Parker Seminars - Sydney 21-23 June 2013 - Dr. Claudia Anrig Sydney Notes 2013.pdf · FINANCIAL...

Parker Seminars - Sydney 21-23 June 2013

www.drclaudiaanrig.com

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Copyright 2013 Dr. Claudia Anrig

All rights reserved. No portion of these notes may be reproduced in any form without written permission.

Family Wellness Survey

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Evaluating Your Existing Practice:

My commitment to children and Chiropractic Pediatrics is…

Please check where you and your office are in regards to a Family Wellness Practice.

NEEDS MAJOR WORK NEEDS TWEAKING TRANSFORMED

OFFICE ENVIRONMENT CHILD EDUCATION PARENT EDUCATION IN OFFICE EVENTS/PROGRAMS COMMUNITY EVENTS/PROGRAMS SCHOOL OUTREACH PROGRAMS STAFF/TEAMWORK NEW PATIENT PROTOCOL FINANCIAL PLAN ACADEMIC COMPETENCE CLINICAL COMPETENCE

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Dr. Claudia Anrig © 2013 2

COMMON DISORDERS WITH CHILDREN

Wellness Practice Information

Weakening the Immune System

Nutrition

Teething

Passive Smoking

Poor sleep habits

Day Care

Food Inducing Allergies

Dairy

Wheat

Soy

Peanuts

Corn

Tree nuts

Egg

Fish

Shellfish

Other Concerns

Dust mites

Animal Dander

Teething

Runny clear mucus

Ear irritation

Fever

Picky eating

Disruptive sleep patterns

Bowel irritation

Notes:

These materials may not be duplicated or used in any informational or instructional medium without prior written consent.


COMMON DISORDERS WITH CHILDREN

The following recommendations for care are based upon the Gonstead system of teaching regarding the parasympathetic and sympathetic systems. You may be caring for a child with a disorder, but the role of the chiropractor is to examine the spine for subluxation and provide the appropriate adjustment; not to treat or cure any disorder, but to remove nerve interference and thus improve quality of life.

This information is not meant to imply that a doctor of chiropractic

treats, cures or prevents any disease.

Acute Nasopharyngitis (Upper respiratory tract infection “Common Cold”) Acute viral nasopharyngitis, or acute coryza, known as an upper respiratory virus or commonly called the cold, is a contagious, viral infectious disease of the upper respiratory system, primarily caused by rhinoviruses (picornaviruses) or coronaviruses. It is the most common infection disease in humans; there is no known cure, but it is rarely fatal. Collectively, colds, influenza, and other infections with similar symptoms are included in the diagnosis of influenza-like illness (1). Clinical Signs and Symptoms Colds are more severe in younger children. Infants: under 3 mos. may be afebrile, older than 3 mos., fever, irritability, restlessness and sneezing. Older children normally manifest the above signs with sinusitis, headaches, malaise and anorexia. Chiropractic Evaluation Vertebral subluxation complex usually occurs with the mid to upper cervical region. Involvement with the lower thoracic region at T9 or T10 should be checked. Special Considerations Informing the parents to expect a slight elevation of fever in the evening hours since the body normally raises temperature during this time period. Make yourself available during off hours to the parents if the fever spikes. Inform nursing mothers nasal discharge and obstruction may create difficulty with breast-feeding. Home Remedies:


Tonsils and Adenoids “Tonsils” and “adenoids” are generic terms applied to the lymphatic tissues located within the oral cavity. In reality, they are part of a ring of lymphatic tissues around the nasopharynx and oropharynx at the entry point to the upper aerodigestive tract. Several separate structures form this ring, classically known as the Waldeyer ring. Adenoids or pharyngeal tonsils are the superior extent of the ring and are located within the nasopharynx (2). Clinical Signs and Symptoms (Chronic Tonsillitis)

Enlarged, mildly red tonsils that are scarred with large pits Slightly enlarged lymph nodes that are not usually tender Sore throat that comes and goes (1)

Clinical Signs and Symptoms (Adenoidal Hypertrophy)

Mouth breathing Nasal tone of voice Ear ache and frequent ear infections (3)

Chiropractic Evaluation Vertebral subluxation complex most commonly found at C4-C6. Special Consideration Informing the parents that most hypertrophic tonsils actually are normal in size. Carefully monitoring your patient during the winter months. Home Remedies:

Asthma Asthma is an inflammatory disorder of the airways, which causes attacks of wheezing, shortness of breath, chest tightness and coughing (1). Studies have shown that more than 35% of Australia’s school-age children have been diagnosed with asthma and 94% of those are under drug treatment (4). Within the first 3 years of life, 16.9% of infants experience asthma or wheeze. Among non-asthmatic children aged 4 to 5 years, 4.1% will develop asthma by the age of 7 (5).


