Author Archives Mark Croucher

Susan’s story

Posted by Mark Croucher
on January 30, 2017
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This is the story of my patient Susan.  She is a college professor who developed severe neck and arm pain with numbness and weakness into her arm. MRI scans showed a large bulging (herniated) disc in her neck and Susan was referred to the neurosurgeon.

The surgeon explained that he would remove the disc, fuse the vertebra and screw in a metal plate to stabilize her neck.  Susan was afraid to undergo the surgery, so instead her neurosurgeon referred her to our office to see if we could solve the problem.

When Susan and I first spoke she explained that she was desperate.  She said she was “a mess, both physically and emotionally”.  She was also terrified that I was going to “crack” her neck.  I explained that with our approach, that was not necessary.  The fact is many chiropractors use low force techniques and will work hard to apply treatments that are not only effective but very comfortable.  We work with these injuries every day.

I examined Susan, reviewed her MRI findings and we moved forward with a treatment plan to help her.

The Result

Susan began to feel improvement with every treatment.  After two weeks, she experienced 40% improvement. After eight weeks, 90% improvement and nearly complete use of her left arm.

Of her experience, Susan says: “I have never had a Doctor as careful about listening to me and explaining the diagnosis and how to treat it, as Dr. Croucher.  He did not sugar-coat anything.  He was conservative in his outlook and delivered incremental, perceivable results.”

At The Spine Center of Williamsburg, our doctors of chiropractic have over 20 years’ experience in dealing with chronic spinal pain, spinal stenosis, disc herniation and painfully degenerative spinal disorders.

If you have a painful spinal issue and would like to see if modern chiropractic can help, call The Spine Center of Williamsburg today.

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You can’t outrun a bad diet!

Posted by Mark Croucher
on January 29, 2017
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 You can’t outrun a bad diet!

There is a bundle of evidence that traditional hunter-gatherers, who are substantially more physically active, burn the same number of daily calories as moderately active Americans.  The average numbers state that men need around 2600 calories per day.  Women need about 1900. Sedentary people obviously need fewer calories each day.  That means if you sit for a living, you might need to put the fork down.

We know that exercise in itself has numerous benefits.  I’m a HUGE proponent of daily exercise!  It helps us to age more gracefully encouraging better moving joints, less inflammation, better heart function and even better immunity.   Huge benefits to be sure.   But looking to exercise as the only way to lose weight might be a road to frustration.  Many of you may have noticed this.   “But doctor, I go to the gym 5 days a week and I weigh exactly the same as I did 6 months ago!”

You might be looking at this the wrong way.  Try thinking of exercise as a way to make you stronger, more flexible and more fit.  Lifting weights can make your muscles grow, making you stronger and that can potentially increase your caloric need.  That can potentially allow you to eat more.  Routine cardio training can increase your heart and lung capacity dramatically.  A good thing for sure!   But what about the food??

Think of your eating habits as a road to a better birthday suit.  If you need to lose weight and you can’t, you might try to figure out how many calories you actually consume in a day and try dropping it down a few hundred calories. Next you could consider the timing and makeup of your food.  For example, consuming a lot of carbohydrate dense food 15 – 30 minutes prior to vigorous exercise can motivate your body to take all that increase in blood sugar and push it into your muscles.  GREAT!!  If however, you consume the same meal prior to staring at the computer for 3 hours you body will likely store that stuff as fat.  Not so great.

When energy needs are lower, like sleeping, watching TV or reading, you don’t need an increase in blood sugar.  So keep the carbs lower then.  During those times, try focusing on fewer calories made of good fats and proteins. Leave the carbohydrate rich foods for times when you need them.  Food is fuel.  Eat for what you are about to do.

 

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stroke and physical activity

Posted by Mark Croucher
on January 11, 2017
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October 2014 427The Importance of Physical Activity in Preventing Recurrent Stroke

When a patient suffers a stroke, their life changes forever.  Drug therapy is typically noted as the number one tool in the fight against having another stroke.  A recent study is underway lead by Dr. S. Chaturvedi, a professor of Clinical Neurology at the University of Miami.  In a recent summary, he points out the importance of exercise in patient recovery and survival.

Exercise is associated with many potential benefits, including lower BP, decreased arterial stiffness, increased high-density lipoprotein levels, decreased insulin resistance, and augmented collateral circulation. This analysis reminds clinicians that increased physical activity is an important “prescription” in the fight against recurrent vascular events. Community or hospital-based exercise programs should be strongly considered for optimal stroke prevention.

He points out that a recent 3 year follow up showed that physical activity was noted as the most important factor in lowering the risk for recurrent stroke.

Doctors need to take the “prescription” of exercise much more seriously.  Patients also need to understand the vital importance of increasing their physical activity.

