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Eat to live….or live to Eat?

“What can I do to reduce my chance of Alzheimer’s?”  As a neurologist, this is one of the most common questions I am asked.  My reply was typically “select different parents, get better genes” as little was known beyond that as far as a risk factors for many diseases of the nervous system.  We still do not know exactly why people get ALS, Parkinson’s disease, amongst others, but it seems to be more and more clear that while nutrition is not the only factor, it is an extremely important one.  More and more studies are being completed that show healthy people get less chronic disease including diseases of the nervous system. There is an abundance of information that comes at us from all directions which can be conflicting and confusing.  I have now discovered a resource that I feel confident enough to guide my own and my family’s nutrition and a resource I refer patients to.  

Nutritionfacts.org  is a nonprofit organization founded by Michael Greger, MD, FACLM to provide science behind nutrition recommendations.  He has videos discussing the science behind ketogenetic diets, artificial sweeteners, which plans to eat to combat certain diseases, amongst 100s of other topics.  And, it is an invaluable FREE resource.  Of note, I have no relationship with this site nor Dr Greger. I am just a very happy recipient of the information given by his nonprofit organization.

If a more healthy diet seems out of reach financially, here are a few additional resources to consider:

Find a Food Program near You

Fair Food Network: fairfoodnetwork.org; 734-213-3999

Based in Michigan, this initiative has a national Double Up Food Bucks program that doubles the value of federal Supplemental Nutrition Assistance Program (SNAP, or food stamps) benefits at farmers’ markets and grocery stores.

Fresh Prescription: ecocenter.org; 734-761-3186, 313-881-2263

This Detroit-based program caters to low-income patients with chronic diseases, caregivers of young children, and pregnant women who are referred by their primary care physicians. Patients receive a prescription for produce that’s filled at partnering farm stands or markets.

Wholesome Wave: wholesomewave.org; 203-226-1112

This national organization can help people start a produce prescription program in their own area. Contact them for a tool kit that includes fundraising strategies and step-by-step instructions.

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Top Doctors 2020

” Do you know a doctor who deserves recognition? We want to know who you think are the top doctors in the state.

Tell us your favorite doctor in the 25 categories below. Doctors with the most nominations will appear in our Top Doctors list in the Winter issue of Arkansas Life.

Please click on the ‘Top Doctors 2020‘ to be taken to the correct website.

Top Doctors 2020

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Short Game Seminar From Former PGA Professional

Legacy Spine and Neurological Specialists proudly hosts former PGA professional and one of the top PGA instructors in the nation Stan Utley to Chenal CC in Little Rock last week.  Stan presented a short game seminar to participants in the Oak Leaf Classic.   Then see how I actually somehow caught on and carried out a great surgical removal of the ball from the deep rough almost holing out!   

To Learn more about his short game expertise visit stanutley.com

Stan’s principles of the golf swing is to utilize the dead weight of the clubhead to do the work.   Using the momentum of the dead weight of the clubhead and wrists to direct such certainly allows one to swing the clubhead faster with much less effort.   Swing fast not hard he explains.   Accelerate the clubhead not the grip!   

Swinging hard and/or incorrect posture can lead to sports spine issues just as incorrect posture and ergonomics can lead to work and activities of daily life spine injuries.  Injury prevention not only can improve your game but your life more importantly (if anything is more important than golf?)!

To learn more about how to best prepare your spine for life’s sports and daily activities or to see treatment please visit our website LegacyNeuro.com or make an appointment to see our physical therapist Jessica Beggs who has vast expertise in spine physical therapy treatment and prevention of injuries.   Incidentally if you suffer from Golfer’s or Tennis’ Elbow issues reach out to Jessica as well.   She has done wonders with mine!

https://legacyneuro.com/?p=4775&preview=true

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Fall, A Season? Or A Safety Concern?

Fall, A Season? Or a Safety Concern?

With the leaves changing and seasons turning it is time to talk about “Fall”, but perhaps not in the way you are thinking.  As the weather changes and the temperature outdoors starts to decrease the incidence of fall related injuries has been noted to increased1. A good working definition for the context of fall that we will be discussing is any event that leads to an unplanned, unexpected contact with a supporting surface2 . Here at Legacy we have an interconnected team of specialists that can identify risk factors that may predispose a patient for falls then provide timely intervention and recommendations on how to decrease the risk of falling.

