine and tetanus, diphtheria, and acellular pertussis vaccine are permitted post-partum.
• Has received an experimental/investigational agent (vaccine, drug, biologic, device, blood product, or medication) within one month prior to vaccination in this study, or expects to receive another experimental/investigational agent during the study period (prior to the Day 201 follow-up call - 180 days after the second vaccination).
• Has an acute illness and/or an oral temperature greater than or equal to 100.0 degrees Fahrenheit, within 72 hours of vaccination (This may result in a temporary delay of vaccination).
• Has immunosuppression as a result of an underlying illness or treatment, or use of anti-cancer chemotherapy or radiation therapy within the preceding 36 months.
• Has an active neoplastic disease (excluding non-melanoma skin cancer), a history of any hematologic malignancy, current bleeding disorder, or taking anticoagulants.
• Long term use of glucocorticoids, including oral or parenteral, or high-dose inhaled steroids (>800 micrograms/day of beclomethasone dipropionate or equivalent) within the preceding 6 months (nasal and topical steroids are allowed) or has received betamethasone or dexamethasone to accelerate fetal lung maturity.
• Has a history of receiving immunoglobulin or other blood product (with exception of Rhogam) within the 3 months prior to enrollment in this study.
• Has a diagnosis of a current and uncontrolled major psychiatric disorder.
• Has been hospitalized for psychiatric illness, history of suicide attempt, or confinement for danger to self or others, within the past 10 years.
• The subject is receiving any of the following psychiatric drugs: aripiprazole, clozapine, ziprasidone, haloperidol, molindone, loxapine, thioridazine, thiothixene, pimozide, fluphenazine, risperidone, mesoridazine, quetiapine, trifluoperazine, trifluopromazine, chlorprothixene, chlorpromazine, perphenazine, olanzapine, carbamazepine, divalproex sodium, lithium carbonate or lithium citrate. Subjects who are receiving an antidepressant drug (not listed above) and are stable for at least 3 months prior to enrollment without decompensating are allowed enrollment into the study.
• Known active human immunodeficiency virus (HIV), hepatitis B, or hepatitis C infection.
• History of alcohol or drug abuse in the last 5 years.
• Has a seizure disorder or is on an anti-seizure medication.
• Has a history of Guillain-Barré Syndrome.
• Plan to travel outside of North America in the time between the first vaccination and 42 days following the first vaccination.
• Has an acute or chronic medical condition that, in the opinion of the investigator would render vaccination unsafe, or would interfere with the evaluation of responses (this includes, but is not limited to, known cardiac disease, chronic liver disease, significant renal disease, unstable or progressive neurological disorder, transplant recipients or uncontrolled diabetes, juvenile diabetes (Type I) or advanced diabetes with renal disease or eye disease, diabetes controlled by diet or insulin is acceptable.)
• Has any condition that would, in the opinion of the site investigator, place the subject at an unacceptable risk of injury or render the subject unable to meet the requirements of the protocol.

In terms of adverse outcomes they are looking at:

• The occurrence of solicited local and systemic adverse events within 8 days post vaccination.
• The incidence of maternal and neonatal complications at the time of delivery. (Emphasis added)

So what does the data from the study show so far?

• In 25 women who received a single 15-microgram dose of the vaccine, the H1N1 flu vaccine elicited an immune response likely to be protective in 92 percent, or 23 of 25, of these women.
• In 25 women who received a single 30-microgram dose of the vaccine, the H1N1 flu vaccine elicited an immune response likely to be protective in 96 percent, or 24 of 25, of these women.

So in 8 and 4 percent of women an immune response likely to be protected was not illicited - extrapolate that to the millions who might get the vaccine. They also note that the vaccine appears (emphasis added) to be well-tolerated, and no safety concerns related to the vaccine have arisen.

So what do we really know at this point? We know that in a small group of 50 healthy, pregnant women in their 2nd or third trimester an immune response to the vaccine was illicited in the majority of these women - some did not.

The report did not reveal whether or not there were local or systemic adverse events within the 8 days following vaccination – they just said no safety concerns had arisen. And they either have no data on maternal or neonatal complications yet or they just didn’t report on them, or they lump these into their “no safety concerns” statement. Note that they are not going to follow these women and children after delivery to see what if any long term effects occur months or years afterwards.

Interestingly the NIAID quotes Anthony Fauci MD stating: “For pregnant women, who are among the most vulnerable to serious health problems from 2009 H1N1 infection, these initial results are very reassuring,”

What Fauci leaves out is that the best data we have on how H1N1 effects preganant women is from studies just published based on data from the United States, New Zealand and Australia.

These data show that 30% of the pregnant women who died from H1N1 were either obese or morbidly obese and 60% had underlying medical conditions that put them at greater risk of overwhelming viral and bacterial infections.

So how can Facui make a blanket statement that all pregnant women are the most vulnerable when the data says otherwise? And then to recommend the vaccine to every single pregnant woman in the country based on the response in a healthy cohort of an incomplete study? Science at its best – or perhaps worst.

The best advice I can give at this point is: In God we trust – everyone else has to bring data.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor – Journal of Pediatric, Maternal & Family Health – Chiropractic
http://www.chiropracticpediatricresearch.net

Special Offer!

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The crucial need for chiropractic research alone should compel you to subscribe and support the efforts of those in the profession trying to gather the data to support what you do day in and day out but hopefully this added special offer will make it a no brainer. Your actions today help support needed research for the future.

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Balloon Boy & Swine Flu

2009-10-22T20:19:06Z

Had you not been paying attention to the real news and events occurring around the world prior to last week and awoke from that slumber you’d be left to believe that all was well in the world since all the media outlets were transfixed by a non-news story, news story. The balloon boy was everywhere…

What was not everywhere was any in-depth reporting of swine flu vaccine side effects, the stripping of our rights as free citizens when it comes to what goes into our bodies or the desperately needed “other side of the story” to counter Rear Admiral Anne Schuchat MD.

I cringed during her interview on 60 minutes as she sat deadpanned, staring straight into the camera and without hesitation told an anxious nation that the Swine flu vaccine has been tested, is safe and children and pregnant women should get it immediately. Her recommendations followed heart wrenching images of a high school teenage football player who had succumbed to H1N1 and was battling for his life in the hospital as distraught parents held on to hope.

As I watched I thought to myself that the strongest parent with the deepest conviction and ability to think critically could not shield themselves from the doubt that was being instilled by our nation’s undisputed expert on infectious disease with a young boy clinging to life in the background.

Shame on 60 minutes, shame on Anderson Cooper, Sanjay Gupta, Larry King and every other media outlet that refuses to tell the other side of the Swine flu story. Shame on them for not interviewing those with a different analysis of the data. Shame on them for blindly accepting everything we are being told by the government and its experts. What happened to their responsibility to find the truth?