Clinical Signs and Symptoms Acute episodes are most often brought on by exercise, heartburn or exposure to irritants such as cold air, noxious fumes (smoking), and allergies.

Cough with or without sputum (phlegm) production Shortness of breath, wheezing, worse with exercise or activity Tachycardia (chest pain, tightness in the chest)

Chiropractic Evaluation Wet-productive cough: Vertebral subluxation complex – parasympathetic involvement Occiput to C5 Posteriority of the 2nd sacral segment Dry-non-productive cough: Vertebral subluxation complex – sympathetic involvement at T2-T3 can effect a depressed thyroid function. Check T7-T12 for supra-adrenals function for hormonal balance. Special Considerations Parents of asthmatics should be able to reach you at home. The child should drink a lot of fluids. Home Remedies:

Enuresis (Bed-Wetting) This is the involuntary discharge of urine during sleep after the age of 5 or 6, when bladder control should typically be established (3). Clinical Signs and Symptoms Occurs more frequently in boys than girls. Primary enuresis – bedwetting since infancy Secondary enuresis – wetting developed after being continually dry for a minimum of six months Chiropractic Evaluation Vertebral subluxation complex seen at the 2nd and 3rd sacral segment or the lower thoracics may be involved. Occasionally a mid to upper cervical segment may be associated with the disorder. Special Considerations Sensitivity for child as he/she informs you of their progress.


Otalgia (Ear Infection or Ache) Otitis Media with Effusion An infection or inflammation of the middle ear (3). Clinical Signs and Symptoms

Tugging or pulling at one or both ears Decreased hearing Fluid draining from the ear Irritability or difficulty sleeping Possible earache Possible fever

Chiropractic Evaluation Vertebral subluxation complex usually occurs at Atlas or Axis region. Home Remedies:

Antibiotic Use Acute otitis media (AOM) is one of the most common diseases in early infancy and childhood. Antibiotic use for AOM varies from 56% in the Netherlands to 95% in the USA and Australia. Research has shown that antibiotics do not reduce tympanometry, perforation or recurrence. 78% of cases of AOM will settle spontaneously in 3 to 7 days without antibiotics. Additionally, 16 children will be treated to prevent just 1 suffering ear pain and 1 in 24 will experience symptoms caused by the antibiotics (6). Over the past 30 years, expert opinion has swung against doctors giving antibiotics for AOM and parents have been urged not to pressure general practitioners to prescribe them (7). Allergies Chiropractic Evaluation Vertebral subluxation occurrence at the upper cervical to upper thoracic region. Sinuses Chiropractic Evaluation Vertebral subluxation commonly found from mid to upper cervical region (C3-C4 Phrenic). Occasional lower thoracic involvement is seen. Home Remedies:


Febrile Seizures A febrile seizure is a convulsion in a child triggered by a fever. These convulsions occur without any brain or spinal cord infection or other nervous system (neurologic) cause (1).

Typically occurs in infancy or early childhood, usually between ages 6 mo. and 5 yrs.

brief duration (always less than 15 min.)

Clinical Signs and Symptoms Generalized tonic-clonic or atonic Child may moan or cry from the force of the muscle contractions Contractions last for several seconds or tens of seconds Child may pass urine, vomit or bite tongue

Chiropractic Evaluation Vertebral subluxation may occur in the mid to lower thoracic region. Investigate the Atlas region for vagal response. Special Considerations Informing the parents to expect a slight elevation of the fever in the evening hours that may create a series of convulsions. Making yourself available off hours if a convulsion should occur. Torticollis Torticollis may develop in childhood or adulthood. Congenital torticollis (present at birth) may occur if the fetus’ head is in the wrong position while growing in the womb, or if the muscles or blood supply to the fetus’ neck are injured (1). Congenital torticollis occurs when the neck muscle that runs up and toward the back of the baby's neck (sternocleidomastoid muscle) is shortened. This brings the infant’s head down and to one side. This is known as congenital muscular torticollis (8). A visible or sometimes palpable swelling, often referred to as a sternomastoid tumor, may appear in a part of the muscle in infants aged 2-3 weeks (9). If left untreated, can result in facial asymmetry (10). Spastic or Spasmodic Torticollis (Cervical Dystonia) – The primary cause is thought to be a dysfunction of the brain; injury to the shoulder, head or neck; potential side effect of pharmaceuticals; and more (11). Chiropractic Evaluation Vertebral subluxation can be involved from the upper cervical to the upper thoracic region. Special Consideration Reassuring the parents the infant will respond.


