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Thursday, 29 November 2012

Movember #4: My Appointment

Sorry for the delay in writing this post.  I've had some trouble getting an appointment with my Family Doctor that fits in with my schedule.

The anticipation of what may be ahead of me wasn't the best.  I mean, who wants a prostate exam?  When I entered the room and explained the purpose of my visit, my Doctor asked if I had any symptoms.  Since I did not have symptoms, and I am only 29, she ordered a PSA but did not do a digital prostate exam.  She explained that unless one has symptoms, only those over 50 require regular prostate exams.  My initial thought was "But....I told everyone on my blog I would get one!".  But, after thinking about it, I decided it would be a bit awkward to insist on an exam against the advice of my Doctor. The good news is, my PSA levels are fine.

I hope you've found these blog posts helpful.  If you ever have any questions or concerns about your prostate, please consult your Medical Doctor.

Dr. Jeff Marshall, BScKin, DC
Back Home Chiropractic
Bidgood's Plaza
Goulds, NL

Monday, 12 November 2012

Movember #3

One of the most common questions I get regarding prostate cancer is who/when to get tested.  People who absolutely need to talk to their doctor are men who:

- Will soon be 50 years old
- Are over 50 years old and have not yet talked to their Doctor about prostate cancer
- May be at higher risk due to a family history of prostate cancer
- have symptoms of prostate cancer (See Movember #2)

The two main tests for prostate cancer are the PSA test, and a Digital Rectal Exam.

PSA Test

PSA, or Prostate Specific Antigen, is a marker in the blood that is tested to see if there is a problem with the prostate.  It is important to remember that PSA is not specific to prostate cancer, but indicates that there may be a problem that needs further investigation.  "Normal" PSA levels increase as we age.  If your PSA levels are above normal for your age, your Doctor may order additional testing. 
Like everything, there are pros and cons to PSA testing.  Here are some of them, but again, it is important to talk to your Doctor
Pro's of PSA:
- put your mind at ease
- tell you if you need further testing
- detect cancer early (before symptoms)
- detect before it speads, therefore when it is easier to treat

Con's of PSA:
- can not tell you how serious the cancer is.  More testing will be required
- not 100%.  It may give you a false negative or a false positive.  Your doctor will take the results in context of your personal situation to make the decision to test further or not.

Digital Rectal Exam

- Since your prostate pushes up against your rectum, your doctor can feel for it's shape, firmness, contour, etc.  This exam is very quick and not nearly as uncomfortable as you may think.

When used together, a PSA and DRE is the best way to detect problems early.  When detected early Prostate cancer is very treatable. 

Just to hammer home the importance of regular testing, lets take a look at the 5-year survival rates.  If detected early, and a point where there is no spead from the prostate the 5- year survival rate is nearly 100%.  If the cancer is regional, that is only in the area of the prostate, the 5-year survival rate is still nearly 100%.  If the cancer has spread to distant areas, the 5-year survival rate drops to 29%. 

I have my appointment booked with my Doctor tomorrow.  To be honest, i'm not looking forward to it.  But, early detection is everything and I'm sure it won't be the highlight of her day either!

Dr. Jeff Marshall, BScKin, DC
Back Home Chiropractic
Goulds, NL

Tuesday, 6 November 2012

Movember 2: What is a Prostate and What Are Symptoms of Enlargement?

What Is the Purpose of the Prostate? thumbnail
Weighing about1 oz., the prostate is roughly the size of a large walnut. It is located just below the bladder and pushes up against the front of the rectum.
The prostate produces "seminal fluid" which protects and nourishes sperm as they travel to the Uterus.  This fluid, which makes up about 20-30% of ejaculate, is basic, which protects sperm from the acidic environment in a woman's vaginal area leading to the uterus.

The prostate is partially made up of muscle. So when it contracts as sperm is being released, it cuts off the urethra, preventing  sperm from coming in contact with urine.

It is very important to be aware of the symptoms of prostate enlargement.  However, keep in mind that most prostate enlargement is NOT cancer and is classified as BPH or Benign Prostatic Hyperplasia. That being said, always follow up with your Doctor if you notice any of these symptoms
- Frequent urination, especially at night
-  Intense need to urinate, or urgency
- Difficulty starting/stopping flow of urine
- Weak, decreased, or interrupted flow
- Burning, painful urination
- Blood in urine or semen
- Painful ejaculation

Now we know what a prostate is, what it does, and what symptoms to look for are.  Tomorrow I will post a short note about what the tests are, who should get them, and when.