This week the CDC reported another 10 deaths in children from H1N1 adding to the previous report from August of 36 deaths. The following is from the CDC website:

Eleven influenza-associated pediatric deaths were reported to CDC during week 40 (Arizona, Colorado, Idaho, Kentucky, Louisiana [2], North Carolina, Ohio, South Carolina, and Tennessee [2]). Ten of these deaths were associated with 2009 influenza A (H1N1) virus infection and one was associated with an influenza A virus for which the subtype is undetermined. These deaths occurred between August 30 and October 10, 2009. Since August 30, 2009, CDC has received 43 reports of influenza-associated pediatric deaths that occurred during the current influenza season (three deaths in children less than 2 years, five deaths in children 2-4 years, 16 deaths in children 5-11 years, and 19 deaths in individuals 12-17 years). Thirty-nine of the 43 deaths were due to 2009 influenza A (H1N1) virus infections. A total of 86 deaths in children associated with 2009 H1N1 virus have been reported to CDC. Among the 43 deaths in children, 28 children had specimens collected for bacterial culture from normally sterile sites and seven (25.0%) of the 28 were positive; Staphylococcus aureus was identified in five (71.4%) of the seven children. One S. aureus isolate was sensitive to methicillin, three were methicillin resistant, and one did not have sensitivity testing performed. All seven children with bacterial coinfections were five years of age or older and four (57.1%) of the seven children were 12 years of age or older.

In the report issued on the deaths of 36 children form H1N1 we learn that the majority of those deaths occurred in children with very significant neurodevelopmental disorders. According to the data some of these children also had chronic pulmonary disorders and some were obese. In fact, most who died had multiple, severe, chronic health conditions. Interestingly, the CDC found that 13 (52%) of the children who died had received at least 1 dose of the 2008--09 seasonal flu vaccine including 11 children who had these high-risk medical conditions. Of further interest is that 15 of those who died and who had chronic medical conditions had also received antiviral treatment. What role, if any, these two factors had in the deaths was not discussed in the CDC report.

The most recent reports from the CDC on children’s deaths associated with H1N1 fails to provide the in-depth characteristics previously provided in their August report. If we are to assume all things are equal then the more recent deaths would display similar characteristics. Yet Schuchat looks into that camera and tells parents that all children are at risk and that the vaccine has been tested and is safe for them.

How could that be when the package insert dated September 2009 for Novartis Vaccines and Diagnostics Limited Influenza A (H1N1) 2009 Monovalent Vaccine states:

Influenza A (H1N1) 2009 Monovalent Vaccine is an inactivated influenza virus vaccine indicated for active immunization of persons 4 years of age and older against influenza disease caused by pandemic (H1N1) 2009 virus.

Under the adverse reactions section Novartis notes they base this off the seasonal flu vaccine:

Adverse Reaction information is based on studies conducted with seasonal trivalent Influenza Virus Vaccine manufactured by Novartis (FLUVIRIN).

Obviously they don’t have enough information on the H1N1 trials to even discuss adverse reactions for that specific vaccine.

In discussing its use in specific populations Novartis states it has not been tested in pregnant or nursing women:

Safety and effectiveness of Influenza A (H1N1) 2009 Monovalent Vaccine have not been established in pregnant women, nursing mothers or children less than 4 years of age.

The Novartis package insert states that three clinical studies were carried out on a total of 520 pediatric subjects (age range 6-48 months) but they do not report on any data from those studies – that seems strange doesn’t it?

Even better (or worse) is Sanofi Pastuer’s package insert for their H1N1 vaccine relying on data for its seasonal flu vaccine which states its only been tested on 31 children!

According to the package insert for Australia's CSL, which is distributing 21 million doses of their H1N1 vaccine, it has also not been tested in these populations and in fact, unlike their competitors, their seasonal flu vaccine has also not been tested on children:

Neither Influenza A (H1N1) 2009 Monovalent Vaccine nor AFLURIA has been evaluated in children. Safety and effectiveness in the pediatric population have not been established.

Here’s what the CDC has to say about its use in pregnant women and children:

What studies have been done on the 2009 H1N1 flu shots and have any been done in pregnant women?

Studies to test the 2009 H1N1 flu shots in healthy children and adults and pregnant women are being done now. These studies are being conducted by the National Institute of Allergy and Infectious Diseases (NIAID). More information can be found at http://www3.niaid.nih.gov/news/QA/vteuH1N1qa.htm.

So after review of initial safety data from just 500 adults in three trials of H1N1 vaccine, additional trials of similar design began in children in mid-August of 2009 and won’t be completed until May 2010. You can see for yourself what they are doing in these studies of children (take a close look at the exclusion criteria):

Under the heading Preventing and Managing Allergic Reactions in the package insert, Novartis stresses the importance of reviewing the patient’s history and to assess benefits and risks prior to giving the vaccine. It also states that treatment and supervision for possible anaphylactic reactions MUST be available:

Prior to administration of any dose of Influenza A (H1N1) 2009 Monovalent Vaccine, the healthcare provider should review the patient’s prior immunization history for possible adverse events, to determine the existence of any contraindication to immunization with Influenza A (H1N1) 2009 Monovalent Vaccine and to allow an assessment of benefits and risks. Appropriate medical treatment and supervision must be available to manage possible anaphylactic reactions following administration of the vaccine.

Funny, I didn’t see any of that going on in those videos of the drive through flu shots.

Keeping in mind that they are using data from the regular seasonal flu vaccine its interesting to note the following for the Novartis vaccine:

Safety data have only been collected on a total of 2768 adult and geriatric subjects since 1982.
Nine clinical studies have been conducted since 1997 with only 1261 subjects
96% of those subjects were white
All studies were conducted in the UK

After they were injected with the vaccine the subjects were followed for 3 days (yes - just 3 days) to see if they had any reaction.

So let’s get this straight - about 3000-4000 adult white people in the United Kingdom were followed for three days after getting a seasonal flu vaccine and we are supposed to feel safe now that its being used on hundreds of millions of people just because the vaccine for H1N1 is being manufactured in a similar fashion? This is for a virus whose antigenic characteristics indicate that it is only distantly related antigenically and genetically to seasonal influenza.

It’s as if everyone woke up and decided to suspend all manner of critical thinking.

According to Novartis the following adverse reactions were uncovered during post marketing surveillance of the regular seasonal flu vaccine:

Body as a whole: Local injection site reactions (including pain, pain limiting limb movement, redness, swelling, warmth, ecchymosis, induration), hot flashes/flushes; chills; fever; malaise; shivering; fatigue; asthenia; facial edema.