Special Note Twenty percent of Intra-Uterine constraint (breech position) fetuses develop Congenital Torticollis. Home Remedies:

Stomach Disorders Clinical Signs and Symptoms

Nausea or upset stomach Picky eater Decreased appetite Vomiting

Chiropractic Evaluation Vertebral subluxation usually seen in the mid-thoracic region. Occasionally the cervical region can be involved. Severe Loss of Appetite Creating Malnutrition Inadequate absorption of food (1).

Clinical Signs and Symptoms May not result in malnutrition Fatigue Restlessness and irritability Bowel disorders (may be primary cause) Limited attention span Increased vulnerability to infections Delayed wound healing Changes in hair and skin color (12)

Chiropractic Evaluation Vertebral subluxation complex seen from mid to lower thoracic region. The upper cervical region can also be involved. Special Considerations Emotional supporting of the parents during this very tiring and frustrating manifestation of symptoms. Jaundice Is seen in approximately 60% of term infants and more frequently in near-term infants (13).


Clinical Signs and Symptoms A yellow color in the skin, the mucous membranes, or the eyes. The yellow pigment is from bilirubin, a byproduct of old red blood cells (1). Chiropractic Evaluation Vertebral subluxation complex usually occurs in the lower thoracic region. Colic Colicky babies cry constantly and hard at about the same time each day at least 3 days a week. About one in five babies develops colic. It is more common in boys and in firstborn children. It usually begins at about 2 weeks of age and goes away by the fourth month (1). Clinical Signs and Symptoms Sudden attacks, hours of screaming, legs drawn up. Chiropractic Evaluation Vertebral subluxation complex mid to lower thoracis region with occasional upper cervical region involvement. Home Remedies:

Reflux Commonly seen in the newborn and infant. The medical diagnosis is “undeveloped digestive tract” with the recommended treatment to take them to “the doctor for immediate and fast medication” (14). Clinical Signs and Symptoms Spitting-up to vomiting after being fed, crying and fussing, in extreme cases, failure to thrive Chiropractic Evaluation Vertebral subluxation complex atlas with occasional mid thoracic region involvement Standard Medical Treatment (1) First round of treatment – H2 Blockers Product names: Tagamet, Zantac, Pepcid, Axid Side effects: Headache, constipation, diarrhea, tachycardia, respiratory issues, dizziness, nausea, vomiting Next Treatment – Proton Pump Inhibitors (PPIs) Product names: Nexium, Prilosec, Prevacid, Aciphex, Protonix


Side effects: Headache, diarrhea, nausea, vomiting, nervousness, abnormal heartbeat, rash, dizziness, muscle pain, weakness Home Remedies:

Bowel Disorders Constipation and Diarrhea Chiropractic Evaluation

Vertebral subluxation Constipation – involvement with the lumbar region Diarrhea – involvement with lower thoracic or the upper lumbars Occasionally the upper cervicals may be the influence

Toe or Foot Flaring Out Chiropractic Evaluation Vertebral subluxation complex commonly seen as an IN ilium or sacral rotation on side of foot involvement. Chiropractic Evaluation Vertebral subluxation complex commonly seen as an EX ilium on the side of foot involvement. Bilateral Toeing In Chiropractic Evaluation Vertebral subluxation complex commonly seen as a base-posterior sacrum causing bilateral compensatory EX ilium. Growing Pains Clinical Signs and Symptoms Pain in the shins or calves that occur at night. Chiropractic Evaluation Vertebral subluxation complex can occur in the lower lumbars, sacrum or ilia. Pediatric Headaches Headaches are quite common in children. A Swedish study of 9,000 children found that over 70% of have had headaches by 15 years of age (15). Headaches may be primary (tension headaches, migraines, etc.) or secondary to, or a manifestation of, another disorder. The fear in childhood headaches is intracranial masses, such as tumors, or other serious disorders (16).


Migraine Headaches Migraines are the most common headaches in children. Studies have shown that at least 5% of children are affected. The highest incidence of childhood migraines are in males aged 10 to 14 (1). Tension Headaches Children with tension or muscle contraction headaches tended to have more nausea and photophobia than adults. The duration may be minutes or days and the pain tends to be bilateral and may feel like a pressure or band (1). Cervicogenic or Vertebrogenic Headaches Characterized by chronic hemicranial pain that is referred to the head from either bony structures or soft tissues of the neck, this form of headache is not commonly reported and the childhood incidence is unknown. Muscle contraction or tension headaches probably describe most of its manifestations (17). Chiropractic Treatment The child or teen patient should be evaluated for vertebral subluxation of the spine. The cervical (C1-C7) region is a common site for reducing, managing or correcting the underlying cause of this disorder. An overlooked site for involvement is the Occipito-Atlantal (C0-C1) joint. Should the headaches continue to be consistent, an evaluation of the C0-C1 region may lead to the discovery of the PS condyle (posterior and superior) contributing to the problem. Headache Patterns In attempting to understand the nature of the patient’s headaches, the doctor should consider establishing if there is a pattern to the headache. Request the parent or patient journal the headaches to see if a pattern exists. Possible Patterns

Mornings – could they be sleeping on their stomach, creating mechanical stress on their cervical spine?