A few quick statistics to emphasize the importance of intervention in patients with poor balance:

  • 25-35% of people 65 and older experience 1 or more falls per year2-4
  • 40% of hospital admissions for 65 and older are the result of a fall-related injury5
  • Average hospital stay for fall injury for ages 65 and up = 11.6 days5
  • Approximately 50% of older adults hospitalized for falls are discharged to a nursing home5

If you are feeling unsteady on your feet, constantly worrying that a fall is imminent, or pain has started limiting your mobility then reach out to your local medical doctor, someone from the Legacy Team, or your local physical therapist for a treatment plan that will have you ready for Spring!

1 Pui-Yee, et al. Higher incidence of falls in winter among older people in Hong Kong.

2 Tinetti ME, Ginter SF. Identifying mobility dysfunctions in elderly patients: standard neuromuscular examination or direct assessment? JAMA. 1988;259:1190-1193.

3 Tinetti ME, Speechley M Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1989:319: 1701-1707.

4 Nevitt MC, Cummings SR. Risk factors for recurrent non-syncopal falls: a prospective study. JAMA. 1989;261:266.7-2668.

5 Tinetti ME, Mendes de Leon CF, Doucette JT, Baker DI. Fear of falling and fall-related efficacy in relationship to functioning among community-dwelling elders. J Gerontology. 1994;49:M140-M147.

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Cervicogenic Headaches: A Real Pain In The Neck

Cervicogenic headaches are an often-overlooked headache type. These headaches cause pain in the back of the head, the temporal areas, and behind the eyes and are often mistaken for—or co-exist with—tension headaches, migraine headaches and neck pain. Often patients with cervicogenic headaches will have a history of a neck injury such as whiplash, or participate in activities that cause excess stress to the upper neck such as working on computers or looking down at smart phones. Poor posture is also a factor.

The treatment for this type of headache starts with physical therapy which helps most people. Sometimes medications like muscle relaxers, gabapentin or Lyrica are used to help treat the pain. For people whose headaches are refractory to conservative treatments, procedures like occipital nerve blocks, steroid injections or percutaneous radiofrequency neurotomy can provide lasting relief.

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Migraines

Many migraine patients recognize specific triggers to their headaches. Migraine patients are more sensitive to certain substances in their foods and environments as well as changes to their routine. Too much or too little sleep, changes in exercise routines, and processed foods can worsen migraine headaches. Heavy, flowery scents or cigarette smoke are frequent triggers. Keeping a headache journal can help identify migraine triggers and eliminate them. Elimination diets that target artificial sweeteners, food dyes, chocolate, processed meats, and/or certain alcohols can help find food triggers. In general, migraine patients are encouraged to eat a diet consisting of whole foods, stay hydrated, avoid caffeine, have a regular sleep schedule, and exercise regularly.

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Trigeminal Neuralgia

Trigeminal Neuralgia is a facial pain disorder caused by compression of the 5th Cranial nerve deep in the brain by an adjacent artery. This condition, also know as Tic douloureux or “Suicide disease” is often misdiagnosed and mistreated. It is the most painful neurological disorder that exists. The disorder causes horrific electrical shocking pains on one side of the face that come and go very rapidly like a machine gun of taser strikes. If properly diagnosed it can be readily cured with a low recurrence rate and low risk of complications by experienced surgeons for those that fail medical treatment. For all, to learn more about TN please visit https://youtu.be/pOV3EC3lpJw for our educational video.

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Effects of Chronic Pain

Effects of Chronic Pain

Anyone that has experienced pain, whether acute or chronic, knows that it can affect multiple aspects of daily living.

The feeling that “I hurt everywhere” or “I have no energy” are common complaints associated with pain scenarios that are treated regularly here at Legacy.

Persistent pain is truly its own disease regardless of its underlying cause.1-3 This type of pain, which is also often characterized as chronic or intractable, has all the ramifications of a disease in that it may have pre-clinical and overt phases.4-6 Many recent and emerging studies clearly document that persistent pain exerts profound impacts on the body’s endocrine, cardiovascular, immune, neurologic and musculo-skeletal systems.7

According to an article on the complications of uncontrolled pain, there are three major classifications of complications associated with chronic pain.8

Deconditioning

“Overuse” of ancillary musculoskeletal tissue with degeneration

Decreased mobility

Obesity

Muscle atrophy

Contractures

Neuropathies

 