• Immune system disorders: Hypersensitivity reactions (including throat and/or mouth edema). In rare cases, hypersensitivity reactions have lead to anaphylactic shock and death.

• Cardiovascular disorders: Vasculitis (in rare cases with transient renal involvement), syncope shortly after vaccination.

• Digestive disorders: Diarrhea; nausea; vomiting; abdominal pain.

• Blood and lymphatic disorders: Local lymphadenopathy; transient thrombocytopenia.

• Metabolic and nutritional disorders: Loss of appetite.

• Musculoskeletal: Arthralgia; myalgia; myasthenia.

• Nervous system disorders: Headache; dizziness; neuralgia; paraesthesia; confusion; febrile convulsions; Guillain-Barré Syndrome; myelitis (including encephalomyelitis and transverse myelitis); neuropathy (including neuritis); paralysis (including Bell’s Palsy).

• Respiratory disorders: Dyspnea; chest pain; cough; pharyngitis; rhinitis.

• Skin and appendages: Stevens-Johnson syndrome; sweating; pruritus; urticaria; rash (including non-specific, maculopapular, and vesiculobulbous).

Note to Anderson Cooper and every other supposed “investigative reporter” – next time you have the Admiral on why not ask her about these data and how she can look at anyone with a straight face and say its been tested and found to be safe.

If you want more information check out our Swine Flu website set up to try and keep track of the constant changes in this very serious issue.

As always I look forward to your feedback comments and questions.

Regards,
Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

Swine Flu - Trust Us, We're Doctors

2009-10-08T21:27:00Z

Well, the Swine flu season is now under way, vaccine has been distributed, the first shots have been given with much fanfare, Tamiflu has been shipped, dentists and pharmacists have been deputized to give shots, health care workers in New York are protesting a mandate to get the shots, Emergency Health Powers have been enacted and the Public Readiness and Emergency Preparedness Act (PREP Act) has been implemented to shield drug companies from any responsibility if things go wrong.

Despite all the hype from the government the majority of people surveyed don’t trust the shots or what the government is telling us and the government is in full media mode characterizing anyone who even questions this “pandemic” as lunatics who are putting children’s lives at risk.

On October 2nd Dr. Anne Schuchat, the CDC’s director of immunization and respiratory disease, said there was “significant flu activity in virtually all states,” which, she added, was “quite unusual for this time of year.”

Interestingly just today the New York Times reports that public health officials say there appears to be a pattern of areas that had big outbreaks in the spring, like New York, Boston and Philadelphia, seeing less swine flu now. Is it any wonder no one trusts those like Dr. Schuchat?

And in an insult to our collective intelligence Dr. Schuchat and others argue that “the vaccine was neither new nor untested” because it is attached to the same “genetic backbone” of weakened flu virus as the 100 million seasonal flu injections given each year, grown in the same sterile eggs and purified in the same factories. And test injections done in September found that it had the same side effects, most of which were sore arms and mild fevers.

Given that Dr. Schuchat probably has more credentials related to infectious disease than any other person on this planet one can understand how intimidating it would be to disagree. However, a high school biology student can see the flaws in her arguments about whether this is a new vaccine or not and whether it’s been tested to an extent that should make everyone feel comfortable.
And if the vaccine is really nothing new and it really has been tested as much as it needs to be then why was the PREP Act implemented by the HHS Secretary?

The truth is nobody knows what’s going to happen - not even Dr. Schuchat with all of her credentials - because they are just making educated guesses and everyone is now involved in a massive epidemiological study of the H1N1 vaccine.

Click here for the latest Swine Flu Updates including:

• Areas Hit Hard by Flu in Spring See Little Now
• Swine Flu Vaccine Reaches an Anxious Nation
• N.Y. Health Care Workers Revolt Over H1N1 Vaccine
• Health-care workers often shun seasonal flu shots
• Swine flu: H1N1 vaccine skepticism spreads among young parents
• Special Report Reveals The Truth About Flu Vaccines
• Nanotechnology and Swine Flu Vaccine
• Swine flu spreading widely worry over pregnant women
• U.S. Braces for Long Flu Season
• US: Swine flu school closings could cost billions
• Early estimates of 2009 pandemic influenza A(H1N1) virus activity in general practice in France:
• Majority of U.S. Parents Wary of H1N1 Vaccine
• Nurses File Suit Over Flu Shots
• Seasonal flu shot may increase H1N1 risk
• Timing of H1N1, seasonal flu shots debated
• Map of Swine Flu Cases
• The Questionable Efficacy of Flu Vaccines... and the Pandemic That Wasn't
• Flu View - Current Flu Activity & Surveillance
• H1N1 Situation Update
• The World Bank H1N1 Update Press Briefing

As always I look forward to your feedback, comments and suggestions.

Regards,

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

Swine Flu Update

2009-09-25T23:58:00Z

Federal health officials just reported that doses of Swine flu vaccine will be double what they expected, officials in Washington state have lifted the limits on the amount of thimerosol allowed in H1N1 vaccines, dentists and pharmacists in Massachussetts have been deputized to administer the vaccine, legal immunity has been granted for swine flu vaccine manufacturers…

The list goes on and on. The amount of information coming out on a daily basis about the upcoming Swine flu “season” is nearly impossible to keep up with.

But you have to keep up.

Your patients are going to be looking to you for rational information and advice on what to do. The White House is predicting 90,000 deaths – think about the fear this is going to instill in your patients this coming fall and winter.

In an effort to help keep you up to date we have put together a website for Swine Flu Updates.

http://swineflu.mccoypress.net

Please tell your patients about it, tell your fellow chiropractors about it and check in regularly yourself for new items. Use them in your newsletters and health talks, post a link on your website, get the information out.

Please also feel free to forward anything you come across so we can add it to the archives.

Your patients will need you more than ever in the coming months – be prepared.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH

matthewmccoy@comcast.net

Editor – Journal of Pediatric, Maternal & Family Health – Chiropractic

http://www.chiropracticpediatricresearch.net

Obama Waffles on Swine Flu Vaccine for First Family

2009-09-21T19:00:00Z

In one of his best (or worst) sidestepping of a direct question President Obama avoided a direct answer to whether or not he and his family would be vaccinated against Swine flu.

The President’s answer also shows both his ignorance and knowledge about certain aspects of the vaccine and the Swine flu itself.

In the actual video of his interview with CNN’s John King the President mistakenly asserted that his children were not in the first line of priority recipients for the largely untested vaccine. He stated that children with neurological conditions were first priority and that his children would come in after that. Unfortunately the text of the story posted on CNN does not add the caveat about neurological disorders and in an obvious error uses children in general as in the first line of recipients. Watch the video.