Prior to lunch – could this be hypoglycemia? Young teenage girl prior or during her menstrual cycle – could hormonal

imbalance or a lower lumbar vertebral subluxation be present? Notes:


Common Disorders References

1. www.topdoctorsonline.com/healthbank/diseaseinformation.html 2. pedsinreview.aappublications.org/content/21/3/75.extract 3. auroh.com 4. AAP General News (Australia) 01-14-99 FED: Australia one of top three

asthma countries MJA; Volume 187 Number 1; 2July 2007 5. www.aihw.gov.au/publication-detail/?id=6442468289 6. Sanders S, Glasziou P. P., Del Mar C., Rovers M. M. Antibiotics for acute

otitis media in children. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD000219. epublications.bond.edu.au/hsm_pubs/159

7. www.abc.net.au/health/thepulse/stories/2011/04/06/3183024.htm#.UZZrB7Xvsdg

8. www.webmd.com/parenting/baby/tc/congenital-torticollis-topic-overview 9. emedicine.medscape.com/article/939858-overview 10. adc.bmj.com/content/93/10/827.abstract 11. www.ygoy.com/2011/05/11/what-is-spasmodic-torticollis/ 12. www.nhs.uk/Conditions/Malnutrition/Pages/Symptoms.aspx 13. www.medscape.com/viewarticle/497028_3 14. www.treatacidreflux.info/ 15. www.ncbi.nlm.nih.gov/pubmed/13869189?tool=bestpractice.bmj.com 16. emedicine.medscape.com/article/802158-overview 17. www.jaoa.org/content/105/4_suppl/16S.full

Notes:


WHY CHILDREN NEED CHIROPRACTIC CARE

Including Developmental and Injury Mechanisms, In-Utero constraint, Birth Trauma, Post-Natal Development of Spinal Asymmetry, Childhood Injuries

and Implications of Pediatric Vertebral Subluxation Complex.

As the twig is bent, the tree inclines. Virgil (19-70 BC) When does the first subluxation begin? There are three causes to vertebral subluxation –

Physical Chemical Emotional/Mental

At what age does a child receive trauma to their spine? The research community suggests that spinal micro and macro trauma may be detected as early as the fetus within the uterus or even during the normal delivery procedures. What is Vertebral Subluxation Complex? Kinesiopathology

Hypomobility - fixation or lack of motion or joint function Hypermobility – adaptation or compensation to hypomobility seen months,

or years after compensation to subluxation Neuropathophysiology, Myopathology, Histopathology and finally Pathophysiology after years and decades lack of normal function. Life is Motion/Function and Motion/Function is life.

Without Motion/Function we don’t manifest optimal life expression. Hippocrates, “Function (motion) was an integral component of form and that physical alterations could be produced if individual constraint occurred over a period of time in one position” (1,2).


Deformity When healthy tissues (i.e. bone, cartilage, muscle and ligaments) are distorted through abnormal mechanical forces. The musculoskeletal system is especially susceptible to deformity (1,2). Biomechanical forces can alter the morphogenis/development of bone, cartilage, muscle and ligaments (2,3). The human fetus will develop seven times more quickly than an infant. Because of the rapid growth, the fetus is the most sensitive to biomechanical forces that lead to constraining pressures and molding (2,3). Extrinsic forces can influence the musculoskeletal system. The forces of shearing, stretching, compression, torsion and bending are all extrinsic factors that can affect the spinal development of the fetus (2). After the seventh month if the fetus does not move into a vertex (head down) position. This occurrence is called Intra-Uterine Constraint.

Intra-Uterine Constraint is one possible way that a fetus may receive unnecessary extrinsic forces that may lead to bone, cartilage, muscle and ligament deformity. There are four positions of the fetus that can cause biomechanical forces, which may lead to alterations to the spine. These four positions are breech, face, brow and transverse lie.

Dunn, a medical doctor reviewed 6,000 cases of breech babies and found the following occurrences (3):

42% Developed Postural Scoliosis 20-25% Torticollis, Mandibular Asymmetry 50% Hip Dislocation

There are three forms of Breech

Frank Complete Footling


A study of Australian women in 2010 showed that first-time breech presentation at term occurred in 4.2% of first pregnancy delivers, 2.2% of second pregnancies and 1.0% of third pregnancies. The rate of breech recurrence in second consecutive pregnancy was 9.9%, and in a third consecutive pregnancy (after two prior breech deliveries) was 27.5% (4). The breech presentation places the fetus neck in a compromising hyperextension position. The head then may compromise in further hyperextension or hyperflexion (1-3).