As always, if you have any questions please feel free to ask

Dr. Jeff Marshall, BScKin, DC
Back Home Chiropracic
Goulds, NL

Monday, 5 November 2012

Movember Series: Part 1

It's that time of year again.  November is upon us and Men around the world are growing mustaches to raise money and awareness for Prostate Cancer.  Since my mustache growing abilities are sub-par to say the least, I've decided to write a series of blog posts about Prostate Cancer culminating in a final post where I speak of my experience in getting a PSA blood test and digital rectal exam.

First of all, it's important to know the risk factors for Prostate Cancer.  There are modifiable and non-modifiable risk factors.  Unfortunately, we can't choose our parents or age. 

As men get older, your chance of developing Prostate Cancer.  In fact, at age 50 years there is a 30% incidence or Prostate Cancer, 35% at 60 years, and 40% at 70 years.  So clearly, getting regularly tested gets more crucial as we age.  The Canadian Cancer Society recommends getting screened yearly after the age of 50.  But, knowing the incidence rate at age 50 stated above, it's important to be aware of symptoms to watch for before the age where regular testing should start (I will review these symptoms in tomorrow's blog).  Like many chronic diseases, heredity plays a factor.  If a family member has been diagnosed with Prostate Cancer, you are in a higher risk group.

Lucky for us, there are modifiable risk-factors as well.  In other words, there are things we can do to prevent Prostate Cancer (and other cancers as well).  Eating a balanced diet with lots of fruits and vegetables while staying active will reduce your risk for many problems, including Prostate Cancer.

Now that we've covered the risk factors, tomorrow I will write about things like: what is a Prostate?  What does it do?  What are the symptoms of Prostate Enlargement/Cancer?  I hope you find this series helpful, and if you have any further questions or concerns please contact me.

Dr. Jeff Marshall BScKin, DC
Back Home Chiropractic
Goulds, NL


Thursday, 21 June 2012

How to Prevent Blood Clots While Flying

This is the time of year when alot of people are travelling.  If your summer vacation involves a long plane ride, you need to take measures to reduce your risk of a blood clot.  These clots that can develop in the veins of your lower legs, can possibly dislodge and travel to your lungs or brain. 
Studies have shown that 1-4500 airplane passengers will develop a clot.  This stat is nothing to be alarmed about, but some people are at more risk than others.

Who is at Risk?

As I said above, the overall risk of developing a clot on a plane is 1 in 4500.  However, women who are taking birth control pills or hormone replacement and are severely overweight have a 30 fold increased risk.  Women who are pregnant are also at an increased risk of developing a clot. 

People who fly often are also at an increased risk, with approximately a threefold increase

Generally, people who are obese and/or smoke are also at an increased risk of developing these clots.
If you are at increased risk, you should consult a professional about using compression stockings.  These stockings promote blood flow and prevent the pooling of blood in your legs that can lead to a clot.

However, for an average healthy person, simply moving around during the flight and pointing your toes a few times an hour will go a long way to help prevent a clot.

Even those not at increased risk of a clot can benefit from wearing compression stockings.  Improving blood flow to your lower legs will prevent swelling and that tired feeling in your lower legs when you get off the plane, leaving you ready to start enjoying your trip right away.

If you have any questions about compression stockings, or anything else, please contact Back Home Chiropractic at 747-0844

Dr. Jeff Marshall, BScKin, DC

Tuesday, 10 April 2012

Posture, Vibration, and Back Pain in Truck/Heavy Equipment Operators

               Equipment Operators and Truck Drivers are an essential part of any construction team.   Even though these people tend to spend much more time sitting down, they often are the ones who present to my office with Low Back Pain.  Not only does sitting for extended periods lead to Low Back Pain, as in Office Workers, Operators and Drivers also experience constant vibration.  This vibration combined with prolonged sitting is what makes operating heavy machinery worse than sitting at a desk.