What President Obama is referring to is a little known study released by the CDC that reports on the deaths of 36 children attributable to complications from the Swine flu. The majority of those deaths occurred in children with very significant neurodevelopmental disorders.

According to the data some of these children also had chronic pulmonary disorders and some were obese. In fact, most of the children who died had multiple, severe, chronic health conditions. So the majority of these children were not normal healthy children but instead had neurological, neurodevelopmental and pulmonary disorders and ended up with complications from the H1N1 flu and ultimately died from these complications.

Interestingly, the CDC found that 13 (52%) of the children who died had received at least 1 dose of the 2008--09 seasonal flu vaccine including 11 children who had these high-risk medical conditions. Of further interest is that 15 of those who died and who had chronic medical conditions had also received antiviral treatment. What role, if any, these two factors had in the deaths was not discussed in the CDC report.

If the President of the United States is aware of what the real high risk groups are why hasn’t the CDC changed their recommendations?

Currently the CDC Advisory Committee on Immunization Practices (ACIP) has recommended that target groups for vaccination include:

Pregnant women,
People who live with or care for children younger than 6 months of age, healthcare and emergency medical services personnel,
Persons between the ages of 6 months and 24 years old,
People ages of 25 through 64 years of age who are at higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems, or those who have medical conditions that pout them at higher risk for influenza related complications.

President Obama was quick to point out that he would ask his HHS Secretary Kathleen Sebelius and his CDC Director Thomas Frieden to instruct him on what to do and that he would follow their recommendations. Well, it appears he is getting different advice than the rest of the country.

While most of the media that picked up on the story chose to go with an Everyman slant that the President and the First Family would “wait in line like everyone else” to get their shots, it really appears they are trying to go to the back of that line.

While the President suggested that he was probably far down the line of recipients, perhaps he should give Sebelius and Frieden another call and remind them that he is a long time smoker and that smokers fall into the category of vulnerability.

In fact, data shows this increased vulnerability resides in former smokers as well.

After weeks, indeed months, of increasingly conflicting information about the Swine flu and the vaccine this most recent display by the President does nothing to instill any confidence that anyone knows what the hell they are talking about. Just a few weeks ago Frieden (who the president says he will listen to when told what to do on the flu) came out in complete disagreement with the President’s own report on the Swine flu and its potential to wreak havoc. Frieden and Sellius disputed the White House’s notion that 90,000 people were going to die from it.

The only way the President is going to be able to redeem himself on this one is to cut to the front of the line, roll up his sleeves and get his two Swine flu shots. While he’s at it he should also get the regular seasonal flu shot at the same time. His daughters, of course should be right in front of him in that line according to the CDC.

This is going to be an interesting flu season for sure.

As always I look forward to your feedback, commnets and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor
Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

Chiropractic Part of Swine Flu Prevention Program in Children

2009-09-08T23:17:00Z

FOR IMMEDIATE RELEASE

Chiropractic Part of Swine Flu Prevention Program in Children

ATLANTA, Georgia – September 8, 2009

A recent update on the Swine flu released by the Centers for Disease Control & Prevention reports on the deaths of 36 children attributable to complications from the viral infection. The majority of those deaths occurred in children with very significant neurodevelopmental disorders.

According to the data some of these children also had chronic pulmonary disorders and some were obese. In fact, most who died had multiple, severe, chronic health conditions.

“The number of children with neurological, neurodevelopmental and pulmonary disorders who ended up with complications from the H1N1 flu and who ultimately died from these complications point to the need to make sure that children with such disorders, and in fact all children, have as little interference to their nervous systems as possible” stated Matthew McCoy DC, MPH a public health specialist, health researcher and editor of the Journal of Pediatric, Maternal & Family Health - Chiropractic.

McCoy added “It also shows that the majority of children who ended up with complications from H1N1 infection were not normal, healthy children. So, if you have normal, healthy children - rather than panic from these media reports its better to consider the things you can do to make sure that your child’s immune system remains functioning at its best.”

In addition to a healthy diet, exercise and proper sleep one crucial way to make sure your child’s immune system is functioning at its best is to make sure their nervous system is free from interference. Since the nervous system has a direct effect on the immune system and because the spine houses and protects so much of the nerve system it is important to have your child’s spine checked for any interference.

“Nerve interference can result from spinal misalignments or abnormal motion in the spine called vertebral subluxations and because the nervous system affects immune function it is important to reduce or correct any vertebral subluxations if found” advised Dr. Christopher Kent, chiropractic researcher and President of the Foundation for Vertebral Subluxation.

“The lesson in all of this is to go back to the basics” stated Kent, “The best defense against viral and bacterial diseases, in addition to the recommendations for hand washing and covering your mouth, is a highly functioning immune system. Chiropractic should be part of an effective flu prevention strategy.”

Chiropractors specialize in the identification and care of vertebral subluxations. Through examination of the spine they can determine if subluxations are present and if found can recommend the necessary care to reduce or correct them. Both McCoy and Kent urge all parents to have their children checked for nervous system interference as soon as possible before and during the upcoming flu season.

Contact Information:

Matthew McCoy DC, MPH

Journal of Pediatric, Maternal & Family Health – Chiropractic

http://www.chiropracicpediatricresearch.net

matthewmccoy@comcast.net

404.247.2550

###

We Already Have National Health Care

2009-08-18T23:56:00Z

US Health Care By the Numbers…

From 2000 to 2005, the proportion of workers aged 18 to 64 with employment-based health benefits fell to 70.6 percent from 74.5 percent.
A record 46.6 million Americans lacked health insurance last year. Of them, more than 82 percent lived in households headed by someone holding a job.
The health care industry constitutes 14 percent of the gross domestic product.
Out of a total population of about 300 million, 35.6 million elderly Americans were on Medicare in 2005.
Of the working-age population, which reached 257.8 million in 2005, 45.5 million were covered by Medicare, Medicaid or military health programs.
Another 18.2 million workers had health insurance through public jobs such as state, federal and local governments, public schools and state universities.
Millions of those workers’ dependents are covered as well. Even if those dependents are not included in the total, taxpayers paid the bill for almost two-fifths of all Americans with insurance in 2005.
The tax subsidy for employment-related health coverage was $208.6 billion in 2006, or 35.4 percent of the amount spent on premiums.
In fiscal 2006, spending on Medicare was $378.7 billion and federal spending on Medicaid was $180.6 billion.
Public expenditures on health care — Medicare, Medicaid, military health care and federal employee benefits — accounted for $888 billion of the $1.96 trillion spent on health care in 2004.
Adding in the subsidies, and premiums paid for public-sector employees, the total comes to $1.2 trillion, or 61 percent.
According to Uwe E. Reinhardt, the James Madison professor of political economy at Princeton, the government accounts for about two-thirds of health care spending.
In 2004, government spending on health care equaled 9.6 percent of the gross domestic product, compared with 6.9 percent in Canada.