Hyperextension may lead to possible Anterior-Superior Occiput subluxation (AS). Hyperflexion may lead to a Posterior-Superior Occiput subluxation (PS).

The Face or Brow Presentation presentation compresses the head and neck into a forced unnatural hyperextended position. This may lead to a possible AS occiput subluxation.

The Transverse lie position occurs when the sidewalls of the uterus causes the hyperflexion or hyperextension of the cervical spine. Either position to the cervical spine of the fetus may cause permanent damage (1).

The Transverse lie is most common with the woman with multiple pregnancies. Routine and regular Prenatal Chiropractic Care may prevent or decrease the possible occurrence of sacral subluxation, which may contribute to inadequate uterine function, pelvic contraction, and baby mal-presentation potentially resulting in a difficult labor for the mother (i.e., dystocia).

Notes:


Birth Trauma Birth trauma can occur when the obstetrician either by hand, forceps, or vacuum extractor uses force to deliver the newborn. These techniques are considered long lever (1,3,5-7).

The positions that the obstetrician most commonly may injure the newborn’s cervical spine are pulling traction while the neck is extended back, rotated, flexed or bent to the side (1,3,5-7).

The long lever techniques and placing the newborn’s cervical spine out of a neutral position compromises the spinal cord and other neurological components and may cause damage (1,3,5-7). In 2009, 32.6% of Australian births were by C-section. Of those, 42.5% were in private hospitals and 28.4% were in public hospitals. This is an increase of 74% over 20 years (8). This increase seems largely driven by the recommendations of doctors (8). As the rate of c-sections has risen, so has the rate of pregnancy-associated deaths (9). A 2007 report in the British Medical Journal found that non-emergency c-sections were linked to twice the risk of death, hysterectomy, blood transfusions and admission to intensive care when compared to women who had a vaginal birth. Additionally, they are five times more likely to need antibiotic treatment after birth and there is a 70% higher chance that a baby born by elective or medically-advised c-section will die before being discharged (10). It has been documented that approximately 24% of cerebral palsy cases could be related to the delivery technique of the breech newborn (1,5). Further Erb’s palsy and Klumpe’s paralysis was also associated to these same unnatural forces on the newborn’s spine (1,5).


Gutmann, a medical/manual medicine doctor studied 1,000 infants with birth trauma. His study revealed that birth trauma (long lever technique) often caused upper cervical vertebral subluxation (11). The study revealed that infants who were adjusted during the study showed improvement with the following disorders – colic, restlessness, fever of unknown origin, seizures, postural scoliosis, etc. Dr. Gutmann speculated that abnormal nerve function may lead to a lowered immune system in children and may be a contributor to common childhood sickness as seen in ear infections and tonsillitis. At birth the newborn’s spine (excluding the sacrum) is approximately 20cm. Within 24 months the spine will grow to approximately 45cm (12,13). Proper spinal development is imperative the first six years of life and thereafter. During this period of significant amount of spinal growth, children should be monitored for detection and correction of vertebral subluxation. Notes:

Chemical Stressors 96% of infants are breastfed at birth. Only 39% for 4 months or less. Less than 15% at 6 months. Additionally, 35% were introduced to solid foods by 4 months and 92% by the recommended age of 6 months (14). Formula fed infants have an increased likelihood of infections and are prone to developing allergies later in life (15-16). 106.2 liters of milk are consumed per person in Australia (17). In June of 2012, a study proved that Australian children that had less than 2 servings of dairy products per day (only 38% of children) were more likely to meet food and nutrient recommendations (18). Australians spend almost a third of their household food budget on fast food and eating out. This is a 50% increase in 6 years (roughly 2004-2010) (19). This could be why almost 3 out of 5 Australian children don’t eat enough fruit, less than 1 in 5 eats enough vegetables, all consume far too much sodium salt, and close to 20% of children between 6 and 11 years of age consume more kilojuoles (calories) than needed (20).