Seemant Chaturvedi, MD, is Professor of Clinical Neurology at the University of Miami Miller School of Medicine. He is also Vice Chair for Veterans Affairs Programs within the Department of Neurology. Dr. Chaturvedi completed his neurology residency at the University of Massachusetts Medical Center and a stroke fellowship at the University of Western Ontario.

Dr. Chaturvedi has coedited two books, Transient Ischemic Attacks (2004) and Carotid Artery Stenosis (2005). He has been involved with several guideline writing committees for the American Academy of Neurology and American Stroke Association and is on the steering committee of several clinical trials.

This information is taken directly from a recent post in NEJM Journal Watch Neurology from the New England Journal of Medicine.

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Sitting to death

Posted by Mark Croucher
on December 14, 2016
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spine-center-postureAre you sitting to death?

A recent systematic review in LANCET showed that high levels of moderate exercise can reduce the risk of increased DEATH that is associated with lots of daily sitting.  Study on more than 1 million men and women.  They found that about 60-75 min per day of exercise seemed to be enough.  However, this does not eliminate the increased risk associated with high TV-viewing time.

We all know the benefits of physical activity.

Less pain

More energy

Less fat

And…it will probably reduce your chances of dropping dead.

What are you waiting for? Get up and get moving!!

Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women.
Ekelund U, et al. Lancet. 2016.
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Parkinson’s research

Posted by Mark Croucher
on December 14, 2016
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Parkinson’s research

Considerable evidence has been mounting supporting a relationship between the gastrointestinal system and Parkinson’s disease. Many pathologists and neurologists believe that Parkinson’s disease may start in the gut, however this view remains speculative.

The discovery that a bug in the gut called H. Pylori could underpin gastrointestinal disease and also lead to ulcer formation was one of the most important observations in modern GI medicine.

The most recent study on gut bacteria and Parkinson’s was published by a Finnish group led by Dr. Scheperjans. The authors of this study point out that the “intestinal microbiota interact with the autonomic and central nervous system via diverse pathways and that these areas are susceptible to Parkinson’s pathology”.

Nielsen and colleagues in 2012 examined H. Pylori infection, and the risk of Parkinson’s disease in a study published in the European Journal of Neurology. There were 4484 Danish patients included and they were drawn from the Danish Civil Registration System. The use of H. Pylori eradicating drugs was associated with a 45% increased risk of developing Parkinson’s disease. Similarly, the use of proton pump inhibitors was also associated with a 23% increased risk for the development of Parkinson’s disease. The authors speculated that chronic H. Pylori infections and also gastritis could possibly be related to the risk of developing Parkinson’s disease, though there were many methodological issues limiting the overall study interpretation.

  • The decision to treat H. Pylori should be made in consultation with both the GI specialist and the neurologist, especially since the infection commonly occurs in 2/3 of the population, and the GI specialist may in some cases need to perform follow-up testing (e.g. a scope to visualize the stomach and intestines).

All information taken from: http://www.parkinson.org

 

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Does gluten make you fat?

Posted by Mark Croucher
on October 31, 2016
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The average American consumes about 132 pounds of wheat per year.  Gluten is the main protein in wheat and in most of the grains Americans eat.  The problem is, our bodies do not have the proper enzymes to completely break down the gluten protein.  That can potentially lead to problems.  In some people this can lead wheat allergy, celiac disease, and non-celiac gluten sensitivity.  People complain of stomach pain, bloating and gas.  Others feel that the gluten makes them experience pain and fatigue.

Observational studies have shown that whole grain diets seem to improve people’s health.  These studies are largely observational surveys instead of experiments.

Modern wheat has been crossbred dramatically to improve bread making, to help with higher yields and to prevent plant disease.  Modern wheat is therefore very different from the ancient forms of wheat. These genetic differences may make ancient wheat safer to consume than modern wheat.

Avoiding gluten has become a billion dollar industry.  It has been recommended for a number of chronic conditions and also for weight loss.  With that said, there really isn’t a lot of evidence that avoiding gluten can lead to weight loss.  A 2013 study on mice showed that when mice were fed the equivalent of 20 slices of whole wheat bread daily, it increased fat gain.  This also had negative affects on insulin sensitivity, energy and lead to higher levels of inflammation.  This evidence may play out differently when studied in humans.

One could argue that a diet without wheat and other gluten containing grains could be beneficial.  Certainly future human studies will help clear this up.

 

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Fat Burning Supplements

Posted by Mark Croucher
on October 13, 2016
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xanthatrim

Fat Burning Supplements

Most Americans want to lose weight.  They try all sorts of supplements to drop the pounds.  Many are just stimulants. They can cause sleep problems, anxiety, and heart palpitations.  Even the most effective don’t help much.