The Employee Benefits Research Institute
Selden, T: Agency for Healthcare Research and Quality
Data from the National Health Expenditures Accounts
Himmelstein, D: Associate professor of medicine at Harvard Medical School.
Reinhardt, U: Princeton University

The Costs of Being Well

2009-07-23T13:31:00Z

Last night President Obama’s held a prime time press conference to push his health care reform agenda. When asked by a reporter what the average American was going to have to give up in order to have meaningful reform the President replied:

“They are going to have to give up paying for things that don't make them healthier.”

I could hear the collective “Amen” being shouted from the entire chiropractic profession across the country.

As you probably already know, the reform the President wants is in real trouble. The Republicans don’t want it, the Democrats don’t want it and Americans may not even want it. The chiropractic profession of course just wants to be included. You have to know that any hope of real reform is over when the AMA supports it. Of course they only supported it once they were promised that those 40% in Medicare cuts would be taken off the table.

Throughout Obama’s press conference there were repeated references, buzzwords, and phrases regarding prevention, wellness, outcomes, etc. Prevention and wellness even enjoys prominent display in the AMA’s talking points about health system reform. The health outcomes movement that started back in the 70’s has made prime time. Prevention and wellness are no longer words used only during Wednesday night lay lectures in chiropractic offices.

The problem of course is evidence. In fact while the AMA promotes prevention and wellness they do so based on evidence. The hard facts are that when it comes to evidence for prevention and wellness the well is pretty dry. From cancer screenings to early interventions we are just not at a point where the evidence overwhelmingly shows its cost effective or even life saving.

And where there are pockets of change such as chronic disease management programs, the problem is a viable financial model. One hospital system recently reported that they had excellent results with a disease management program – reduced hospitalizations, reduced medication errors, reduced mortality and morbidity. They cancelled the program. They cancelled it because the program was so successful that the hospital was losing money and if it continued they would have to shut down the hospital.

You see, we are not ready for real reform. Health care is 16% of the GDP of this country and making a change to something that big isn’t going to be easy and is not going to happen overnight. According to the health policy and outcomes experts I speak to, this whole current effort is a blip in the 20 year overhaul of the health care system in this country. I have not spoken to one expert that says it’s going to happen without a major crisis. In fact, it seems the coming unwinding of health care is going to make the financial crisis look like a Sunday drive. Most have told me that it is going to have to implode and rebuild. Whatever anyone thinks about Obama and his policies – he does recognize the problem and he is trying to tell people how dire the situation is. His proposed solutions are another story.

And what of chiropractic?

According to the ACA’s website in their section on Health Reform:

Doctors of chiropractic employ a non-surgical and non-pharmaceutical approach to health care that utilizes “spinal manipulation” to treat a range of neuro-musculoskeletal conditions. (The range of conditions treated typically includes: back pain, neck pain, pain in the joints of the arms or legs, and headaches and other spinal-related maladies -- conditions that the vast majority of Americans will experience one or more times during their lives).

Subluxation is of course not included.

Yes – they mention wellness and prevention in other places but the above is the focus. In fact, the ACA is not alone as some 40 organizations, groups and businesses within chiropractic told Obama just this in a “unified” document produced by the group:

But what level of evidence is there that we prevent neck pain, back pain or pain in the joints of the arms or legs? What literature that does exist on the topic generally says we maybe make people feel better a week sooner than if they did nothing. And some systematic reviews of the manipulation literature suggest we don’t even do that.

But that’s what the leadership in this profession has done – put all its eggs in the one basket of pain. And we let them do that.

I suggest that instead of worrying about whether we are included in this - no reform reform - of health care – that we instead focus on the real issue. The lack of research supporting the basic premises of the profession. Its widely “believed” by the vast majority of chiropractors that a person under chiropractic care from birth (or even prior) will enjoy better health outcomes throughout their life. How about gathering some evidence for that? And while we’re at it lets make sure we are seeing if there is a correlation between those health outcomes and the degree to which the person is subluxated and what the costs savings are.

Then in 20 years when the system has really fallen apart maybe this time we’ll have some real evidence for how we affect people’s lives.

Or we could do more low back pain research?

As always I look forward to your feedback, comments and suggestions.

Regards,
Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor – Journal of Pediatric, Maternal & Family health – Chiropractic
http://www.chiropracticpediatricresearch.net

Andrew Weil MD – Chiropractic Expert?

2009-07-06T02:30:00Z

Once again chiropractors who focus their practice on the management of vertebral subluxation, take x-rays to evaluate the biomechanical intergrety of the spine and offer their patients affordable long term care options are under attack. This time it’s not from the controlling cartel of the chiropractic profession but from self proclaimed “integrative medicine pioneer” Andrew Weil MD.

In a response from a reader asking his opinion about chiropractic, the esteemed Dr. Weil advises against all of the above. But of course, if you have back pain a chiropractor may be able to help you opines the good internet doctor.

This isn’t the first time Weil has bashed subluxation based chiropractic. He immortalized his negative views in one of his books. I was told he apologized for the comments in his book several years ago when he was invited to speak at Parker – either the story wasn’t true or the apology was insincere since he obviously still holds these opinions.

What is so disturbing to me is that Weil cloaks his recommendations about chiropractic on evidence – as if he actually reviewed any before making his proclamation. And worse still is what one finds from just a cursory review of his website. Chock full of one claim after another about a whole host of remedies mostly substituting pharmaceutical products for whatever he is legally allowed to sell off his website.

In one section he promises “Achieve Optimum Wellness in 8 Weeks!” Eight weeks? Optimum wellness? Eight weeks? Really? I fully admit I did not do a literature search to see if Weil has any published evidence that those following his plan are actually achieving “optimum wellness” in 8 weeks, but if it’s out there I would love to see it.

And certainly the good Dr. Weil wouldn’t recommend anything that isn’t based on evidence as he dutifully points out in the code of integrative medicine practitioners on his website:

Practitioners of integrative medicine use less invasive, less expensive, and more natural treatments whenever possible, but they neither reject conventional therapies nor accept alternative ones uncritically. Instead, they are taught that good medicine is based in good science, that it is inquiry-driven and open to new paradigms.

Do as I say not as I do when it comes to chiropractic, eh Dr. Weil?

In his response to the reader Weil describes chiropractic as just another form of manual medicine and that we originally focused entirely on the spine and the "notion" of subluxations. He tells his readers that this notion “…is now dated” and that we now concentrate on all manner of pain relief – where he believes chiropractic may be of real value . One thing’s for sure – he agrees with the controlling cartel of the profession on that one.