Studies are linking this to obesity, insulin resistance and type-2 diabetes as currently 6% of Australian children between 4 and 13 are obese, 17% are overweight and 1 in 4 teenagers are overweight (20,21). A can of soda contains up to 55mg of caffeine and energy drinks may contain up to 350mg of caffeine (22-24). Australians consume 42kg (92lbs) of sugar per person each year while European countries are at 40kg (90lbs) per person per year and Americans consume 45kg (or 100lbs) of sugar per person every year (25-27). Australian children will be given 39 doses of 13 vaccines before the age of 4 (28). Vaccine ingredients include but are not limited to the following (29):

Mercury & aluminum Hydrochloric acid Formaldehyde Ethylene Glycol Latex MSG

In January of 2013, the seasonal flu vaccinations across Australia for children under 5 were suspended after 23 children in Western Australia were admitted to hospital with convulsions. More than 60 children around the state may have had adverse reactions including fevers, vomiting and febrile convulsions (30). Amalgam, or dental fillings, contain 50% mercury, 30% silver and differing amounts of tin, zinc and copper (31). Most foods on the grocer’s shelf contain (32):

Nitrates and nitrites (including sodium nitrite)

Sulfites (including metabisulfites)

Sulfur dioxide

Benzoic acid (aka sodium benzoate)

BHT (butylated hydroxytoluene)

BHA (butylated hydroxyanisole)

Coloring

Coal tar

Propylene glycol

MSG (monosodium glutamate)

Refined or bleached flour (i.e. whitened using chloride oxide)


Poisons banned overseas because of serious health concerns are still used in Australia and take up to 16 years to investigate. There are 29 pesticides currently under review by the Australian Pesticides and Veterinary Medicines Authority (APVMA) and at least 9 of these have been under review for 13 years (33). In Australia, over 8,000 pesticides and veterinary products are registered for use but more than 80 of these are prohibited in the United Kingdom, France, Germany and the other 24 member countries of the European Union. 17 of these are known likely or probably carcinogens, 48 of these pesticides are flagged as potential endocrine disruptors and more than 20 are classified as extremely or highly hazardous by the World Health Organization (34). When tested, fruits and vegetables in the U.S. were found to have traces of several different pesticides (35):

Sweet bell peppers – 64

Lettuce – 57

Hot peppers – 51

Apples – 50

Peaches – 42

Cucumbers – 40

Strawberries – 38

Imported grapes – 37

Green beans – 35

Pears – 33

Genetically engineered foods are becoming more common (36):

Corn

Soy

Potato

Tomato

Canola

Cottonseed oil

Papaya

Radicchio

Squash

Salmon 18% of dairy cows in the United States are injected with rBGH and dairies often mix milk before packaging it for distribution (37).


Roxarsone (chicken feed) contains arsenic and tests on chickens in the U.S. have found 466 ppb of arsenic in chicken liver (38). Animals are often fed antibiotics, creating antibiotic resistant bacteria (37). A recent survey of Australian secondary school students revealed that 111,800 had smoked at least 1 cigarette in the week prior to the survey. 37% of 12-year-olds to about 62% of 17-year-olds smoked at least 3 days a week. 17,900 secondary school students are committed smokers with that age range being 10% of 12-year-olds up to 31% of 17-year-olds (39). A recent poll of secondary school students revealed the following (40):

60% admitted to drinking

4% smoked marijuana

2% had taken tranquilizers

1% had used cocaine or opiates Off-labeling of prescription drugs has become a major problem. 2/3 of drugs prescribed to children have not been tested for them and drugs are used off-label in nearly 80% of major children’s hospitals (41-44). A survey of Australian general pediatricians and child or adolescent psychiatrists found that 40% reported off-label prescribing of psychotropic drugs that included antidepressants, psychostimulants, antipsychotics and mood stabilizers (45). The top ten drugs typically prescribed off-label in the United States include (46):

Albuterol

Phenergan

Ampicillin

Auralgan

Lotison

Prozac

Intal

Zoloft

Ritalin

Alupent syrup Physicians are prescribing drugs based on a “best guess” as to the dosage, efficacy and even safety (41-43).


Emotional Stressors 1 in 8 children in the United States will be diagnosed with high anxiety. This can typically be attributed to fractured families, school/internet bullying and failure to succeed (47). Nearly 1 in 2 Australian children report being bullied and face-to-face or “traditional” bullying is twice as prevalent as cyberbullying and most children are afraid to tell an adult out of fear that the problem will escalate (48,49). In 2008, more than 656,000 young people in America (ages 10 to 24) were treated in emergency rooms for injuries sustained from violence and in a student survey in 2009, 19.9% reported being bullied, 11.1% had been in a physical altercation, 5% missed school and 5.6% carried a weapon for protection (50). In the 2009-2010 U.S. school year 28% of students aged 12-18 reported being bullied at school and 6% of students reported being cyber-bullied. In that same school year, 33 deaths occurred, 85% of public schools recorded 1.9 million crimes which translates to 40 crimes per 1000 students (51,52). According to an article in 2012, school violence is on the rise in Australia. Almost 1 in 4 weapon offences reported to Queensland police were committed by 10 to 18-year-olds and more than 1000 violent acts against teachers and students are committed every year in educational institutions: 2/3 in primary and secondary schools according to a report commissioned by the State Government (53). Hyper-parenting was a term coined by Alvin Rosenfeld, PhD to describe a new dangerous trend in child-rearing that includes the following (54):