                First of all, maintaining good sitting posture will help prevent Low Back Pain associated with this type of work.  Having an adjustable seat with suspension to minimize vibration, and properly placed controls is important.  However, these things are both out of the control of the worker and often not cost effective to change.

Here are a couple quick and inexpensive tips to help improve your posture.

1.)    Add Lumbar Support

Posture supports can be purchased at most Pharmacies and Big Box Stores.  Ideally, the Low Back support should be adjustable to accommodate different body types and preferences

2.)    Use a Seat Cover

The seats in Construction Equipment are commonly made of non-breathable materials such as synthetic leather.  The problem with using this type of material is that they allow you to slip forward, which promotes poor posture.  A breathable, non-slip material will prevent this and make it easier to keep your low back against your back rest. 

3.)    Reach with your arm, don’t lean.

While concentrating at the task at hand, it is easy to start leaning over towards the levers or gear shift so they are closer.  Leaning to one side for extended periods, especially when combined with vibration, can be damaging to your spine.  Sit up straight so that the centre of your chest is directly above the centre of your seat. 

                As mentioned above, vibration adds a unique problem for equipment operators.  A certain amount of vibration is unavoidable; however there are a few things than can be done to minimize it.

1.)    Regular Maintenance

Equipment maintenance and driving surface conditions can contribute to the amount of vibration experienced by the driver.  Ensure equipment is well maintained and haul roads are also maintained.  Also, particularly rough areas should have signage so that drivers can adjust their speed. 

2.)    Operator Behaviour

Techniques such as reducing driving speed and taking rest pauses throughout the day can minimize vibration exposure.  A recent document published by the Alberta Government in 2008 suggests rest breaks of 10-15 minutes per 2 hours of exposure

These strategies can help to prevent injury.  If you already have Low Back Pain, you should consult a licensed Chiropractor for treatment and advice. 

Dr. Jeff Marshall, BScKin, DC

Back Home Chiropractic, Goulds, NL

Wednesday, 29 February 2012

NL Construction Article (2)

The following article will appear in the March issue of the NL Construction Magazine

In all stages of construction, there is a need to do overhead work.   People with shoulder problems know that when you have pain, the first thing you hear from your Health Care Professional is to limit overhead activity.  But, no matter what the job is, there is always a need to work overhead.
 The most common shoulder problem I see among overhead workers, such as those in the construction industry, is Subacromial Impingement.  This basically means that a Rotator Cuff muscle is getting pinched under a piece of bone.  The pain associated with this is usually felt near the side of your shoulder and can sometimes travel down your arm.
                In order to prevent this type of Impingement Syndrome, you can look like building a house.  The house is only as strong as its foundation.  Similarly, in order to have a healthy shoulder, you need a stable and well positioned shoulder blade.  Your entire arm only attaches to your body by that little joint between your collar bone and breast bone.  This joint is not very strong, so you need the proper coordination of 18 different muscles.  If these muscles are not in proper balance, the shoulder blade can rest in the wrong position.  I usually explain why this is a problem to patients by comparing it to closing a door.  If you push a door closed by pushing the knob, it’s easy.  If you push near the hinges, you still get it closed but you need to work much harder.  The same happens in your shoulder if it is sitting in the wrong position.  Over a period of time, pain is the result. 
If you already experience shoulder pain, it is important to have the issue looked at by a licensed Chiropractor.  Even occasional pain can be a sign of a worsening problem that needs to be addressed. 
Here are a couple quick stretches/exercises that will help prevent this type of imbalance in an overhead worker.
Trap Stretch
                Sit up straight and sit on one arm, or grab the bottom of your chair.  Gently move your neck to the opposite side and down, as if you are looking at the knee opposite to the hand you are sitting on.  Hold this position for 20-30 seconds then relax.   Repeat for the opposite side

Chest Stretch
                Stand next to a wall and place for your forearm against the wall, with your elbow above your shoulder.  Step forward slightly until you feel a comfortable stretch.  Hold this position for 20-30 seconds then relax.  Repeat for the opposite side.

Wall Angel
                Stand with your back against the wall with both elbows bent to 90 degrees and raised to be level with your shoulders.  While concentrating on keeping your shoulder blades held down and back, slowly raise your arms about 6-10 inches then slowly lower to the starting point.  While doing this, try to keep your hands and wrists as close to the wall as you can.  Repeat 10-12 times, then relax. 