Then the warnings begin from our newfound expert on all things chiropractic. He tells readers they should stop chiropractic if they don’t feel better after “...a few sessions…” or “…two weeks of treatment…” and that you should seek help elsewhere. Now where is his lofty advice about “integrative medicine” and “communication” here? Why not suggest talking to your chiropractor about why you are not improving? Worse still is his fairly plain insinuation that the chiropractor wouldn’t be addressing these issues in the first place. We must not know how to determine whether or not a patient is responding to our care so the patient has to figure it out for themselves. I highly doubt Weil would suggest a patient simply stop taking their medication and “go somewhere else” if they were not improving under an MD’s care.

And make sure you “…avoid the routine use of x-ray’s by chiropractors to diagnose spinal misalignment” admonishes Weil. As if to say - go to a chiropractor instead who randomly, grossly manipulates your spine without looking to make sure you have something worth manipulating or what direction it needs to be manipulated in. Ah yes, short term, gross spinal manipulative therapy to fire off mechanoreceptors and block pain signals. Stay away from specific chiropractic adjustments to reduce vertebral subluxation as demonstrated by x-ray and objective assessment.

And of course he doesn’t recommend chiropractic for people with serious bone problems, osteoporosis, infections, cancer etc.

Osteoporosis?

That’s leaves out most of the populations of Florida, Southern California and Arizona! Watch out all you chiropractors adjusting grandma – Weil does not approve.

It’s amazing that for someone who is supposed to be an expert in integrative health care that Weil doesn’t get the role of chiropractic and a properly functioning nervous system regardless of the presence or absence of disease. I suppose Weil hasn’t fully adopted the inside out approach – can’t sell too many potions on that philosophy I guess.

Finally, Weil points out the reports of rare complications that have been reported from chiropractic and states these are from the “traditional, high pressure, low speed manipulation.”

Low speed?

More evidence of his ignorance about chiropractic methods.

Lastly, when looking for a chiropractor Weil advises choosing one with a degree and one who doesn’t try and lock you into long term treatment or asks you to sign a contract.

Well, I have my own advice for those considering any of Dr. Weil’s treatments, potions, lotions, elixers or assorted wellness plans.

First, if you have health problems or just want to be well and are seeking an alternative, consider actually going to see a doctor or health provider in person as opposed to using one trying to treat you over the internet! Weil has no secret or magic formula for health that other providers don’t possess.

And for every pill, potion, lotion, elixir and wellness plan you consider buying from him – ask him to show you the evidence from peer reviewed, randomized, double blind, clinically controlled trials that it is safe and effective. If he can’t produce it – then take a placebo and save your money.

As always I look forward to your comments, feedback and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

Please Sir, I Want Some More

2009-06-25T11:28:00Z

The evening arrived; the boys took their places. The master, inhis cook's uniform, stationed himself at the copper; his pauperassistants ranged themselves behind him; the gruel was servedout; and a long grace was said over the short commons. The grueldisappeared; the boys whispered each other, and winked at Oliver;while his next neighbours nudged him. Child as he was, he wasdesperate with hunger, and reckless with misery. He rose fromthe table; and advancing to the master, basin and spoon in hand,said: somewhat alarmed at his own temerity:

'Please, sir, I want some more.'

Oliver Twist - Charles Dickens

I received a large number of responses to my last Update where I confronted the delusion being bandied about by some in the profession that we really have a say in the national health plan being chiseled out right now. The majority of the responses were from those agreeing with me and thanking me for stating it.

There were a few however that wondered why it would be so bad to be accepted in a national health plan based on a Medicare pain based model. I’m familiar with this argument. It’s the one we’ve been swallowing hard on for decades and there are all sorts of rationales for it. They span the gamut from foot in the door promises to the old bait and switch – get them in for pain and then educate them about “real” chiropractic. One spine at a time. At that rate the world will end before it changes.

I have to wonder why our profession continues to believe that it must take the crumbs from the table. Where does this pathetic lack of self esteem come from? It’s almost schizophrenic. On the one hand we spout grandiose claims about changing the world through chiropractic and then on the other we beg for any acceptance that anyone is willing to give us – even if it’s on their terms.

While I can possibly understand this coming from the faction of the profession that has repeatedly painted us into the neck and back pain box I simply cannot understand why certain subluxation based organizations go along with it. I have simply not heard a reasonable explanation. For the sake of unity? Give me a break.

The latest example of this is: The Path to Change in the US HealthCare System: The Chiropractic Perspective. A Joint Policy Statement on Healthcare Reform Presented by a United Chiropractic Profession.

We even have a deep seated need to put “unity” in the title. Funny, I haven’t seen a “unity” document from the AMA on a national health plan – if anything the AMA is against it. They know the Medicare reimbursement rate is a dozen years old and aren't scrambling to be paid those rates for everyone. In fact there is a healthy and vigorous debate occurring within medicine on the pros and cons of national health care – not every doctor agrees with the AMA after all. Not so in the chiropractic profession. The leadership has spoken for us: We want in and we want in bad - we don't care what you pay us. I think there are scores of chiropractors lying awake at night praying for the return of the Mercedes 80’s.

And just what does this unified policy statement have to say to the President? To start, here is a breakdown of key words and phrases in the document and how many times they were used:

Now of course you can read the document yourself and determine what it is that our leadership is so eagerly telling the President that we are uniquely qualified and positioned to offer to the sick and suffering citizens of the United States, but the above chart says a lot.

This document pushes the same old line that we can fill the gap in primary care providers by offering a cost effective approach to the sixth most expensive health condition – low back pain. And just to show we’re “unified” we also have this subluxation thing - discussed in two paragraphs of a 28 page document. A document mind you that is purportedly meant to showcase our unique contribution to health care.

As I've said before I don't believe the Obamas are under chiropractic care - including their children. And why would they be? The unified leadership of our profession is telling them that unless they have low back pain they don't need a chiropractor. And for the kids - this document tells the President and First Lady that unless their two girls have colic or ear infections - no need for chiropractic.

Judging by this document we have nothing unique to offer. In fact every single other service focused on in the document is already offered by several other health care providers. This includes manipulation and manual therapy (look how many times those words were used compared to adjustment).

Now I know we like to joke about the level of intelligence in Washington DC but does anyone really believe that these folks are that ignorant? Let’s review this once again. Remember those five pillars of health we educate our patients on:

1.    Proper Nutrition
2.    Proper Sleep
3.    Proper Exercise
4.    Positive Mental Attitude
5.    Properly Functioning Nervous System

We don’t have a patent on 4 of those 5 pillars of health. The only one that’s uniquely ours is a properly functioning nervous system through the adjustment of vertebral subluxation. That is in fact our strategic competitive advantage. Marketing 101.