Parent’s pursuit of perfection and success Over-scheduled lifestyles Early stress and increasing pressure to perform

Critical self-image is common among pre-teen and teenage girls in Australia. A survey of young people in 2010 revealed (55):

• 68% of teenage girls believe they are less beautiful than the average girl • 25% of those said they want to change “everything” about themselves • 84.4% of young people know at least 1 person with an eating disorder • 62.8% know up to 5 people who may have an eating disorder

Self-mutilation is becoming a common problem among Australia’s teenagers but actual numbers are hard to determine due to its secretive nature. Only 10% will present to a hospital for treatment (56). There are recent reports that self-injury is the fastest-growing adolescent behavioral problem (57).


In the United States, conservative estimates suggest that over 10% of teenagers are self-mutilating and, of that number, 64% are cutting (58). About 20% of teens in the U.S. will experience depression, less than 33% will get help and 30% will develop a substance abuse problem (59). Suicide is the leading cause of death among young people aged 15-24 in Australia (56).

Physical Stressors In Australia, one of the leading causes of death in children under the age of 14 is accidental injury of which drowning and automobile accidents are the most prolific (60). Glauser and Cares, two medical researchers discovered that during a collision, a child in a lap belt will elongate (lengthen), jack-knife, and strike the back of the car seat. This is a known cause for pediatric trauma to the spine and spinal cord (61). The younger child is at higher risk in an auto injury. Two factors that place the younger child at risk are improper use or lack of car restraints (car seats and seat belts), and the ratio of a larger head to a smaller child torso. The pediatric spine is particularly vulnerable to automobile trauma. A child left without any car restraint will most likely receive the severest injury. It has been equated that an 8kg or approximately 17 pound child is unrestrained in a 30mph collision will accelerate and create the force of 250kg or approximately 800 pounds (62).

The National Safety Council conducted a study observing 536 infants their first year of life. The study discovered that 255 (47.5%) had fallen head first from a high place (63). These types of injuries may occur by leaving an infant unattended while on a changing table, couch or bed. Message to our parents

Prevent these injuries by never allowing an infant to go unattended while on a high surface

Infants should have regular chiropractic evaluation An infant’s spine and joints can be adversely affected by the use of jumpers, bounces, activity centers and walkers.


Injuries and the baby walkers: Is it worth the risk? Baby walkers are ranked as the third most common cause of injuries to Australia’s young children and data shows that the risk of injury is almost 4 ½ times higher than the risk of injury from prams and strollers, and nearly four times higher than the risk of injury from high chairs. (64). Warren Truss, Consumer Affairs Minister, said, “An estimated 1 in 100 children using baby walkers will sustain serious injury from its use.” The most common cause of injuries resulted from falls down stairs subsequently injuring the head. Most injuries may be minor bruises and swelling of the head, forehead, face and cheeks.

Serious injuries from baby walkers include: Skull fracture Concussion Intracranial Hemorrhage Burns Cervical spine fracture Death

The Committee on Injury and Poison Prevention of the American Academy of Pediatrics forwarded several reasons why baby walkers should not be recommended.

Walkers do not help an infant learn how to walk And may delay normal motor & mental development

Since it has been shown that the “safety standards” do not protect children from injury, it is time for them to be banned altogether (65). Falls The infant and toddler learning to develop their muscular coordination for standing or walking will encounter numerous falls to the sitting position. Balance unfortunately does not exist for the infant, toddler and pre-adolescent. According to the Australian Bureau of Statistics, 43% of childhood injuries are caused by falling from a low height – one metre or less (66). With boundless energy and curiosity the toddler will test their new world. The home is the primary site for the adventuresome two and three year olds to receive injuries. Falls with immediate noticeable side effects or symptoms are not uncommon for this age group and parents should be educated to participate on a regular basis in wellness checks by their Doctor of Chiropractic.