Dr. Jeff Marshall, BScKin, DC, CSCS
Back Home Chiropractic

Thursday, 16 February 2012

NL Construction Magazine Article

The following article appeared in the January issue of the NL Construction Magazine:

Low back pain (LBP) is a very common problem on the construction site.  In fact, about 80% of people will experience at least one episode of LBP in their lifetime.  Not only does LBP affect our ability to play with our kids and to do things around the house after work, but LBP is one of the most common reasons for lost time at work.  In the US, over $100 billion is spent both directly and indirectly due to Low Back Pain each year.  This is a huge number but we all know that WHSCC costs, loss of skilled workers, finding replacement labour, and direct medical costs can add up fast.  Not to mention the personal cost to the one who is injured.  For these reasons, it is important that the prevention of these types of injuries is in focus; not only for employers and Health and Safety personnel, but with each individual worker.
When treating Low Back Pain, I always recommend exercises for the spine.  For patients who have strenuous jobs like those in the construction industry, this comes as a surprise.  They all have very strong backs, and are used to lifting heavy loads.  However in the large amount of research done on low back pain, poor endurance has been shown to lead to more LBP than poor strength.  The reason for this is the large muscles responsible for lifting things are separate than those small muscles that hold the back stable and your spine in line as you go about your day.  If these small muscles become fatigued, you will be more at risk of an injury because your spine will not be properly braced to do the work it needs to.       
To increase the endurance of the spinal stabilizers, it is best to train them by holding a neutral spine for increasing periods of time.  Here are a couple great, and simple, exercises for training your spinal stabilizers
Front Plank

Get down on the floor, face down.  Come up on your toes and forearms, like in the picture below.  Keep your stomach pulled in, stomach muscles tight, and breathe normally.  Hold this position until you start shaking a lot, or you feel like you are unable to keep your hips on a straight line from your head to your feet. Hold this position for 30 seconds for three sets.
            Side Plank

Laying on your side and resting on your forearm, lift your hips up so that only your forearm and your lower leg touches the ground.  Keep your stomach pulled in, stomach muscles tight, and breathe normally.  Imagine a straight line going from your nose to your belly button, that is how high your hips should be.  Hold this position until you start shaking a lot or you are unable to hold your hips up any longer.  Once you can hold this for three sets of 30 seconds, progress a full side plank by only allowing your feet and forearm to touch the ground. 

Bird Dog

Kneel on the floor with your hands placed firmly about shoulder width apart.  Keep your stomach pulled in, stomach muscles tight, and breathe normally.  Practice lifting one hand and the opposite knee an inch off the floor while balancing on the other hand and knee.  Once you get the hang of it, point one arm straight out front and extend the opposite leg to the rear.  Hold this position for 10 seconds and then alternate sides.  Repeat this three times

Any questions or concerns?  Give us a call at 747-0844
Dr. Jeff Marshall, BScKin, DC

Friday, 6 January 2012

Regular Chiropractic Care for Chronic Back Pain

For a long time, Chiropractors and Chiropractic Patients have advocated that regular chiropractic treatment has a great preventative affect on their back pain and also contributes to their well-being.  With increased research in Chiropractic, more studies are objectively supporting this anecdotal evidence. 

A recent article published in "Spine" by Senna, M and Machaly, S in January 2011 is one such study.  In this study three groups of people with Chronic Low Back Pain were studied.  One group received a sham treatment (placebo).  A second group received 12 treatments over a month, then discontinued treatment.  A third group did 12 treatments over a month, but then contined treatment once every 2 weeks for another 9 months.

At the end of the first month, both treatment groups had similar outcomes.  At the end of the 10 month follow-up period, those who had ongoing maintenance care had significantly better results in terms of pain and disability levels than those who discontinued care after one month.  The group who continued maintenance care also had better lumbar mobility and better perceptions of their general health than the other treatment group.

This does not imply that all patients will require maintenance care.  However, this does objectively show what I have seen in practice.  That many people with chronic low back pain do benefit from ongoing maintenance care.

Do you have any questions about this or anything else?  Give us a call at 747-0844 or drop by Bidgood's North Plaza, Goulds

Dr. Jeff Marshall, BScKin, DC, CSCS