Now listen, I’m not some rabid hate straight who thinks anyone doing anything else is guilty of sin and doomed to burn in hell for eternity. In fact, I don’t think you can fully correct a subluxation unless you are addressing all of these other aspects. But let’s be real: diet, exercise, vitamins, wellness, prevention and any other intervention or health buzzword you want to throw into the pot is not unique to us.

Wellness is on its way to becoming a trillion dollar industry – with or without chiropractors. This is not about you or me – or even the profession. It is about those who are sick and suffering. They can get “wellness” from a gym rat or from their next door neighbor selling the latest multilevel marketing miracle juice - but they can only get a specific chiropractic adjustment to reduce a subluxation from a chiropractor.

Why aren’t we telling the government and the public that?

As always I look forward to your feedback, comments and suggestions.

Regards,

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor – Journal of Pediatric, Maternal & Family Health – Chiropractic
http://www.chiropracticpediatricresearch.net

Chiropractic, Delusion & National Health Care

2009-06-12T00:14:00Z

Unless you are someplace with no television, internet or newspapers you know that the health reform train is gathering steam. Obama has decided to insert himself directly into the debate and attempt to ensure that there will be a government plan to go along with all the other reforms. From everything I’ve been reading there’s a good chance he’ll get his way.

I have no desire to argue the pros and cons of a government health plan or whether or not real change will happen – at this point the issues are much more pragmatic. For instance - if it’s coming, will chiropractic be included? The leadership in the profession has decided we should be included so if you believe we should just stay completely out of it – you’ve been outvoted.

Further to this, the leadership has decided that we should be included to the fullest extent of our scope of practice as defined by the states. Not sure how a national health plan will navigate that one so it’s probably unrealistic. Of course, there is no mention of subluxation in any of the pronouncements by the national chiropractic leadership – interesting.

If we are included (and there is no guarantee we will be) it will most likely be based on the Medicare model. No exams, no x-rays, no instrumentation, no other diagnostic or analytical procedures. Of course our chiropractic leadership is pushing to expand services based on scope - but let’s be real. The Office of Inspector General has just released a scathing report that much of the chiropractic payouts on Medicare are not medically necessary. Coincidentally, Obama plans on paying for a new national plan with $300-400 million dollars in savings from Medicare cuts. Hmmm.

Considering the OIG report, a dearth of research suggesting positive health outcomes from chiropractic and (as far as I can tell) the fact that Obama and his family are not under lifetime, family wellness chiropractic care – where does this delusion that we’ll even be included, never mind get an expansion of services, come from? Positive mental attitude and all that stuff I suppose.

Experts such as MIT’s Professor of Economics Jonathan Gruber give us a reality check. An article in Time stated:

“For universal coverage to have any meaning, there will have to be a minimum set of guaranteed services. But what does that mean? Does it include preventive care? How about mental-health care? Abortion services? These are the kinds of decisions that will determine how expensive health-care reform will be for consumers, business and government. And what goes into the basic benefits package is a political minefield — which is why many health-care experts say they don't want it left in the hands of Congress and lobbyists. ‘If you start fighting over whether chiropractors should be in the benefits package, this bill is dead.’ Stated MIT’s Gruber.”

If we have any luck we’ll end up included with 12 visits for subluxation as long as there is an associated neuromusculoskeletal disorder – just like Medicare. And what do you want to bet that one of the chiropractic managed care companies currently strangling the profession to death right now somehow weasles its way into administering the chiropractic benefit?

You see it’s the old saying about success. Success is defined as “Preparedness Meets Opportunity.” So here is an opportunity but once more the profession is not prepared. Had we not squandered our resources during the Mercedes 80’s and put some of that cash into health outcomes research beyond NMS disorders we might be in a different place. Had we not wasted $8 million on suing the federal government to “Save Our Subluxation” and instead went back to congress and asked them to clarify their intent regarding chiropractic in Medicare and who really owns subluxation we might be in a different position. Had we pushed for the ability to opt out of Medicare when there was an opportunity to do so – we might be in a different position. No one is opting out now – that’s for sure. Oh – but maybe some football player, some D list celebrity, or some unknown MD’s testimonial will convince the government to entrust 16% of the GDP on chiropractic. The delusion continues.

Of course you have heard Obama’s mantra about reducing costs and improving outcomes. The theme is everywhere. There was a time when it was just us chiropractors that went around ranting and raving about errors in medicine, quality, prevention etc. It gave us plenty of material for our Wednesday night lay lectures. Now, the average middle class worker can tell you a thing or two about health care quality and economics. We’ve lost our voice on this because we didn’t lead. We didn’t produce the data to substantiate the 100 + years of rah-rah-sis-boom-bah anecdotes about the miracles of chiropractic. We have failed in our stewardship of this great profession and the mission it was given. We complained for decades that they had no evidence to support what they do and never tended to our own garden.

So do we just give up? Of course not. But half-ass attempts at turning this ship around and deluding ourselves into thinking we are actually part of the conversation won't do. The goal line is not this national health care debate - this isn't even first down. The goal line is 10-15 years from now when the wheels will be coming off the wagon. It will take an organized and concerted effort from the entire profession to get us on the right track and collect the massive amounts of data needed to turn the tide. Will we be ready then?

Or we could just pray that they’ll pay us for muscle stim and heat.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH matthewmccoy@comcast.net
Editor
Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

Autonomy, Consent & Medical Paternalism

2009-05-23T21:52:00Z

As I write this a mother and her young son are on the run – fugitives from the law. There is a nationwide manhunt focused on their capture. Federal, state and local law enforcement officials are tracking their moves, local and national news media are alerting all citizens to be on the lookout.

Just what crime has been committed by this mother and son team? Was it a bank robbery? Drug trafficking? Murder? Are they Al Queda?

None of the above – these fugitives from justice are the latest victims of medical paternalism. They are the latest in a long line and ever growing segment of our population who have had their most basic of civil liberties taken from them. Their personal autonomy in regards to what gets done to, taken from, or put into their body has been stripped by the legal system.

You see, little Daniel Hauser has Hodgkins lymphoma and his mother and father weren’t too keen on the standard medical treatment and after beginning chemotherapy decided they wanted to try something else. Brown County District Judge John Rodenberg didn't agree and ruled last week that Daniel's parents were medically neglecting him and ordered him to be evaluated by a medical physician. Colleen Hauser and her son Daniel then fled following tests that allegedly show his tumor to have grown. Rodenberg issued an arrest warrant Tuesday for Colleen Hauser, ruled her in contempt of court and also ordered that Daniel be placed in foster care and immediately evaluated by a cancer specialist for treatment.