Supplement companies spend millions on marketing this stuff to us with no real evidence that what they are selling works, or if these potions are safe.

Pro bodybuilders and movie stars use drugs to get lean.  These drugs include thyroid medications, testosterone, estrogen blockers, amphetamines, and diuretics.  Not good.

Keep it simple!  Eating more calories than you need per day will end up making you fat.  Lack of exercise will most likely make you fat and certainly will make you unhealthy. Eating artificial food, junk food and diet food is usually and endless cycle of obesity.  The best advice I can give people is STOP DIETING, START EXERCISING and EAT A PROPER DIET.

  1. Increase your daily exercise.  Notice I said daily.  Lift weights, walk a lot more, or ride a bike (or all of the above).  More lean muscle usually equals less fat.  Figure out what you can do and get moving!  Make sure you get appropriate nutrition before and after you exercise.
  2. Reduce your calories (a little) but DON’T starve yourself.  It will backfire.  Start with a professional body fat analysis and BMI report.  Many gyms offer this and maybe even your doctor.  That will tell you how many calories you need per day in order to lose weight.
  3. Eat mostly plant and animal products. (Stop buying junk)
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New thoughts on cholesterol

Posted by Mark Croucher
on June 21, 2016
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Interesting study questioning the relationship of LDL cholesterol and cardiovascular disease.

  • A recent study in BMJ medical journal found that high LDL-Cholesteral may be consistent with living longer in most people over 60 years.  This finding is opposite of the cholesterol hypothesis (ie, that cholesterol, particularly LDL-C, causes clogged arteries and early death). It seems that elderly people with high LDL-C live as long or longer than those with low LDL-C.  This analysis provides reason to question the validity of the cholesterol hypothesis. This study provides the rationale for a re-evaluation of guidelines recommending drugs to reduce LDL-C in the elderly as a component of heart disease prevention strategies.

Strengths and limitations of this study ▪ This is the first systematic review of cohort studies where low-density lipoprotein cholesterol (LDL-C) has been analysed as a risk factor for all-cause and/or cardiovascular mortality in elderly people. ▪ Lack of an association or an inverse association between LDL-C and mortality was present in all studies. ▪ We may not have included studies where an evaluation of LDL-C as a risk factor for mortality was performed but where it was not mentioned in the title or in the abstract. ▪ We may have overlooked relevant studies because we have only searched PubMed. ▪ Minor errors may be present because some of the authors may not have adjusted LDL-C by appropriate risk factors. ▪ Some of the participants with high LDL-C may have started statin treatment during the observation period and, in this way, may have added a longer life to the group with high LDL-C and some of them may have started with a diet able to influence the risk of mortality. ▪ We may have overlooked a small number of relevant studies because we only searched papers in English.

http://bmjopen.bmj.com/content/6/6/e010401.full.pdf

 

 

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Low CARB

Posted by Mark Croucher
on April 21, 2016
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lchf_food“CONCLUSION:
Our findings suggest that a low-carbohydrate diet is effective in lowering the HbA1c and triglyceride levels in patients with type 2 diabetes who are unable to adhere to a calorie-restricted diet.”

Although caloric restriction is a widely used intervention to reduce body weight and insulin resistance, many patients are unable to comply with such dietary therapy for long periods. The clinical effectiveness of low-carbohydrate diets was recently described in a position statement of Diabetes UK and a scientific review conducted by the American Diabetes Association. However, randomized trials of dietary interventions in Japanese patients with type 2 diabetes are scarce. Therefore, the aim of this study was to examine the effects of a non-calorie-restricted, low-carbohydrate diet in Japanese patients unable to adhere to a calorie-restricted diet.

Intern Med. 2014;53(1):13-9.  A non-calorie-restricted low-carbohydrate diet is effective as an alternative therapy for patients with type 2 diabetes.

The normal range for the HbA1c – (hemoglobin A1c) test is between 4% and 5.6%. If your hemoglobin A1c levels are between 5.7% and 6.4% you are at risk of diabetes, and levels of 6.5% or higher indicate diabetes.

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Chiropractic care for older patients with chronic lower back pain

Posted by Mark Croucher
on April 18, 2016
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IMG_3750Chiropractic care for older patients with chronic lower back pain seems to offer cheaper and faster pain relief.

A recent study (February 2016) in the Journal of Manipulative and Physiological Therapeutics examined older patients with multiple health problems who used chiropractic care during their chronic lower back pain episodes.  They found that these patients had lower overall costs of care, shorter episodes, and lower cost of care per day than patients in the other treatment groups.

Costs were even lower for patients who used a combination of chiropractic care and conventional medical care when compared to those patients who did not use any chiropractic care.

 

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