Hormonal

1.       Excess catecholamine production with hypertension and tachycardia

2.       Glucocorticoid excess or deficiency

3.       Hypotestosteronemia

4.       Insulin – Lipid abnormalities

5.       Immune suppression

 

Neuropsychiatric

1.       Nerve – Spinal cord degeneration

2.       Cerebral atrophy

3.       Depression/suicide

4.       Insomnia

5.       Attention deficit

6.       Memory loss

7.       Cognitive decline

 

 

Knowledge and understanding of pain complications only aides in better treatment of the entire patient instead of treating just the active pain site. Here at Legacy we always strive to provide comprehensive care by offering services from skilled and experienced healthcare professionals. There are many treatment options offered at our facility that have the ability to encompass multiple body systems that could be affected by chronic pain. Whether the patient’s needs are medication therapies, minimally invasive surgical intervention, spinal injections, diagnostic studies, or physical therapy ▬▬ the Legacy Team is well-equipped to assist their patients back to a better, more functional way of living

 

  1. Brookoff D. Chronic pain: A new disease? Hosp Prac. 2000. 7:1-13.
  2. Murphy K. Chronic pain syndrome: What is it: And how can we help? Am Pain J Management. 1994. 4:129-31.
  3. Carver A and Foley K. Facts and an open mind should guide clinical practice. Curr Neurol Neurosci Rep. 2001. 1:97-8.
  4. Curlje O, Von Kostt M, Simon CE, et al. Persistent pain and well-being: a WHO study in primary care. JAMA. 1998. 280:147-151.
  5. Liebeskind JC. Pain can kill. Pain. 1991. 44:3-4.
  6. Mantyselka BT, Turennen J, Ahonen RS, and Rumpusalo EA. Chronic pain and poor self-rated health. JAMA. 2003. 290:2435-2447.
  7. Chapman RC and Gavin J. Suffering: The contributions of persistent pain. Lancet. 1999. 353:2233-7.
  8. https://www.practicalpainmanagement.com/pain/other/co-morbidities/complications-uncontrolled-persistent-pain?page=0,1
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Sciatica

Sciatica is a painful condition of the nerves in the lower back that is associated with a variable degree of pain, numbness, tingling and weakness of one or both legs. Often it is self limited and resolves on its on. However, it can be persistent and need treatment. It is usually due to a ruptured or herniated or bulging disc. Discs are the cushions between our vertebrae of the spine. Normally these function as shock absorbers of the spine but over time the normal covering of the disc- the annulus- can become weak and allow the central part of the disc- the nucleus- to become displaced outside its normal location. If this displacement is adjacent to one of the nerves that run from the lower back into the legs it can produce sciatic pain.

Non-operative Treatment can consist of any or all of these options for those cases that do not spontaneously resolve:

* Spinal Exercises, Traction and other forms of spinal therapy

* NSAIDS

* Neuropathic medications such as Gabapentin

* Course of oral steroid medications

* Spinal Epidural injections In refractory cases minimally invasive microsurgical decompression and/or discectomy is a very safe and effective treatment.

 

At Legacy we offer this surgery for most patients at the outpatient surgery center through a MIS (minimally invasive) 1 inch or less incision. The success rate in terms of pain relief, return to work, return to ones sports or other activities of life are outstanding. Usually within 4-6 weeks most patients are able to resume normal activities. Patients with sedentary type work can usually return to their job in 2-5 days.

 

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Cell Phones and Neck Pain

Cell phones and neck pain

A new catchphrase in the health care world is Text Neck. It is a term that describes neck pain and damage sustained from looking down at a cell phone, tablet, or other electronic device for too long. In today’s society the cell phone is very much a necessity to most people and as a result, individuals begin to experience pain from overuse of these handy little devices.

 

Symptoms of Text Neck

  • Upper back pain (nagging pain to sharp, with or without muscle spasms)
  • Shoulder pain
  • Radiating pain in the arms or hands due to poor postural alignment

Treatment of Text Neck

  • Use handheld devices at eye level as much as possible
  • Take frequent breaks every 20-30 minutes
  • Physical Therapy
    • Core strengthening/stabilization exercises
    • Cervical musculature stretching
    • Soft Tissue Mobilization
    • Modalities for pain

 

The link below does an excellent job of explaining cervical spine anatomy and how it relates with neck pain, including “text neck”: https://www.spine-health.com/conditions/spine-anatomy/cervical-spine-anatomy-and-neck-pain

 

Image courtesy of: Always Connected. How Smartphones and Social Keep US Engaged\

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