The attorney representing Brown County Family Services James Olsen stated "We're trying to do what's right for this young man" and Daniel’s family doctor testified that he had tried to make appointments for oncologists but the family refused. Judge Rodenberg ruled that if Daniel’s outlook was good he would order chemotherapy and radiation. According to Daniel's father they just wanted to use complementary treatments in addition to the chemo and did not want to use as much chemo as the doctors ordered.

Don’t get me wrong – I don’t for a second believe there are any easy answers to this tragic twist of fate. But that’s just it isn’t it? The judge, the family doctor, the oncologists – even Sanjay Gupta, believe there is an easy answer. You see the “experts” tell us that treatment for Hodgkins lymphoma has a 90% cure rate.

But it isn’t that simple and it isn’t that simple for more reasons than one. Since the experts are quoting cure rates let's start with the concept of evidence based medicine. What repeatedly gets lost when this term is thrown around is that the evidence is only one piece of the puzzle. As Haynes et al state: “Evidence does not make the decision, people do.”

The other equally important pieces of the puzzle include:

• Patient preferences
• Clinical state and circumstance of the patient
• Clinical expertise of the care provider

From: Haynes, B. et al. BMJ 1998;317:273-276

What does this mean? It means that for a patient to decide (notice we run into a problem right there because it’s the patient who decides, no one else) what course they want to pursue to address their health concern they should first look to the evidence with their care providers.

Principally, the question has to be answered whether or not the evidence applies to this particular patient. To do that one needs to look at the studies and determine if the studies showing a 90% cure, for example, apply to this particular patient.

Questions such as:

Were the study subjects of the same age, sex, weight, stage of cancer, type of cancer etc?
What co-morbid conditions existed in the study sample?
How large were the studies?
Did any subjects in the studies experience a worsening of their condition as a result of the treatment and what were the characteristics of those subjects?
Are we talking about one study or a whole host of studies that have repeatedly found the same results?

What about long term follow-up of those children who undergo the standard medical treatment for this? What sorts of problems do they end up with and who gets to decide whether those adverse effects are worth it? Does Daniel? His mother? The judge? Sanjay Gupta?

And what of those who don’t go the traditional medical route – do we have any data on them? If so, what does that data tell us?

Once these and many other questions are answered then we can begin to determine whether or not those studies and that evidence apply to our patient sitting right here in front of us. This is the step of applying the evidence to the clinical state and circumstance of the patient.

In addition to looking at the evidence one needs to look at the desires of the patient. What does the patient want to do? What about cultural issues and beliefs about disease causation and treatment? So entrenched is the pathophysiological model of disease and its resultant combatant treatment strategies in American culture that no one is even discussing this in the case of Daniel.

And the tragedy doesn’t end there. What’s going to happen if and when they catch these fugitives from justice? Daniel has stated he will resist any attempts to have chemotherapy and/or radiation forced upon him. In one interview I heard the doctor being interviewed slyly state that “they have ways around that.” I was mortified. Imagine you have just been diagnosed with the dread disease and in addition to having to deal with that you have to deal with barbaric attempts to subdue you so you will take your medicine. What sort of healing can take place under that type of psychic torture?

And what of the care providers who will administer the treatment against Daniel’s will and the will of his mother? What sort of consent issues arise? And what if it doesn’t work? Will the mother be blamed because the experts will then say had he undergone the chemotherapy sooner he would have lived? A mother was just convicted this week in the death of her child from diabetes because she did not allow the child to have conventional medical care. Is this any different?

In all of the interviews, all of the stories, with all of the talking heads and medical experts and even Anderson Cooper – I’ve not heard one person ask whether anyone sat down with these parents and asked them what they wanted to do or what Daniel wanted to do?

Daniel did have at least one round of chemotherapy which apparently had some ill effects that led to the family questioning whether or not to move forward with it. Did anyone sit down with them and discuss options? Options on the regimen? Options on the complementary care? Surely there had to be other options besides becoming fugitives. How caring must those encounters have been that this was the option a mother and her son chose.

I keep hearing that all these people are really just looking out for Daniel’s best interests. Well guess what folks – Daniel and his mother aren’t convinced that you really are. So who really failed here? Perhaps Anderson Cooper and Sanjay Gupta could explore that?

As I said, I don’t have the answer, and I don’t believe anyone else does either. In fact anyone who does display the arrogance of saying they know exactly what to do in this situation should scare the hell out of all of us.

For more information on Autonomy, Consent and Medical Paternalism please see a detailed review I did that was published on this topic:

McCoy M. Autonomy, Consent and Medical Paternalism: Legal Issues in Medical Intervention. The Journal of Alternative and Complementary Medicine. July 2008, 14(6): 785-792. doi:10.1089/acm.2007.0803.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

Spring 2009 Issue Just Released!

2009-05-20T21:07:00Z

We launched the Journal of Pediatric, Maternal & Family Health – Chiropractic at the beginning of the year with the first article of the inaugural issue. We are proud to report that the Winter 2009 Issue is completed and we have begun publication of the Spring 2009 Issue and have a number of very exciting papers to release. The first is a wonderful clinical study by Dr. Erin Elster reporting on results in 16 infants who had colic and acid reflux. This is a fantastic study and should be read by all chiropractors and then shared with their patients and community.

I want to take a moment to thank all of you that have subscribed to the journal and/or submitted papers in response to the Call for Papers. As I wrote in the inaugural issue we are at a critical time in the profession and even more so when it comes to the issues surrounding pediatric chiropractic care. Just since we started publication this year the care of children by chiropractors has been attacked in the media and in the research world. The need for research on chiropractic pediatrics and pregnancy cannot be overstated.

If you have not already subscribed please do so today and please don’t stop there – forward this Update to a close friend and colleague and encourage them to subscribe. Your subscription helps defray the costs of providing a home for those in our profession who choose to take the bold step and engage in research for the betterment of the profession.

In addition to subscribing I encourage you to take the next step and engage in the process of research. The easiest way for a practitioner to do this is through the writing of a case study and we have some resources to help you do that. Take one of the miracles from your office and turn it into a case study research paper that the whole world can read and share.

Beyond that please utilize us as a resource - use the research published in the journal to educate your patients and community. Distribute press releases in your community about each paper as its published - check out our press room for copies of press releases you can simply tweak and use in your community. Use the information we provide in the Research Updates and Health News Updates in your patient newsletters. Send your patients to the site so they can see that there is research and information that supports your style of chiropractic. There all all sorts of ways to use the information we are providing to you - take advantage of it.

Again, I want to thank you for supporting our efforts and I look forward to your feedback, comments and suggestions.

Regards,
Matthew McCoy, DC, MPH
Editor – Journal of Pediatric, Maternal & Family Health – Chiropractic
matthewmccoy@comast.net
http://www.chiropracticpediatricresearch.net