Falls, small and large, unilateral (one sided dominance) sports and activities, as well as repetitive and poor postural habits are considered part of a normal life of a child. It is these normal life occurrences that can cause the minor injuries or strains to the developing spine by causing vertebral subluxation. The presence of vertebral subluxation of the lack of normal spine movement may interfere with the development of the spine with symmetry (equal balance). A child developing asymmetry may lead to one of the primary causes to permanent vertebral subluxation with the adult spine. Under the age of five most falls and traumas occur at home or at a day care facility. In Australia, the majority of hospital admissions for children aged birth to 17 years is falls (67). In 2006, it was reported that trampolines caused 23% of all reported injuries in Australia. Emergency visits for trampoline-related injuries increased by 113% between 1990 and 2005. Additionally, trampoline use at home continues to bea significant source of childhood injury morbidity (68). From the age of 5 to 18 most accidents occur at the school. Sports, physical education classes and unorganized activities play a role in these injuries. An estimated 120,000 children seek medical care in Australia each year as a result of playground injuries, with those in the 5 to 9-year-old age group most at risk (69). Fifty percent of these injuries resulted in head and cervical trauma. The most common equipment for childhood injuries are (68):

Climbing apparatus – 32.8% Trampolines – 24.6% Swings – 10.3% Slides – 9.5%

Most transport-related injuries requiring hospital treatment among school-age children (5-14 years) resulted from pedal cycle (bicycle and tricycle) accidents (67). Sports injuries account for 15-20% of all injury presentations to hospitals by young people in Australia (70).


The majority of sports injuries to boys are rugby related. In 2008, almost 270,000 children played competitive rugby in school This is a 390% increase from 2002. (71,72). The majority of sports injuries to girls are related to basketball (71). Additional sports that are related to childhood injuries in Australia include hockey, horseback riding and netball (73). Each year in the U.S., over 6,000 students will go to an emergency room and 21,000 will be seen by a healthcare provider due to backpack injuries (74,75). Sudden neck snapping in extension, flexion, and compression to the head or buttocks from falls can cause spine and/or spinal cord injury (76). Activities that are commonly associated with falls that can cause pediatric spinal trauma are skate boarding, trampoline, roller blades, horseback riding, surfing, water slides, or diving in shallow water. Infants of physical abuse can also sustain injuries to the spine and spinal cord from violent shaking of the head (77,78). Many childhood activities and traumas can cause the vertebrae to lose their normal motion and position. Delicate nerve tissue can be damaged, resulting in interference with the brain’s ability to control associated organs and tissue. When the child has vertebral subluxation(s), the body responds with abnormal spinal growth. This occurs when obvious symptoms may not be present, however optimum health and well-being are compromised. If accidents are the leading cause of death and severe injuries to children in most westernized countries, one can only assume that an epidemic number of children have sustained some level of pediatric spinal injury and trauma. Hidden Physical Stressors Children require a certain number of hours of sleep (79):

• Infants – 12.7 hours • Toddlers – 11.7 hours • Preschoolers – 10.4 hours • 1st to 5th grade – 9.5 hours

A lack of necessary sleep can cause undue stress to a child’s body and immunity (79).


Research has shown that a television in a child’s bedroom can contribute to a 50% increased likelihood of childhood obesity (79,80). A University of Sydney Study published in 2012 revealed that 30% of five-year-olds have a TV in their bedroom and 1 in 5 kindergarteners are overweight or obese on their first day of school (80). The typical child spends over 4 hours a day plugged in to some kind of electronic device: hand-held video games, computers or television (81). The Inside-Out Movement – Chiropractic improves function and function is improved from the Inside-Out. Progressive parents should be encouraged to have their personal Doctor of Chiropractic who specializes in Family Wellness Care. Doctors of Chiropractic are the only health care providers who are dedicated to the detection, elimination and prevention of the Vertebral Subluxation.

Notes:


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Family Wellness Survey

Name

Address

Phone ( ) - Cell ( ) - Fax ( ) -

Email

Do you feel that you are known as a pediatric or family wellness chiropractor?

Do you want to expand in the area of chiropractic pediatrics or family wellness?

Evaluating Your Existing Practice:

My commitment to children and Chiropractic Pediatrics is…

Please check where you and your office are in regards to a Family Wellness Practice.

NEEDS MAJOR WORK NEEDS TWEAKING TRANSFORMED

OFFICE ENVIRONMENT CHILD EDUCATION PARENT EDUCATION IN OFFICE EVENTS/PROGRAMS COMMUNITY EVENTS/PROGRAMS SCHOOL OUTREACH PROGRAMS STAFF/TEAMWORK NEW PATIENT PROTOCOL FINANCIAL PLAN ACADEMIC COMPETENCE CLINICAL COMPETENCE

Would you like me to follow up with you on how we can develop your family wellness

practice?

Please give this to Dr. Claudia at the end of the seminar to be scheduled for a private one-on-one teleconference call to see if Generations might be right for you

or fax it to +61 559 291 6688.

Parker Seminars - Sydney 21-23 June 2013 - Dr. Claudia Anrig Sydney Notes 2013.pdf · FINANCIAL...

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